4.2 Raquis toracolumbar
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Transcript of 4.2 Raquis toracolumbar
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20ᵒ-4
0ᵒ
Gerald T, et al. (1980)
20-29 30-39 40-49 50-59 60-69 70-79
Hombres 26,27ᵒ 29,04ᵒ 29,75ᵒ 33ᵒ 34,67ᵒ 40,67ᵒ Mujeres 26,83ᵒ 28,42ᵒ 32,66ᵒ 40,71ᵒ 44,86ᵒ 41,67ᵒ
20ᵒ-40ᵒ CIFOSIS˃40ᵒ-45ᵒ HIPERCIFOSIS
CIFO
SIS
PREVALENCIA HIPERCIFOSIS EN ADULTOS
20%-40%Kado DM, et al.(2004)
Takahashi T, et al. (2005)
Bansal S, et al. (2014)
Edad
CG
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MEASUREMENTS: Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and prevalence ofobstructive and restrictive ventilatory pattern.
RESULT: One hundred thirty participants (40.2%) were diagnosed with thoracic kyphosis. FVC% and FEV1% were lower in the presence of kyphosis their deficit was proportional to kyphosis severity. kyphosis is associated with dyspnea and ventilatory dysfunction of a restrictive and an obstructive type. Kyphosis should be included in the differential diagnosis of dyspnea and ventilatory dysfunction in the elderly.
PARTICIPANTS: A total of 323 nonheart failure participantsunderwent clinical evaluation for the presence of kyphosis and spirometry.
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!!ULTIMAS NOTICIAS!! PONLE FRENO AL AUMENTO DE LOS GRADOS DE TU CURVATUA
DORSAL!!
ESTUDIO MEJORA CIFOSIS
Renno et al (2005) -3,1ᵒ
Katzman et al (2007) -6ᵒ
Greendale et al (2009) -5,0ᵒ
Kuo et al (2009) -2,3ᵒ
Bautmans et al (2010) -3,4ᵒ
Seide et al (2014) -12,3ᵒ
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EJE LATERO-MEDIAL
30° -35° Extensión toracolumbar
20°-25° EXTENSIÓN DORSAL
15° EXTENSIÓN LUMBAR+
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35°FLEXIÓN DORSAL
50°FLEXIÓN LUMBAR
85°FLEXIÓN TORACO- LUMBAR
+
EJE LATERO-MEDIAL
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25° FLEXIÓN LATERAL DORSAL
20°FLEXIÓN LATERAL LUMBAR
45° Flexión lateral toracolumbar
EJE LATERO-MEDIAL
+
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30° ROTACIÓN DORSAL
5° ROTACIÓN LUMBAR
35° ROTACIÓN TORACO-LUMBAR
90° ROTACIÓN CRANEO-CERVICAL
125° ROTACIÓN
+
+
EJE SUPERO-INFERIOR
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EJE SUEPEROINFERIOR
White AA, Panjabi MM (1990)
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EJE PLANO MOVIMIENTO OTRA TERMINOLOGIA
ANTERO-POSTERIOR
FRONTAL FLEXIÓN LATERAL INCLINACIÓN LATERAL
SUPERO-INFERIOR
TRANSVERSAL ROTACIÓN TORSIÓN
LATERO-MEDIAL SAGITALFLEXIÓN INCLINACIÓN
ANTERIOREXTENSIÓN INCLINACÓN
POSTERIOR
CINEMÁTICA DE LA COLUMNA
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Fuerzas compresivas Fuerzas de tracción o separación Fuerzas de translación o cizalla Deslizamiento o torsión
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Cargas compresivas moderadas en una posición de flexión => prolapso de disco (Callaghan and Mcgill 2001).
Las hernias comienzan por la fisura progresiva de anillos fibrosos (Adams and Hutton, 1985).
Por repetir y repetir…
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Actividad MPa N/mDecúbito supino 0.10 100Decúbito lateral 0.12 120Decúbito prono 0.11 110
Decúbito prono, espalda extendida, apoyando en codos
0.25 250
Riendo de buena gana, tumbado lateralmente
0.15 150
Estornudando, tumbado lateralmente 0.38 380Picos de darse la vuelta 0.70-0.80 700-800
De pie relajado 0.50 500De pie, realizando maniobra de Valsalva 0.92 920
De pie, inclinado hacía adelante 1.10 1100Sentado relajado, sin respaldo 0.46 460
Sentado activamente con la espalda enderezada
0.55 550
Sentado con máxima flexión 0.83 830Sentado inclinado hacía adelante con los
codos apoyados0.43 430
Sentado encorvado hacía atrás en la silla 0.27 270Levantarse de una silla 1.10 1100
Caminando con zapatillas minimalistas 0.53-0.65 530-650Caminando con zapatillas tradicionales 0.53-0.65 530-650
Corriendo con zapatillas blandas 0.35-0.85 350-850Corriendo con zapatillas duras 0.35-0.95 350-950Subiendo escaleras, un paso 0.50-0.70 500-700
Subiendo escaleras, de dos en dos 0.30-1.20 300-1200Bajando escaleras, de paso en paso 0.38-0.60 380-600
Bajando escaleras, de dos en dos 0.30-0.90 300-900Levantando 20 kg, inclinado con la
espalda redondeada2.30 2300
Levantando 20 kg como nos dicen en la escuela de espalda
1.70 1700
Agarrar 20 kilos cerca del cuerpo 1.10 1100Agarrar 20 kilos a 60 cm del pecho 1.80 1800
Presión incrementada durante la noche (sobre un periodo de 7 horas)
0.10-0.24 100-240
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Activación Multífidus
Manual Therapy 2012
Compresión lumbar debido a descenso actividad muscular
Flexión cadera
Posición lumbar
Granata and Marras, 2000McGill et al. 2003
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