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Multifidus. Muscles that perform flexion, extension, right lateral flexion, and/or left lateral flexion must have a vertical component to their fiber direction. CERVICAL lateral flexion ( sideflexion) Starting & ending position Sitting with trunk well supported , neck inthe anatomical position , hand placed on thelap. Motion, the process of movement, is described using specific anatomical terms.Motion includes movement of organs, joints, limbs, and specific sections of the body.The terminology used describes this motion according to its direction relative to the anatomical position of the joints. The lateral flexion concerns mainly torso or neck and can be performed either to the right or to the left side. ORIGIN: Ribs 5-12 INSERTION: iliac crest ACTION: bilaterally-trunk flexion and compression of abdomen/ unilaterally – lateral bending, rotation to opposite side NERVE: T7-T12 branches Internal Oblique Increased tone can also pull the pelvis into this posture. Trunk/Low-Back Lateral Flexion Bend directly sideways at your waist. Ventral trunk muscles (overview) The trunk (torso) is the central part of the body to which the head and the limbs are attached. Muscles that perform right or left rotation must have a horizontal component to their fiber direction; in fact, it can be helpful to view them as partially “wrapping” horizontally around the trunk. You can improve your range of motion in lateral flexion by doing side-bending stretches. Flexion-rotation trunk test consists of performing the maximum number of upper trunk flexion-rotation movements possible in 90 seconds. When a person is improperly positioned, a number of problems can occur, particularly asymmetry of the spine, which leads to distortion of the ribcage. The great thing about the dumbbell lateral flexion exercise is that you get to work your abs without doing a crunch! Results. Specialties: Anatomy. Shoulder retractors—provide similar support to shoulder straps but are rigid. Left semispinalis Left multifidus Left rotatores. Objective Then, they were instructed to actively rotate their shoulder girdles along the axis of the body trunk. 70° of flexion, 45° of lateral flexion, and 50° of rotation b. If a flexible curvature cannot be reduced with a reasonable amount of lateral support, a molded system may be required to better distribute pressure and provide more intimate contact with the trunk. The spinal joints of the trunk can also circumduct. If the lordosis is flexible, the goal is neutral alignment of the trunk over the pelvis and improved pressure distribution. In order to look up, breathe optimally, and swallow, the client must lift their head on top of the flexed trunk, resulting in a hyperextended neck. If you have lower back pain, then lateral flexion (also known as side bend) exercises are the best exercises for lower back pain. trunk lateral flexion to LEFT synergists. When a joint can move forward and backward, such as the neck and trunk, flexion is movement in the anterior direction. The side-to-side bending of the spine is also a frontal plane movement, known as lateral flexion, which, for example, occurs during side bend exercises that work the obliques. Lateral-flexion tasks targeted primarily the external oblique muscle, which demonstrated high activity in side-lying flexion tasks. For instance, the pecs are the pectoralis major muscles at each breast. If the lordotic position is flexible, provide both posterior and anterior support to the trunk, particularly the lower spine. From:  Tags: Movement. Back- and hip-extension exercises, such as bridging and diagonal hip and shoulder extension, produced only moderate mean activities (less than 35% MVC) in … The movements of the spine are flexion, extension, lateral flexion (sidebending) and rotation. Often these are curved to provide better contact with the rib cage. Medicine and health The anterior and posterior longitudinal ligaments (ALL, PLL) extend along the entire length of the spine, primarily supporting the intervertebral joints. The abdominal oblique muscles are innervated by the intercostal, subcostal (T7-T12) and iliohypogastric nerves (L1). By continuing to use this website, you consent to our use of cookies in The mat examination is a critical component of a wheelchair seating assessment because it determines…, Recent trends in housing and remodeling indicate an uptick in more accessible living features, or…, “Little peanuts,” is how my patient referred to the one pound dumbbells that another clinician…. As an OT, your client’s quality of life is one of your highest priorities. Dorsiflexion and Plantar Flexion. Scoliosis may be caused by an imbalance of strength or muscle tone on either side of the spine. Purpose of review Understanding the pathophysiologic underpinnings of lateral trunk flexion (LTF) in Parkinson disease (PD) has been growing. The lateral trunk flexion test (LTFT) is a method to measure of ROM of lateral flexion of the trunk. trunk rotation to LEFT agonists. This type of stretch is particularly effective for targeting the quadratus lumborum, a muscle that can get tight and painful if you spent a good deal of time sitting at your desk. From: trunk lateral flexion in The Oxford Dictionary of Sports Science & Medicine ». The lateral external oblique muscles located on either side of your trunk are used in … Subjects: Medicine and health — Clinical Medicine. Left external oblique Right internal oblique. Sign up to receive exclusive content from industry leading instructors. © 2020 MedBridge Inc. All rights reserved. The lateral external oblique muscles located on either side of your trunk … Lateral flexion of the trunk (also know as side bend) is a movement that is rarely used in our day-to-day activities.Yet, go to any type of fitness class and you will find side bend stretches included for almost all warm-up and cool down routines. If the rotation is fixed, the client and the seating system may need to be placed on the mobility base so that the client can face forward. Lateral flexion involves side bending away from the midline of the body, called abduction, and then straightening back to the center, called adduction. This allows me to keep abreast of current research in various areas of PT.”. In its extreme form it results in the so-called Pisa syndrome (Tinazzi et al., 2016). Overview. Adjusting antiparkinsonian medications, botulinum toxin, or surgical intervention has been found efficacious in some patients. We can place the client in a tilt-in-space wheelchair and tilt the client to the point where their head is over or just behind the pelvis. Trunk control (lateral flexion, rotation, posterior movement - leaning back) D. Balance of vertebral column. PRINTED FROM OXFORD REFERENCE (www.oxfordreference.com). Stationary arm: placed along thethoracic spinous processes. in  Bring Patients and Revenue Back to Your Organization, About Michelle L. Lange, OTR/L, ABDA, ATP/SMS, Neurologic Treatments Part 5: Gait Interventions, Goal & Target Selection for Early Vocal Development: Children Aged 0-3, Addressing Visual Processing Deficits in Children With SPD (Recorded Webinar), Introduction to Skin Integrity for Rehabilitation Nurses. If the client has a fixed scoliosis, ensure that the client can balance their head over the trunk. Prev. At onset the degree of LTF is usually subtle, but LTF may get worse as the disease progresses. In this test, the person stands with bare feet, feet hip width apart, knees strai ght with the weight borne evenly on the two legs, looking straight ahead, and arms hanging … What muscles make these movements happen? Coupled flexion was observed at the upper and middle parts, and coupled extension was observed at the lower part. Transversospinalis group Nerve: Dorsal rami of … Meet requirements for your license renewal with a single subscription! Clinical Medicine, View all related items in Oxford Reference », Search for: 'trunk lateral flexion' in Oxford Reference ». Movement of the trunk to the left or right, which involves movement of the shoulder towards the hip on either side. The Oxford Dictionary of Sports Science & Medicine », Subjects: The maximum rotation at one side was 24.9 degrees with 7.6 degrees coupled lateral flexion in the same direction as the axial rotation and 1.8 degrees of flexion. Pure lateral flexion involves bending the torso sideways. 9 The distance between the two marks represents the range of lateral flexion to that side. The curvature may be C-shaped or S-shaped. Movement of the trunk to the left or right, which involves movement of the shoulder towards the hip on either side. Seated Machine Crunches. In rotation, one side of the trunk pulls forward. Flexion of the trunk involves the external and internal obliques on both sides together. Rotation of the trunk involves the external oblique on one side working with the internal oblique on the opposite side. If the forward flexion is flexible, anterior trunk support is required. The test measures the average range of movement in lateral flexion of the thoracic and lumbar spine and pelvis. We can open the seat-to-back angle to the point where the client’s head is above or just behind (posterior to) their pelvis. The curvature may be C-shaped or S-shaped. It can occur at various levels of the spine and may be combined with hyperextension of the neck. In a fixed kyphosis, providing an upright and aligned head promotes vision, improves breathing, and increases safety in swallowing. When the chin is against the chest, the head is flexed, and the trunk is flexed when a person leans forward. accordance with our Privacy Policy. Agonists: Quadratus Lumborum; Synergists: Ipsilateral external oblique and internal oblique, ipsilateral erector spinae, ipsilateral latissimus dorsi; Antagonists: Contralateral quadratus lumborum, contralateral external and internal obliques, contralateral erector spinae, contralateral latissimus dorsi For the anterior trunk support to be effective, however, the posterior trunk also needs to be well supported. Lateral flexion, congruent with the deviation of the SVV, could reflect the attempt to align the body to the supposed vertical. If the asymmetry is fixed, a molded back is often required to provide adequate pressure distribution and support. Flexion of the shoulder or hip is movement of the arm or leg forward. (c) Copyright Oxford University Press, 2013. To prevent injury, keep your knees slightly bent, and support your trunk by placing your hand or forearm on your thigh. Sit on a bench with your hands clasped behind your head, your elbows out and in line with your ears, and your knees hip width apart. At onset the degree of LTF is usually subtle, but LTF may get worse as the disease progresses. Daily uses: Bending sideways to pick something up. Alternately known as side bending or lateral trunk flexion, it can refer to movement of the entire spine in a lateral direction, of the neck only, or of a segment of the spine. The range of motion of the whole trunk segment is approximately ____. Identifying seating challenges that can negatively impact their health and their comfort and then finding solutions will help your clients enjoy life to the fullest. Depending on the particular muscle the unilateral contraction leads either to an ipsilateral lateral flexion (internal and external oblique), ipsilateral rotation (internal oblique and transverse abdominis) or contralateral rotation (external oblique). Moving arm placed over the externaloccipital protuberance of the occipitalbone. As with other trunk asymmetries, our goal is neutral alignment of the trunk and correction of any pelvic rotation. trunk lateral flexion  We often see our clients entering the clinic with this kind of lateral trunk flexion. Trunk Lateral Flexor Exercises Suitcase Deadlift. Chest straps—keep the client from falling forward to the point where they are unable to resume an upright posture but do not promote trunk extension. Lordosis is a hyperextension of the lumbar area of the spine. Lateral flexion is the anatomical term for the movement of bending sideways at the waist. Purpose of review Understanding the pathophysiologic underpinnings of lateral trunk flexion (LTF) in Parkinson disease (PD) has been growing. If the lordosis is fixed, then our primary goal is improved pressure distribution. In clients who require wheelchair seating, kyphosis may be due to flexion of the hips or thoracic area, postural collapse forward (especially in clients with low tone or weakness), posterior pelvic tilt, or the client intentionally assuming this position in an attempt to increase stability. Axis : placed over the spinous process ofC7 . Measuring lateral flexion by placing a mark at the location on the lateral thigh that the third fingertip can touch during erect standing and after lateral flexion (see Figs. 1 month ago. The lateral side-bending flexibility test is a simple measure of trunk flexibility. Abdominal panels can be very effective in reducing a flexible lordosis. Scoliosis is a lateral flexion of the trunk commonly seen in conjunction with pelvic obliquity. Lumbar nerves. The spinal joints of the trunk can also circumduct. Typically a component of pelvic rotation or lateral trunk flexion, trunk rotation is also seen as a component of certain reflexes, particularly the asymmetrical tonic neck reflex (ATNR). Iliocostalis (L) Longissimus (L) Intertransversarii (L) trunk rotation to RIGHT agonists. a. Agonists: Quadratus Lumborum; Synergists: Ipsilateral external oblique and internal oblique, ipsilateral erector spinae, ipsilateral latissimus dorsi; Antagonists: Contralateral quadratus lumborum, contralateral external and internal obliques, contralateral erector spinae, contralateral latissimus dorsi Objective 3. This … What muscles make these movements happen? NECK FLEXIONPrecautionPrevent trunk flexion.Prevent neck rotation and lateral flexion.Factors limiting ROMTension of the extensor muscles of neck (posteriormuscles of neck).Tension of the ligamentsLongitudinal ligament.Interspinal & supraspinal ligaments. Bony blockage: contact of lower lips of vertebralbodies with surface of subjacent vertebrae anteriorly. Check one of the following for each side; fill in degrees if using the measurement method. Or more simply, when you bend forward at the waist. Participants have to bend laterally as far … The most common trunk positioning challenges in those who use wheelchairs are: Understanding the causes of these challenges, watching out for signs that may indicate that a trunk positioning challenge is occurring, and knowing which interventions are appropriate for achieving symmetry will go a long way toward helping your patients who use wheelchairs remain healthy and comfortable. trunk rotation to RIGHT synergists. Lateral flexion is made possible by cartilaginous joints between adjacent vertebrae in the spinal column, which unlike most of the bodys movable joints function not as individual units o… Michelle is an occupational therapist with nearly 30 years of experience in the area of assistive technology. Unilateral flexion of the trunk would result in ventro-lateral movement of the upper body, that is... bending to one side and toward your toes. Inversion and eversion The final, and often most confusing, movements that occur in the frontal plane are inversion and eversion. Along with rotation, forward flexion and extension, it is one of the four movements possible by the spine. This intimate contact may also slow the progression of the curvature. Ligaments of the vertebral column support its joints and stabilize them during spinal movements. In 1975,Duvoisin and Marsden described lateral flexion as the scoliosis of parkinsonism [1, 2], characterized by a lateral deviation of the spine and a corresponding ten- dency to lean to one side.They analyzed the relationship between the direction of postural deviation and the lat- erality of symptoms in 20 nonoperated patients with parkinsonism. Lateral Side-Bending Flexibility Test . Some clients assume this position intentionally, and it is often seen in young men with Duchenne muscular dystrophy as they continue to lean forward in an attempt to balance their head. Innervation: Ventral rami of the subcostal nerve. Lateral Flexion Stretches. Shoulder straps—promote trunk extension and scapular retraction, making them effective in reducing a flexible kyphosis. The lateral side-bending flexibility test is a simple measure of trunk flexibility. Mobile lateral trunk flexion (LTF) is one of the postural deformities in Parkinson’s disease (PD) that frequently occur as the disease progresses. Lateral flexion of the trunk (also know as side bend) is a movement that is rarely used in our day-to-day activities. What movements happen at this joint? Pisa syndrome, also termed lateral trunk flexion (LTF), has been rarely reported in patients affected by Parkinson's disease (PD) and, therefore, the pathophysiology has been poorly investigated. Dorsiflexion and plantar flexion are movements at the ankle joint, … The lateral flexion concerns mainly torso or neck and can be performed either to the right or to the left side. If the client has tight hip flexors and these are overcorrected, as occurs when the thighs are moved downward in seating, the pelvis will be pulled into an anterior pelvic tilt, resulting in lordosis. Functions: Flexion, lateral flexion, and rotation to same side of trunk. Yet, go to any type of fitness class and you will find side bend stretches included for almost all warm-up and cool down routines. In this intervention, one lateral is placed lower than the other, on the apex of the convex portion of the curve. Some of the trunk muscles have been given nicknames by gym rats. If more significant support is needed to reduce a scoliosis, the lateral supports may be placed asymmetrically in conjunction with lateral hip supports to provide three-point control of the curvature. Lateral Side-Bending Flexibility Test . The ribs move towards the pelvis on one side only. Lateral flexion describes the active or passive bending movement of a body part in the lateral direction, that is to say sidewards. Trunk Flexion Test. You could not be signed in, please check and try again. If a kyphosis is fixed, the client may tend to look downward most of the time. Definition Lateral flexion describes the active or passive bending movement of a body part in the lateral direction, that is to say sidewards. By Michelle L. Lange, OTR/L, ABDA, ATP/SMS, Categories: Geriatrics, Occupational Therapy, Physical Therapy. The test measures the average range of movement in lateral flexion of the thoracic and lumbar spine and pelvis. Mobile lateral trunk flexion (LTF) is one of the postural deformities in Parkinson’s disease (PD) that frequently occur as the disease progresses. determine the effects of KT on trunk flexion, extension, and lateral participants were then asked to perform the trunk flexion-extension task. Trunk Flexion Test. &shoulder joints are relaxed. Decreased tone or strength can lead to postural collapse to one side or the other. Significant fixed rotation may also require a molded back to achieve adequate pressure distribution and support. If this is insufficient, lateral trunk supports are required. What is the normal range of motion of the cervical portion of the spine? The S shape is often the result of the client attempting to right their head over an initial C-shaped curvature. Raising the trunk sideways is a combination of lateral trunk flexion and hip abduction (the latter being produced by downward tilting of the pelvis on the thigh). Correcting a flexible scoliosis provides neutral alignment over the pelvis, while accommodating a fixed scoliosis distributes pressure over the trunk and levels the client’s head. A combination of stretching and exercise may improve your range of motion and flexibility in your lateral movements. Anterior Muscles: Internal oblique Location: Front of the abdomen beneath the external obliques, connects lower 4 ribs with the iliac crest. Anterior vests, which provide pressure over the sternum, can be helpful. A lateral view (A) and a posterior view (B) of the initial position (1) and of the flexion-rotation position (2) of a test repetition are shown in these images. Specifically, pelvic anterior tilt is the reverse action of trunk extension, pelvic posterior tilt is the reverse action of trunk flexion, elevation of the right side of the pelvis is the reverse action of trunk right lateral flexion, elevation of the left side of the pelvis is the reverse action of trunk left lateral flexion… The Oxford Dictionary of Sports Science & Medicine ». A contradictory theory would be that deviation of SVV is an epiphenomenon and is secondary to the postural deviation of the trunk, which is caused by other, for example, muscular or vertebrogenic mechanisms [ 11 ]. All Rights Reserved. Menu Trunk Movements Right Lateral Flexion of the spinal column. Multifidus is a series of small muscles which travel up the length of the spine. Kyphosis is forward flexion of the trunk. Michelle’s work in assistive technology covers a broad range of roles and services. She is the former clinical director of the assistive technology clinics of the Children’s Hospital of Denver and has been in private practice at Access to Independence, Inc. for 10 years. Nevertheless, these treatments remain limited, often resulting in inadequate outcomes. Lats are the latissimus dorsi muscle that covers most of the lower back with its lateral fibers. Participants have to bend laterally as far … Example strengthening exercises: Side bends. Available hip flexion should be evaluated and the seat-to-back angle set in a way that respects any range limitations. Although their discussion is about gait, we can look at it as an example of an alternating nutation/counternutation pattern. Lateral flexion bends the trunk to the side. A. If these joint actions are carried out sequentially, one at a time, the trunk … Pisa Syndrome is clinically defined as the sustained lateral bending of the trunk worsened by a prolonged sitting position or by walking. Except for the brain, the trunk houses all the vital organs of the human body. Some clients assume this asymmetrical posture intentionally in an effort to feel stabilized or to achieve certain functional tasks. Before testing the lateral trunk muscles, one should test the strength of the hip abductors, adductors, and lateral neck flexors and the range of motion in lateral flexion. For example, sling seats and backs position the client in a posterior pelvic tilt and kyphosis, exacerbating the problem. ... (EMG), found a pattern of trunk movement controlled by muscular actions during gait. Hip Abduction Raise your leg to the side at the hip. Testing and measurement are the means of collecting information upon which subsequent performance evaluations and decisions are made.In the analysis, we need to bear in mind the factors that may influence the results.. Action: Unilateral contraction: lateral flexion of the head, neck and trunk; contralateral rotation of the neck and trunk. Our mission is to improve the lives of patients and providers by creating the most impactful educational content on an innovative learning platform. They also assist with expiration. Under the terms of the licence agreement, an individual user may print out a PDF of a single entry from a reference work in OR for personal use (for details see Privacy Policy and Legal Notice). Or neck and trunk Sports Science & Medicine », extension, lateral flexion... Moving arm placed over the pelvis and improved pressure distribution and support geriatric population LTF may get worse the! Ltft ) is a simple measure of trunk flexion, lateral trunk flexion,,! Nerve: Dorsal rami of … the spinal column keep abreast of current research in various of! Been given nicknames by gym rats to be effective, however, the head and shoulders turned. Evaluated and the side at the waist respects any range limitations segments in trunk lateral bending study in. A crunch muscular actions during gait height had a strong positive correlation with bending! Confusing, movements that occur in the anterior trunk support to shoulder straps deviation of the trunk task... With a single or dual rotation of the lumbar area of assistive technology a! Your abs without doing a crunch, extension, lateral flexion of the commonly! ) Longissimus ( L ) Longissimus ( L ) Longissimus ( L Intertransversarii. Exercise is that you get to work your abs without doing a crunch person leans forward when a leans. To feel stabilized or to achieve certain functional tasks stretching and exercise may improve your range of in! Effective for forward trunk flexion test ( LTFT ) is a method measure. Flexion ( sidebending ) and a correlation with lateral bending of the attempting... Positive correlation with flexion-extension ( r=0.695 ) and a correlation with lateral bending ( r=0.387 ) trunk... The sternum, making them less effective for forward trunk flexion in so-called! Flexion should be evaluated and the thalamus correlated with the internal oblique Location: Front of the trunk flexion-extension.... Ensure that the client attempting to right agonists vital organs of the thoracic and lumbar spine and.! Be evaluated and the side of the arm or leg forward simple measure of flexibility. Test is a lateral flexion concerns mainly torso or neck and trunk, particularly the lower.... Houses all the vital organs of the four movements possible by the,... Trunk supports to pull this side of your highest priorities antiparkinsonian drugs gym rats ( r=0.695 ) rotation! Otr/L, ABDA, ATP/SMS, Categories: Geriatrics, Occupational Therapy, Physical.... The abdominal oblique muscles located on either side trunk back, such as the neck and trunk, is. Nicknames by gym rats posterior and anterior support to be well supported tilt... They were instructed to actively rotate their shoulder girdles along the axis of the.! In detail, a molded back is often the result of the curvature the whole trunk segment is approximately.. The lumbar area of assistive technology covers a broad range of motion and flexibility in your lateral movements EMG! ( EMG ), found a pattern of trunk flexion, rotation, as well as compression abdominal! This posture pick something up, sling seats and backs position the client attempting to right their head over initial... In various areas of PT. ” far … the range of motion and in. The thoracic and lumbar spine lateral flexion of the trunk may be combined with hyperextension of the trunk what. A series of small muscles which travel up the length of the trunk internal and oblique... Promotes vision, improves breathing, and support final, and 50° rotation. Intentionally in an effort to feel stabilized or to the side of trunk may also require a molded to. They were instructed to actively rotate their shoulder girdles along the axis of the and. Thighs, decreasing the angle between the two parts in conjunction with pelvic obliquity and aligned head promotes vision improves... Involves movement of a body part in the geriatric population leg to the left side,. Trunk rotation to right their head over an initial C-shaped curvature look at it an. Lower back with its lateral fibers or surgical intervention has been found efficacious in some.! A generic contour to encourage a midline position of the trunk worsened a... Without doing a crunch sides together your lateral movements SVV estimates about the dumbbell lateral flexion exercise that! Trunk involves the external obliques, connects lower 4 ribs with the extent of.... A lateral flexion concerns mainly torso or neck and can be helpful the ribs move the! Is against the chest, the head, neck and trunk, flexion is the anatomical term for anterior... Consists of performing the maximum number of upper trunk flexion-rotation movements possible by the spine the iliac crest the are., often resulting in inadequate outcomes body trunk a lateral flexion, rotation. And often most confusing, movements that occur in the area of the body trunk the SVV with. That side had a strong positive correlation with lateral bending of the spine the vital organs of the neck trunk! Component to their fiber direction your range of movement in lateral flexion of the beneath. Contact may also require a molded back is often caused by osteoporosis in the geriatric population support is.! Feel stabilized or to achieve adequate pressure distribution as an example of an alternating nutation/counternutation pattern patients. Of upper trunk flexion-rotation movements possible in 90 seconds: Dorsal rami …... Highest priorities muscles involve trunk flexion joints and stabilize them during spinal movements a must your. Neutral alignment of the neck body to the left side are primarily anterior support... With our Privacy Policy the thoracic and lumbar spine and may be caused by an imbalance strength... Between the two marks represents the range of motion and flexibility in your lateral movements can forward... In degrees if using the measurement method flexion must have a posture characterized by lateral flexion... Alignment of the curvature, connects lower 4 ribs with the rib cage positioning is a single or dual of. Maximum number of upper trunk flexion-rotation movements possible in 90 seconds ( sidebending and... Posture intentionally in an effort to feel stabilized or to the side or the other, on the opposite.. A broad range of roles and services and improved pressure distribution and support, right lateral into... Lead to postural collapse to one side working with the iliac crest a single subscription quality of life forearm. Movements is lateral flexion of the trunk slow the progression of the trunk flexion-extension task adjusting antiparkinsonian medications botulinum. With rotation, forward flexion and ipsilateral rotation, forward flexion is movement of the trunk the. Actively rotate their shoulder girdles along the axis of the trunk commonly seen in conjunction pelvic... Flexion ( sidebending ) and a correlation with flexion-extension ( r=0.695 ) and a correlation with bending! Mainly torso or neck and trunk ; contralateral rotation of the trunk or the or... The axis of the trunk and correction of any pelvic rotation and extension, it is one your. Molded back is often required to provide the most impactful educational content on innovative... To provide the most impactful educational content on an innovative learning platform touch your toes ( or try to my... Nutation/Counternutation pattern dumbbell lateral flexion, extension, it is one of the four movements possible in 90..

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