I was in such pain before and after my surgery, but since coming to Dynamic Physical Therapy, I am sooo much better. I'm finally getting my life back.

Kathleen Davenport

Lumbar Spine Coupled Motions: A Literature Review with Clinical Implications

Peter Huijbregts, PT, MSc, MHSc, DPT, OCS, FAAOMPT, FCAMT

Assistant Online Professor, University of St. Augustine for Health Sciences, St. Augustine, FL, USA Consultant, Shelbourne Physiotherapy Clinic, Victoria, BC, Canada

Introduction
Paris and Loubert1 defined coupled motions as combined motions that are mechanically forced to occur. Kaltenborn et al2 proposed a more clinically oriented definition describing coupled motions as movement combinations that result in the greatest ease of movement, i.e., producing the greatest range of motion and the softest endfeel. In biomechanical terms, coupled motion is the phenomenon of a consistent association of a motion along or about one axis, whether it be a translation or a rotation, with another motion about or along a second axis; the principal motion cannot be produced without the associated motion occurring as well3. Coupled motion can also be defined as the motion that occurs in directions other than the direction of the load applied4,5.

Coupled motions have obvious implications for manual medicine and, therefore, text books on this topic usually provide descriptions of coupling behavior, e.g., in the lumbar spine1,2,6-8 (Table 1). However, these text book descriptions are generally not supported by primary references1,2,7. If references are provided, they are frequently outdated and of questionable methodology6,8. Evidence-based practice (EBP) requires the use of best available research evidence9. Recently, Whitmore10 produced a case report using a limited review of the literature on lumbar motion coupling to provide an evidence-based rationale for a manual medicine approach to the rehabilitation of lowback pain (LBP) hypothesized to originate in mechanical dysfunction of L5-S1. A limited review of the literature carries the risk of not uncovering contradictory evidence. This goal of this article is to review the research evidence available on lumbar motion coupling. We will discuss the studies retrieved, review evidence for clinically relevant possible determinants of coupling behavior, and conclude with clinical implications of the evidence presented.

View entire article
 

Dynamic is the smartest choice for your physical therapy care.

At Dynamic Physical Therapy, our physical therapists are the most experienced and educated in physical therapy treatments. We have six locations throughout Northern Michigan in Cadillac, Manistee, Gaylord, Marion, Buckley and Traverse City. We are the most recommended Northern Michigan physical therapy center for back pain. We also specialize in neck pain, knee pain, arm pain and hand pain, and our physical therapists and aides can help relieve your pain in the most effective way possible. For orthopedic treatment and aquatic therapy, rehab for sports related injuries like shoulder injuries and foot injuries, physical therapy for Cerebral Palsy, stroke rehabilitation, therapy for carpal tunnel syndrome, headaches and arthritis relief, and even jaw pain treatment, Dynamic Physical Therapy is the smartest choice for comprehensive physical therapy care and physical rehabiliation services.