🔰🔰 Spinal motion : Fryette's law of spinal motion in 1918

from : Laws of Fryette 다이어그램 | Quizlet

“Principles of Osteopathic Technic” Harrison H Fryette American Academy of Osteopathy, 1980. First Edition 1954 ISBN (ASIN) B0006Y0VBI, (ASIN) B0007F1Y80 Hardcover. 246 pages. Perspective: Osteopathy, Osteopathic Principles, Spinal Mechanics

 

구분	타입 1 (정상적 척추 움직임)	타입 2 (비정상적 척추 움직임)
척추후관절의 위치	- Neutral position 즉, •Neutrality(중립) basically means where the facet joints are idling  -Fryette, 1918년-	Non neutral position
척추뼈가 굽힘 혹은 폄이 되어 있는가?	없음	있음
짝운동 (가쪽굽힘  + 돌림) 방향은 같은가 반대인가?	반대 방향	동일 방향
척추뼈 몸통의 돌림 방향은 볼록한 쪽인가 오목한 쪽인가?	오목한 방향으로 회전함	볼록한 방향으로 회전함
임상에서의 모습	가쪽으로 만곡됨 (측방 만곡0	- 굽힘시:  특정 분절의 가시돌기가 돌출됨 - 폄시: 특정 분절의 가시돌기가 함몰됨

1st Law - ERS / FRS

side bending and rotation happen to the same  side: primary dysfunction

N = neutral or easy flexion (articular facets are in neutral position; parallel and not touching)
>>When vertebrae are in neutral/easy flexion , side bending and rotation occur to opposite sides

2nd law - NSR

sidebending and rotation happen to opposite sides: secondary adaptive dysfunction

>>When vertebrae are in hyper flexion (F) or hyper extension (E), side bending and rotation occur to the same side.

■ Laws of Fryette

1st law: NSR, ESR or FSR
N = neutral or easy flexion
(articular facets are in neutral position; parallel and not touching)
>>When vertebrae are in neutral/easy flexion side bending and rotation occur to opposite sides
2nd law: ERS or FRS
>>When vertebrae are in hyper flexion (F) or hyper extension (E) side bending and rotation occur to the same side.

 

 

 

 

■ Biomechanics - NSR right

1) vertebrae sidebends left
2) side shift to the right
3) rotation occurs to the right (convexity)
>>TVP posterior and high on right side
>>SP deviated to left

■ Biomechanics -ERS / FRS left

1) vertebrae previously hyper flexed (F) or hyper extended (E) rotates left
2) a side shift occurs to right (convexity)
3) sidebending occurs to left
>>TVP posterior and low on left
>>SP deviated right

■ NSR

-group dysfunction: 2-3 segments involved or more rotate in the same direction
-multifidi muscles span 1-3 vertebrae and cause rotation to the same side (causative for NSR dysfunction)
- Adaptive dysfunction (not primary) usually over or under a primary dysfunction
-type of dysfunction seen in scoliosis
-will correct after the primary lesion has been treated.
-If doesn't correct means its chronic and has become a compensation and requires treatment.
-psoas major responsible for group NSR L1-5

 

■ ERS

- Vertebrae is fixated in a hyperextended position so forward flexion is painful or difficult
- ipsilat multifidi is responsible for the fixation on the dysfunction side
- facet is imbricated (closed) goal of manipulation is to open
- TVP is posterior and low on the side of imbrication
-find ERS in childs pose position as vertebrae does not accept flexion but disappears and will hide in extension
-active side bending look for "break" in arc of spine; if break occurs to only one side - means there is fixation on the opposite side facet

■ FRS

-Vertebrae is fixated in hyper flexion; facet cannot close it is stuck open (disimbrication)
-pain can be intense and gait is antalgic with an inability to straighten or extend spine
-vertebrae does not accept extension movements
-found in sphinx position and disappears in childs pose
- mechanical problem (disimbrication) occurs on the opposite side of rotation - disc is moved posterolaterally and blocks the opening of the facet on opposite side of rotation.
-spasm of multifidus muscle on side of rotation fixes the vertebrae in this position
-greatest parameter is usually extension or side bending (often referred to as laterality)
-goal of manipulation is to close the disimbrication

■ Compensating hype / hypermobility

Any loss of mobility in a joint causes compensatory hyper mobility in another joint either above or below the fixation.
hyper mobility is characterized by muscular hypotonia and spontaneous pain from inflammation in soft tissues causing nerve root irritation from edema and anoxia

 

 

 

■ Characteristics of reactive hyper mobility

-common to find vertebral lesions in thoracic spine that are asymptomatic early stages
- highly pathogenic b/c affects on dura mater, cranial sacral movement, vasomotricity (visceral impact) and symptomatic over functioning in areas above or below
-EX: stiffness T1-5 causes hyper mobility in C7 or C6 and results in cervical brachial neuralgia
-hypermobile areas prone to degenerative arthritis

■ Hyper mobility

-some hyper mobility will occur in the same joint as the primary fixation.
hypo mobility in SI joints during walking cause reactive hyper mobility of lumbar which can lead to degenerative disc disease and sciatica

■ What is an adaptation? causes?

its a NON-Neutral dysfunction; either in hyper flexion or extension (ERS or FRS)
ALL primary dysfunctions require an adaptation (over or under) but not all adaptations require correction
ALL non neutral dysfunctions affect just one vertebrae.
Primary lesions are asymptomatic while multiple adaptations generate symptoms

■ What' s difference between adaptation and compensation?

it always following a primary lesion. It will always take place in a neutral position and in a group (NSR)
ALL adaptation neutral dysfunctions affect a group
Causes:
-somatic dysfunction
-short leg
-reflex (antalgic posture)
-adaptations reduce body ability to adapt to other things; lowers defence
-reversible dynamic lesion (doesn't always need treatment)
- primary lesions are asymptomatic while multiple adaptations generate symptoms

■ What is Martindales Law?

Applies to adaptive groups of vertebrae in a non-neutral lesion (primary vertebrae in a non-neutral lesion allows for correction of the adaptive group)
FRS - primary vertebrae is the upper vertebrae of adaptive group; perform a lateral mobilization of the primary vertebrae to correct adaptive group
ERS - primary vertebrae is bottom of group; de-rotate starter vertebrae to correct adaptive group
NSR - rest of the group (not primary) are NSR dysfunctions. Rotation of the entire group is produced in the convexity.
if adaptation does not correct after the primary vertebrae has been treated then de-rotate apex of the curve vertebrae to invert/reduce convexity.
groups: C1-3, C4-6, C7-T2, T3-5, T6-9, T10-L1, L2-5