Extension exercises for neurological claudication

[spandanphysio]

Hello friends, can you prescribe lumbar extension exercises for a patient with having moderate claudication distance? If yes what precaution should be taken? I'm asking for general comment not specific to any patient.

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[bobbypt]

hi....there is a test called von glenderen test(commonly known as bicycle test). this test basically helps relieve from pain(neurological) when one rides a stationary bicycle with spine flexion posture. the stenosis is relieved and patient feel comfortable. If this test is positive....never give any extension exercises past neutral...however, multifidus can be exercised by slight extension to neutral. Abdominal exercises are the best resources...hope this helps!!!!

[jesspt]

I don't know why you would want to give extension exercises if a patient has claudication from stenotic changes in their lumbar spine. The risk of exacerbating their symptoms seems likely, to me.

[spandanphysio]

thanx both of u for rply..i have seen in claudication patient flat back develops from flexion exs for prolong time.is it desirable or will put extra stress on discs?specially if pt is young.what i mean by moderate distance is pt is able to bear extension for some time.

[spandanphysio]

hello friends pls share u r experiences?is it safe to go for bridging.

[linbin]

hi friend
i wonder why you are so keen to give extension exercise to claudication subject.
i feel bridging can de done provided the spine should be kept in neural zone -ie ,midwar between anterior and posterior pelvic tilt.

[linbin]

hi friend
i wonder why you are so keen to give extension exercise to claudication subject.
i feel bridging can de done provided the spine should be kept in neural zone -ie ,midwar between anterior and posterior pelvic tilt.

[alophysio]

Hi,

In general i agree with the above.

However if extension is required, then it should be able to be obtained if at all possible.

Perhaps the problem lies in a motor control issue where extension is not controlled properly and so a change in motor pattern might be helpful.

I have used this on people who had pain standing in erect neutral but a change in muscle usage and patterning into extension resulted in being able to hang washing on a line above head height without pain.

Shirley Sahrmann has a good but difficult to read textbook on movement impairment syndromes and Peter O'Sullivan has done some work in this area as well.

Good luck!