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Digital Seminar

Spine Health & Trunk Stability: Influence of the Thorax & Respiration

Debra Dent, BPT, Dip Manip PT, OCS, FCAMPT
6 Hours 21 Minutes
Audio and Video
Oct 26, 2016
Product Code:
Media Type:
Digital Seminar


An Evidence-Based Practice Solution for Spinal Health, Stabilization, & Posture

The thorax is a vital component of spinal function, as the center of trunk rotation. Its function is significant in shifting weight from lower extremities (LE) and upper extremities (UE) through regions of the spine. It is a prime base for muscle and fascial connections that affect the cervical/ UE and lumbo/pelvic/LE regions. The diaphragm's dual functions are in posture and respiration. Its muscular and neurological connections to the lumbar spine, abdominals, and pelvic floor, along with its ability to maintain intra-abdominal pressure, are both vital for spinal stability and functional posture.

Dysfunction of the respiratory complex, trunk muscular imbalances, muscular inhibition and weakness, myofascial restrictions, loss of axial rotation, and chronic hyperventilation all have significant effects on posture, trunk stability, chronic pain, motion, and upper and lower extremity function.

This recording improves your knowledge and skill set regarding spinal health, stabilization, and posture. Ms. Dent demonstrates the vital integration of the thorax and diaphragm into a functional spinal program for long-term, successful patient outcomes. Participants will discover how normal breathing patterns are regained and maintained for spine health and overall patient well-being. Practice these techniques in an interactive, hands-on lab and leave with the confidence to immediately implement them into practice.


* Credit Note - **

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing the on-line post-test (80% passing score) and completing the evaluation). 

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your profession's standards.  

For Planning Committee disclosures, please statement above.  For speaker disclosures, please see the faculty biography.

Florida Occupational Therapists & Occupational Therapy Assistants

PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number #50-399. This course qualifies for 6.3 self-study continuing education credits.

CE Broker

California Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 6.25 continuing competency hours.

Texas Physical Therapists & Physical Therapist Assistants

This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2106032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. This activity will provide 6.25 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.

Physical Therapists & Physical Therapist Assistants

This self-study course consists of 6.25 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

Illinois Physical Therapists & Physical Therapist Assistants

PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 6.0 CE credit hours.

New York Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.6 contact hours.

Other Professions

This self-study activity qualifies for 6.25 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Debra Dent, BPT, Dip Manip PT, OCS, FCAMPT Related seminars and products

Debra Dent, BPT, Dip Manip PT, OCS, FCAMPT, has nearly 40 years of experience specializing in manual therapy of the spine. She is a graduate of the University of Manitoba, Canada where she received her Diploma of Physiotherapy and her Bachelor of Physical Therapy. Ms. Dent also received her Advanced Diploma of Manual and Manipulative Physiotherapy and is a Fellow of the Canadian Academy of Manual Therapists (FCAMPT). She is certified as a Part B Manual Physical Therapist from the Canadian Physiotherapy Association and is an Orthopedic Certified Specialist (OCS).

Ms. Dent was an instructor for the Canadian Physiotherapy Association prior to moving to the U.S. She has been a guest clinical instructor at the University of South Florida, teaching the Spinal Manual Therapy Program for the MScPT undergraduate program and has taught a large number of manual therapy courses in the U.S. and Canada.

Ms. Dent is the owner of Cross Border Seminars and presently works as a consultant and contract PT in Palm Harbor, Florida. Her primary case load is rheumatology/fibromyalgia patients and she works with a multitude of related dysfunctions, as well as aging and osteoporosis.

Speaker Disclosures:

Financial: Debra Dent is the owner of Cross Border Seminars. She receives a speaking honorarium from PESI, Inc.

Non-financial: Debra Dent has no relevant non-financial relationship to disclose.


Additional Info

Access for Self-Study (Non-Interactive) Access never expires for this product.

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  1. Analyze clinical implications for various patient populations.
  2. Characterize the function of the diaphragm as it relates to posture, muscular relations, and stability of the spine.
  3. Evaluate musculoskeletal issues in respiratory dysfunction.
  4. Categorize sympathetic vs. parasympathetic responses in neuromuscular control.
  5. Articulate pathologies related to less than optimal respiratory function.
  6. Choose effective techniques to alter respiratory patterns and trunk core stability.
  7. Individualize education for patients with breathing pattern disorders. 


Clinical Observations & Implications
  • Evidence-based practice and clinical observation
  • Clinical implications for patient populations
    • Chronic low back and SI joint pain
    • Scoliosis and trunk weakness in the elderly
    • Chronic hip and lateral knee pain
    • Chronic cervical pain and headaches
    • Shoulder impingement
    • Thoracic outlet syndrome
    • Fibromyalgia
    • Balance and gait deviations
    • Athletic performance
  • Case histories — Could this be your patient?
    • Chronic pain
    • Marathon runner/triathlete
    • Chronic low back and neck pain
  • Respiratory and thoracic anatomy/biomechanics
    • Thoracic anatomy
    • Rib anatomy
    • Thoracic biomechanics
    • CT junction biomechanics
    • TL junction biomechanics
      • Trunk musculature
        • Core-inner group
        • Outer group
        • Posterior oblique
        • Deep longitudinal
        • Anterior
        • Lateral
        • Psoas/hamstring integration
        • Scalenes, SCM, C spine muscles
      • Muscles of inspiration
      • Muscles of expiration
    • Mechanics of respiration
      • Normal breathing-mechanical effects
    • Physiology of respiration
      • Lung volumes
      • Lung perfusion
      • Hyperventilation/alkalosis
  • Fascial integration
    • Thorocolumbar fascia
    • Lateral femoral fascia/IT band
    • Abdominal fascia
    • Cervical/UE and Pelvis/LE biomechanical relationships
Neuromuscular Control
  • Central nervous system on muscle tone and movement
  • Sympathetic and parasympathetic responses
Lab Demonstration
  • Evaluation and treatment techniques
  • Evaluation of posture as it relates to respiratory function, UE, pelvis and lumbar function
  • Mechanics of respiration
  • Diaphragmatic, lateral costal, sternal, apical breathing
  • Diaphragm position
  • Seated arm raise
  • Seated trunk rotation
  • Standing torque
  • Muscle function testing
    • Supine active SLR
    • Prone active SLR and active arm raise
      • TA, multifidus, and pelvic floor function
      • Posterior oblique system
      • Anterior oblique system
      • Lateral system
  • Rib position and mobility testing and active mobilizations
  • Length testing and lengthening techniques
  • Core facilitation entry training program
  • Case histories evaluations, treatments, and outcomes
Theory & Evidence-Based Practice
  • Suboptimal breathing patterns
    • Over-inflation
    • Upper chest breathing
  • Diaphragm and thoracic restrictions effects on the lumbar spine/hips/LE, C spine and UE- trunk rotation, or lack of trunk rotation effects
    • Posture and flawed load transference
    • Trunk stability and the diaphragm/core/incontinence
    • Hypertonicity/over activation of the superficial trunk muscle
    • Chronic low back and SI joint pain with poor control
    • Scoliosis and trunk weakness in the elderly
    • Chronic hip and lateral knee pain
    • Chronic cervical pain and headaches
    • Shoulder impingement issues
    • Thoracic outlet syndrome
    • Fibromyalgia
    • Balance and gait deviations
    • Athletic performance
  • Respiratory alkalosis/hyperventilation and the consequences
  • Chronic fatigue, fibromyalgia, chronic pain

Target Audience

  • Physical Therapists
  • Physical Therapist Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Athletic Trainers
  • Licensed Massage Therapists


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