Professional Day Field Trip Essay

Accelerated Rehabilitation Clinic, the location assigned as my professional fieldtrip, is located on East Huron Street. I observed Ms. Allison Ferguson, the supervising Physical Therapist on staff. Ms. Ferguson's caseload consists of many patients with low back pain. The lack of good core control in these patients leaves them susceptible to injury and pain. This lack of control is especially significant given the weakness of the transversus abdominis. There is a method to aid in strengthening this deep muscle that has recently become popular in the United States.

The Stabilizer is a piece of equipment used to assist in biofeedback. It consists of an air bladder with a pump and gauge to monitor the increase of pressure during core strengthening. The Stabilizer is placed in the lumbar curve of the spine to help identify movement. The patient then performs transversus abdominis contractions and abdominal exercises while the Stabilizer is in place. The air bladder is filled and must be kept at the same level by maintaining a neutral spine. A anterior pelvic tilt will decrease pressure while a posterior pelvic tilt will increase pressure on the biofeedback device.

The transversus abdominis is important because it attaches to the thoracolumbar fascia, and plays a major role in back stabilization. To activate this muscle, you must pull the navel in and down. This muscle can also be activated in a Klegel's exercise. In this exercise, the patient acts as though they are going to urinate and hold the stream. This will work the pelvic floor and transversus abdominis. Many times, this muscle becomes inactive or "shuts down." More advanced exercises recruit the rectus abdominis and obliques in addition to the transversus abdominis.

Learning the technique of utilizing the Stabilizer for biofeedback in conjunction with muscular activation is important. The transversus abdominis is a key core stabilizing muscle that is considered the most important abdominal muscle. Its attachments and depth make it extremely important for patients with low back pain. The transversus abdominis, as well as the other abdominal muscles, aid to increase back support through the opposing muscle group. There have been several different methods to attempt to activate the abdominals properly. Initiating a sequence starting at the deeper layer of abdominals to the most superficial layer of abdominals utilizing visual stimulus is said to be effective, but I have not observed this. However, Ms. Ferguson convinced me that this is indeed an effective tool. This will assist me in succeeding in the Physical Therapy work force, as I will be able to utilize a method that works in strengthening the transversus abdominus.

The experience of learning this new therapeutic exercise raises questions as to whether or not it is an effective and easy-to-use technique. The exercise is able to be progressed and performed based on the advancement of strength. To find further information regarding the effectiveness of the Stabilizer as a product, it would be wise to look for literature on Medline through the Galter Library website.