Overview of the Core

• Evidence of function and clinical significance
• Definitions and myths

Core Function in Multiplanar Activity

• Region: Superior, inferior, central
• Anatomy & physiology of stabilizers vs. mobilizers

Evolution of Contraction for Core/Spine Stabilization

• I-IIA-IIX-IIB - muscle contraction slow twitch to fast twitch
• Stability vs. mobility of the brain in the geriatric client
• Contract-Relax-Antagonist-Contract principle (CRAC)
• Sherrington’s Law: Are we emphasizing poor patterns during treatment?

Core Strength Evaluation

• Trunk Impairment Scale (TIS): core stability and mobility control
• Bent Knee Fall Out (BKFO)
• Side-lying SLR
• 3-Plane Core Test

Evidence-Based Strategies for Stability

• Supine core stability
  • Abdominal Ball Press Lab:
  • Anterior abdominal wall re-education
  • Application: low back pain
  • Trochanter Tension Lab:
  • Supine techniques to contract gluteus medius/minimums, TFL, and QL
  • Application: single leg standing balance for mobility and transfers
• Seated core stability
  • Dolphin Lab:
  • Core dissemination during frontal plane mobility
  • Application: lateral mobility: bed mobility, toileting, functional reach
  • Stable Ball Drop Lab:
  • Stabilizing the anterior and posterior abdominal walls
  • Application: low back pain and fall risk
• Standing core stability
  • Wall Plank Lab:
  • Application: low back pain, LOB, fall risk
  • PNF Chop Lab:
  • PNF functional reaching diagonal patterns
  • Application: high to low reaching during functional tasks

Evidence-Based Strategies for Mobility

• Supine core mobility
  • ASIS Press, Scapular Elevation Lab:
  • Mobilization of the pelvis to reduce soft tissue tightness
  • Application: sagittal plane movement of the upper body over the core
• Seated core mobility
  • Quad Sit-up Lab:
  • Sit-stand utilizing lower extremity emphasis
  • Application: low back pain, sit-stand/transfers
  • Mobile Drop Lab:
  • Core rotation and reaching in all planes with various weighted objects
  • Application: functional reach for ADLs
• Standing core mobility
  • Standing ASIS, Dynamic Chop Lab:
  • Tactile cues for pelvic extension during sit-stand
  • Application: COG over BOS during upright tasks with reduced energy expenditure
     

Foundational Anatomy and Core Concepts

• Anatomy of the ‘Inner Core’ and ‘Outer Core”
• Introduce theories of how the core muscles function

How and Why does our Core Become Dysfunctional

• The Biopsychosocial model of care
• Factors that contribute to a dysfunctional (or inactive?) core
• Common patterns in someone with a dysfunctional core
• The brain and body connection: Body mapping via the homunculus
• The upper and lower cross patterns of dysfunction
• Injuries associated with upper cross and lower cross dysfunction

Assessing Core Muscle Function

• Old models of assessment
• New models of assessment: three planes of motion and movement screens

Progressively Train the Core: Strategies and Tips

• Stage 1: Core muscle facilitation: Supine
• Stage 2: Core function: All 4’s
• Stage 3: Core function: High kneeling
• Stage 4: Core function: ½ Kneeling
• Stage 5: Core function: Standing
• Stage 6: Core function: Standing sport specific

Injuries Associated with Dysfunctional Core & Corrective Strategies

• Low back pain
• Poor posture
• Snapping hip
• Urinary leakage (urge incontinence)

Integrated Techniques for Improving Function

• Manual therapy
• Kinesiology tape
• Floss bands
• Vibration tools

FAQ & Case Studies
 

Evaluating the Role of the Diaphragm:

• Why does core matter? 
• Diaphragm: core anatomy and 3 functions
• Respiration: basic description & mechanics
• Postural Stabilization: basic description & mechanics
• Concurrent respiration and postural function
• Consequences of poor core activation

Assessment Techniques to Quicky Identify Ideal vs Compensatory Patterns

• Picking up on subtle compensatory strategies
• Common areas where we tend to see insufficiency
• Respiration: 3 levels (lower ribs, waist, and lower abdomen)
• Common compensatory strategies with respiration
• Postural stabilization: 3 levels (lower ribs, waist, and lower abdomen)
• Common compensatory strategies with postural stabilization
• Sitting diaphragm assessment (respiration, postural function, concurrent)
• Supine diaphragm assessment (respiration, postural function, concurrent)
• Variations in higher positions

Diaphragm Training: Impact on Performance and Movement

• Where to start
• Factors influencing outcomes 
• Training 3 functions in sitting 
• Training 3 functions in supine
• Specific positions to target common key areas of insufficiency
• Typical compensatory strategies: what to look for and how to recognize

Integrate New Breathing and Core Patterns into Functional Movements and ADLs

• Strategies and tools to facilitate re-education
• Potential limiting/contributing factors to consider
• Progression strategies/considerations
• Key factors to watch for as load or challenge is increased