Physical Therapy Perspectives in the 21st Cent by J. Bettany-Saltikov, et. al.

By J. Bettany-Saltikov, et. al.

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Biomechanics of the spine in the sagittal plane The study of the sagittal aspect of the spine needs to include a consideration of the biomechanical aspects of the spine. One needs to consider the existing physiological curves in the sagittal plane as the spine is not straight in this plane as it is in the frontal plane. 1 A powerful brake: The anterior longitudinal ligament of the spine The anterior longitudinal ligament inserts on the anterior vertebral body. Anatomically on a spine cadaver stripped of its muscles, it takes more than 27 kg of traction to cause a creep extension and an eventual rupture.

The removable brace does not cause a creep until it is worn continuously, which explains the importance of compliance in the results of treatment. 1 Fragility of the vertebral body The fragility of the vertebral body can occur either during adolescence in Scheuermann's disease or in old age, with osteoporosis. (Scheuermann, 1921) Scheuermann's disease is a defect in the growth plate at the cortex of the main core of the vertebral body. The cortical plate is altered and deformed, secondarily disk will enter the 44 Physical Therapy Perspectives in the 21st Century – Challenges and Possibilities interior of the vertebral body (Schmorl's hernia), which causes a narrowing of the disc and stiffness.

It is essential to explain to parents that physical therapy cannot prevent the scoliotic earthquake, but scoliosis-specific exercises can produce an earthquake-resistant construction that will limit the damage. Above 25 °, the linear mechanism with a vicious circle of evolution has been described by Stokes: the asymmetric pressure on the vertebral body and disc modifies the growth of the vertebral body with accentuation of the deformity. The distance of the apical vertebral body from the line of gravity further increases the asymmetry of pressure.

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