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پاور پوینت (اسلاید) تمرينات اصلاح کننده لوردوز (Advanced Corrective Exercises Hyper Lordosis)



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پاور پوینت (اسلاید) تمرينات اصلاح کننده لوردوز (Advanced Corrective Exercises Hyper Lordosis)

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پاور پوینت (اسلاید) تمرينات اصلاح کننده لوردوز (Advanced Corrective Exercises Hyper Lordosis)

پاور پوینت (اسلاید) تمرينات اصلاح کننده لوردوز (Advanced Corrective Exercises Hyper Lordosis)

پاور پوینت (اسلاید) تمرينات اصلاح کننده لوردوز (Advanced Corrective Exercises Hyper Lordosis)  با سلام

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توجه داشته باشید هرگونه بهم ریختگی در متن زیر در اثر کپی کردن از پاورپوینت می باشد و در فایل پاورپوینت اصلی هیچ اشکال و به هم ریختگی وجود ندارد

Normal lumbar lordosis

Lordosis: Anterior curves in the cervical and lumbar regions.
Lordosis is a term also used to denote an anterior curve, although some sources reserve the term lordosis to denote abnormal conditions (Kisner, 2007).Gelb et al. reported normal lordosis in middle and older aged volunteer as 64°,1995). 4

Normal lumbosacral angle is 140°
Normal lumbar lordotic curve is about the 50° normal sacral angle is 30
Pelvic angle is 30°(Magee, 2006).

Picture from mageeThe mean angle of lordosis was and 29.07 ±9.71 in women group and 24.00±10.50 in men (Kargarfard et al, 2010).Lumbar lordosis were measured 49 degree in young 100 adults without spinal abnormalities (22 -79 degree) (Lee, 1999).. Women (mean, 49.5 degrees +/-10.7 degrees )
Men (mean, 43.0 degrees +/-10.7 degrees (Youdas, 2006).Normal lumbar lordosis5

کمالی میانگین لوردوز کامل کمر را در افراد 20 تا 70 سال شهرستان بابل 11.5±54.5 گزارش کرده است (1382).

Normal lumbar lordosis6

تعيين نورم كايفوز و لوردوز جامعه ايران.پژوهشكده تربيت بدني

1387,(رضا رجبی (مسئول طرح Normal lumbar lordosis7

Low back arches forward, creating an in-creased forward curve in the low back.(Cailliet, R, 1988; as cited in Therapeutic Exercise)

Lordosis is an excessive anterior curvature of the spine (Fahrni, 1976; Finneson, 1981; Kendall, 1983; McKenzie, 1981; Wiles, P., and R. Sweetnam,1965(

افزایش بیش از حد گودی کمر را گود پشتی می نامند (دانشمندی، علیزاده و قراخانلو، 1387)Hyper lordosis افزایش گودی کمر به نحوی که از حد طبیعی بیشتر باشد را گودی کمر مینامند (دانشمندی، جزوه).8

Lordotic posture:
Is characterized by an increase in the lumbosacral angle, an increase in lumbar lordosis, and an increase in the anterior pelvic tilt and hip flexion ) Cailliet, R . Cited in Kisner,2007).

Hyperextension of the lumbar spine, with the pelvis in anterior tilt (Patel, 2005 ). A high correlation was noted between LLA and SIA (r = 0.883, p = 0.0001).(Lin, Jou , 1992; Mac-thiong et al. 2003; Vaille et al, 2005). Hyper lordosis9

muscles

Some muscles around the hip and spine become tight and some become weak and stretched, causing an imbalance.
10

Hip flexorsHip flexors (in particular the iliopsoas muscle).

Tight muscles:Trunk extensors (erector spinae and quadratus lumborum) 11

Underactivity and inability of the gluteus maximus to maintain an upright trunk position, the latissimus dorsi may become synergistically dominant (overactive or tight) to provide stability through the trunk, core, and pelvis (Sahrmann, 2002, as cited in NASM).
. The latissimus dorsi attaches to the pelvis and will anteriorly rotate the pelvis, which causes extension of the lumbar spine (Sahrmann, 2002; Neumann, 2002, as cited in NASM).

Tight muscles:12

weak muscles:

13

Vladimir Janda categorizes the
body’s muscles: postural or phasic muscles(janda, 1968; as cited Chaitow, 2007)

When overused and fatigued, postural
muscles tend to become hypertonic, while phasic muscles tend to become weak and inhibited. The phasic muscles are antagonists to postural muscles.
Because postural muscles tend toward hypertonicity, they create a functional weakness in the phasic muscles through the process of reciprocal inhibition(Chaitow, 2007)

Lower crossed syndrome14

Specific postural changes in LCS:
anterior pelvic tilt, increased lumbar lordosis, lateral lumbar shift, lateral leg rotation, and knee hyperextension.

lower crossed syndrome15

Prevalence of hyperlordosis

(32%) of School children in the Czech Republic (KRATEˇNOVA´ ,ZˇEJGLICOVA´, MALY´, FILIPOVA´, 2007).
No sports activities were reported by 20% of children, and these children had significantly higher probability of poor posture than children performing sports. (KRATEˇNOVA´ et al., 2007).
فراوانی ناهنجاری لوردوز در سه رده سنی نوجوان، جوان و میان سال 25.8% گزارش شده ، است (نظریان، دانشجو، قربانی و قایدی، 1388).
22.99% of pupils aged 11-13 years in Karaj (Lasjouri and Mirzaei, 2005)
83.7% of lifting load workers of Behshahr industrial factory (Gharahgouzlou, 2000).
سیمرغ و همکاران شیوع هایپر لوردوز را در دانشجویان دختر 19-34 سال 25.49 گزارش کردند (1338).16

Prevalence of hyperlordosis

9.75% of teenagers' boy and 6.89% of teenager girl between 11-15 year-old of Lorestan province (Bahrami and Farhadi, 2006).
65% of individuals with Schuerman disease, 27.8% of postural kyphotic individuals (Vanzi, Chih , Meves , Caffaro, and Pellegrini , 2007).17

Mobility impairment in the hip flexor muscles and lumbar extensor muscles
Impaired muscle performance due to stretched and weak abdominal muscles
Watson reported that 67% of players with lordosis suf-
fered muscular injuries, while in the group without postural changes, only 36% suffered the same injury (1995).

Complications of hyperlordosisResearch has shown low-back pain to be predominant among people who have altered lumbar lordosis (curve in the lumbar spine) (NASM).18

Stress to the anterior longitudinal ligament (Kisner, 2007).
Narrowing of the posterior disk space and narrowing of the intervertebral foramen by Increased lumbar extension, leading to spinal nerve root compression (Kisner, 2007).
Approximation of the articular facets.(Kisner, 2007; Gross, 2009).
Increased weight on posterior vertebral arch structures
LBP and myofascial trigger points from hypertonicity in these muscles and exaggerate the lordosis.(Chaitow, 2009)
spinal pathology such as facet joint dysfunction, disc herniation, spondylolysis, or spondylolisthesis can result. .(Chaitow, 2009)

Complications of hyperlordosis19

The lumbar spine in the child has an exaggerated lumbar curve, or excessive lordosis. caused by the presence of large abdominal contents, weakness of the abdominal musculature (Magee, 2006).
Beginning at approximately 9 years of age, there seems to be a tendency for increased forward curve or lordosis of the low back. The deviations should become less pronounced as the child grows older (19,22).

Lordosis relationship with age, gender and sportIn children in age-groups between 8 and 16 years of age, there is a slow continuous increase in lumbar lordosis (Willner and Johnson, 1983).
Kyphosis and lordosis increased and mobility decreased in the 90 children who were examined both at age 5-6 and 15-16 years. The relationship between kyphosis and lordosis decreased in girls but not in boys (Widhe, 2001).20

Lordosis relationship with age, gender and sport

21

Lordosis relationship with age, gender and sport

Farhadi and Bahrami reported the prevalence of lordosis: 6.89% in
girl and 9.75% boy (2006).


Zuluaga et al. reported that lumbar lordosis reaches its highest degree(55°) in adolscence (13-19) and decreases by aging (1995).The average of lumbar lordosis in men and women decreases by aging (Nissinen, 2008; Kamali, 2003; Gelb et al, 1995).. Lordosis was absent in an increasingly large proportion of men and women as age rose above 60 years.(Milne, Lauder, 1974).
22

Lordotic curve in female 20-65 years old is greater than their male counterpart(Nourbakhsh, Moussavi, Salavati, 2002).

Lordosis and hyperlordosis were the most prevalent among the young (38.8%) and adult (48.7%) females respectively (Nazarian et al. 2009).Women (mean, 49.5 degrees +/-10.7 degrees ) demonstrated about 6.5 degrees more LLC than their male (mean, 43.0 degrees +/-10.7 degrees ) counterparts. Youdas, Hollman, and Krause, 2006).Lordosis relationship with age, gender and sport23

Female volleyball players have rounded shoulders and excessive arch of the lower back (Performance Conditioning Volleyball, 2006).

Volleyball players were predominantly kyphotic, their lumbar lordosis was flattened and head protruded, especially in those having longer training experience (Grabara, 2009).. In the lumbar spine there was no difference as to either posture or sagittal motion between former female elite gymanasts in comparison with matched control subjects (Tsai and Wredmark, 2002). Lordosis relationship with age, gender and sport24

There was a significantly higher incidence of lordosis in the soccer and football players when compared to the other sportsmen (Young, 2001)

Futsal players show changes on the body alignment. The most common changes seen were in ankle and knee in both groups. The changes of the alignment in lumbar spine was more common in group 1(suffered injuries related to Futsal) (Ribeiro, 2003).Lordosis relationship with age, gender and sport25

Watson observed that only 26.5% of soccer, rugby and
American football players investigated had their lumbar
spine alignment preserved.
He also found an incidence of 51.9% soccer players with enhanced lumbar lordosis (1995).

subjects participating in Gaelic football and soccer were monitored over a period of 21 months. It was found that subjects participating in these two sports showed a significant increase in lordosis (Young, 2001).Comparison between soccer players and the volunteer with no sports activities: In athletes, spinal alignment was achieved by a less pronounced thoracic kyphosis and a more pronounced angle, sacral tilt and lumbar lordosis (Wodecki, Guigui, Hanotel, Cardinne, and Deburge, 2002).Lordosis relationship with age, gender and sport26

Lordosis angle was also greater in SC versus RC and "climber's back" was characterized by an increased thoracic kyphosis, increased lumbar lordosis. The climbing ability level was strongly correlated to the postural adaptations.(Förster, Penka, Bösl, Schöffl, 2009).

Chronic lower back injuries are also common in windsurfers and may be related to prolonged lordosis (lumbar extension) of the spine while 'pumping' the sail (Neville V, Folland JP, 2009).Lordosis relationship with age, gender and sport27

In young athletes between 8 and 18 years showed that larger angles of thoracic kyphosis and lumbar lordosis were associated with greater cumulative training time. Gymnasts showed the largest curves. Lack of sports participation, on the other hand, was associated with the smallest curves. Age and sex did not appear to affect the degree of curvature.(Wojtys EM, Ashton-Miller JA, Huston LJ, Moga PJ. , 2000).

Distance runners and sprinters had a greater degree of thoracic kyphosis and greater degree of lumbar lordosis. Swimmers, bodybuilders, rugby and soccer players had partial lordosis. Uetake T, Ohtsuki F. , 1993).
Lordosis relationship with age, gender and sport28

29

Common Causes

Sustained faulty posture and repetitive movement

Repetitive movement also affects everyday people Waiters and waitresses, much the same as a mother carries her child.Muscle that is repeatedly placed in a shortened position, such as the iliopsoas complex during sitting, will eventually adapt and tend to remain short (10,14).30

Sustained faulty posture and repetitive movement

Repetitive movements can cause imbalances by placing demands on certain muscle groups more predominantly. This is evident when looking at many athletes such as football players.31

weak abdominal muscles with tight muscles, especially hip flexors or lumbar extensors

A tight psoas decreases the neural drive and therefore optimal recruitment of the gluteus maximus. This altered recruitment and force
production of the gluteus
maximus (prime mover for
hip extension), leads to
compensation and substitution
by the synergists (hamstrings)
and stabilizers (erector spinae).
32

Heavy abdomen: Pregnancy or Obesity

As the pregnancy progresses,both forward rotation and hyperlordosis increase as the sacroiliac ligaments become lax. These factors contribute to increasing mechanical strain on the low back, sacroiliac, and pelvis (Ritchie, 2003).
The degree of lumbar lordosis was positively related with the number of pregnancies, age and height and negatively related with weight of the subjects. (Nourbakhsh 2002).Lumbar lordosis increases during pregnancy, but physical exercises reduces lordosis increasment and low back pain (Kashanian, Akbari, and Alizadeh, 2009). 33

Heavy abdomen: Pregnancy or obesity



Kamali et al. reporetd Lumbar curve is greater in over-weight women (2004).
Lumbar lordosis happens due to increase in anterior mass by increasement in mother’s wieght, fetus and breast (Hainline, 1994).34

Compensatory mechanism that result from deformity, such as kyphosis

Lumbar lordosis had significant correlation with thoracic kyphosis(Lee, 1999).
65% of individuals with Schuerman disease, 27.8% of postural kyphotic individuals (Vanzi, Chih , Meves , Caffaro, and Pellegrini , 2007).

Kyphosis and lordosis increased and mobility decreased in the 90 children who were examined both at age 5-6 and 15-16 years. The relationship between kyphosis and lordosis decreased in girls but not in boys (Widhe, 2001).

A definite correlation exists between the presence of idiopathic lumbar scoliosis and hyperlordosis of the lumbar spine. (Pelker and Gage, 1982).

A positive correlation was also observed between the ranges of the kyphosis and lordosis in most of the age-groups (Willner and Johnson,1983).

35

wearing high-heeled shoes!!

Although other effects, such as decreased gait speed and step length, and increased knee flexion at heel strike have been found in more than one study, no increase in lumbar lordosis has been found. The results indicate that the greatest compensation is at the ankle and knee. Where a significant effect occurred in the lumbar spine (males, dynamic study), high heels decreased the lumbar lordosis(de Lateur, Giaconi, Questad, Ko, Lehmann, 1991).
By one-hour adaptation to a corresponding shoe type. With increasing heel height, the lumbar lordosis and the pelvis inclination were decreased. The back and abdominal muscles did not alter their activities. (BENDIX, SØRENSEN, and KLAUSEN, 1984).
36


In sagittal plane kinematics during gait, the lumbar lordosis did not increase in high-heeled gait. The knee flexion and ankle plantarflexion increased in high-heeled gait(Song SH, Yoo JY, Ha SB. 1997).Intrasubject comparison of barefoot and high-heeled stance showed that the wearing of high heels caused lumbar flattening, a backward tilting pelvis (OPILA, WAGNER, SCHIOWITZ, CHEN, 1988).
Snow et al. did not observe changes in the positioning of the pelvis and the lumbar spine while walking in high heels even though they noted at the same time a forward shifting of the COM (1994).Wearing high-heeled shoes!!37


Positive heel inclination of subjects brought about significantly lower anterior pelvic tilt, lumbar lordosis, and sacral base angles when compared with zero heel inclination. Clinically, patients with low back pain may be affected by high heel usage because of the reduction of the normal lumbar lordosis (Franklin, Chenier, Brauninger, Cook, Harris, 1995).STS from a chair while wearing high-heeled shoes demands significant ES and RF muscle contractions. The sustained and repeated wearing of heels with excessive heights can induce inappropriate neuromuscular behaviors due to muscle imbalance (Kim et al. 2011).Wearing high-heeled shoes!!38


There are many Internet sites that support the belief that high-heeled shoes cause increased lordosis. However, published research for this topic mostly does not support this belief; but some mixed results, small subject groups, and questionable methods have left the issue unclear (Russell, 2010).
Significant increase in erector spine activity was observed in Trunk Flexion and during Flexion-Relaxation Position when wearing high hell shoes. The prolonged wearing of shoes with stiletto type low and high heels by individuals without back pain is not safe for their spine and may lead to chronic paraspinal muscle fatigue. (Mika, Oleksy , Mikołajczyk, Marchewka, 2009).Wearing high-heeled shoes!!39

A corrective exercise program is only as good as the assessment process (NASM).

Assessment:40 لطفا در خرید این فایل تردید نکنید
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