After trauma to the low back, a decrease in intervertebral joint stiffness can occur, which can lead to inability of the motor-control system to compensate for the tasks imposed on the tissues, resulting in spinal instability. Intervertebral joint stiffness can be thought of as a tightening of a corset around a spine segment, facilitated through coactivation of small and large spinal muscles. The motor-control system might be able to adapt initially with cocontractions of the intrinsic muscles, but an unbalanced demand between the small and large muscles can lead to muscle fatigue and poor task performance. The inability of the intrinsic spinal muscles to provide adequate stability might also be the result of improper motor-control skills and damage to the same tissues repeatedly. Activities-of-daily-living (ADL) instruction is a tool clinicians can use to train or retrain patient motor-control skills, thereby increasing spinal stability and reducing direct demand on injured tissues.
Speicher, T, RD Martin, and RM DeSimone. "Functional Rehabilitation. Managing Low Back Pain Through Activities-Of-Daily-Living Education." Athletic Therapy Today 11.6 (2006): 74-77.
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