The developmental prone 3 month position may be used both in the
assessment and intervention phases of the client interaction. The information
gleaned from this position is rooted in principles of developmental
kinesiology. The client is placed in prone with arms overhead and forming a 90
degree angle between the trunk and arm. The client is asked to lift her head,
extending the spine slightly. The movement pattern is observed. The clinician
assesses for ideal co-activation between the spinal muscles, axioscapular
muscles, and the activation of the latero-dorsal abdominal wall. In an ideal
pattern, the clinician should see spine extension initiated from T4 and
well-balanced activation between the back muscles and the lateral abdominal
muscles.
Common movement and activation faults include:
Common movement and activation faults include:
-
Spinal segmental mobility: areas of hypermobility
including cervical spine, thoracolumbar and lumbar spine vs areas of
hypomobility including upper/mid/lower thoracic spine
-
Imbalance/in-coordination in muscle activation
o
Hyperactivation of: cervical extensors, accessory
muscles of respiration, upper scapular fixators (upper traps, levator
scapulae), thoracolumbar extensors
o
Insufficient activation of deep cervical flexors, lower
scapular fixators, laterodorsal aspect of abdominal wall
When using the developmental prone 3-month position as a training
position, one of the challenges is the patient’s ability, or inability, to find
and control specific segments in their spine.
Prone Developmental 3-month position: Pre-Intervention
Various rehabilitative and fitness approaches utilize concepts surrounding motor control of spinal segmental mobility. The Spinal Wave is an assessment and exercise that is taught during the Functional Conditioning Range (FRC) seminar. One of the mantras of FRC is “joint independence before joint interdependence” and the Spinal Wave allows the clinician to assess and train spinal joint independence in their patient.
In this video I am taking my client through the Spinal Wave as a way to train segmental spine mobility.
Segmental Spinal mobility assessment from quadruped (Spinal Wave)
The Spinal Wave can be modified or biased to change the emphasis.
Options include:
Out of quadruped, the client can rock back onto his heels to lock
out his L/S and focus on segmenting through the lower thoracic spine up through
the cervical spine.
Segmental spinal mobility (Spinal Wave) training with lumbar spine locked
Prone Developmental 3 month position: Post-Intervention
Alternatively, the
patient can go into a supported (hands behind neck) “rabbit pose” to lock out the
cervical and thoracic regions and thereby focus on the lumbar spine.
Most patients are better able to start the spinal wave from the
pelvis and work cephalad vs. at the occipito-atlantal articulation and working
caudally. The clinician can use the
latter as a progression of the Spinal Wave.
Try this with the patients that you’re having a hard time getting
them to be completely neutral during the developmental prone 3 month position,
and I think you’ll find that it will become one of your primers to quality
activation in this position.
Blogpost by Locatelli Rao, DPT, OCS
Movement Links Certified Clinician
Pasadena Physical Therapy
Movement Links Certified Clinician
Pasadena Physical Therapy
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