Advanced Stability Training

Advanced stability training is started only when the patient has no pain and basically stable back
This are the exercises that will build on training already achieved , using : 1. 2. 3. 4. Body movements alone Using balance board Using stability or physio balls Employing proprioceptive training

Advanced stability training exercises are for the patients or clients whose demands in the workplace or in the sport activities require extraordinary

1. Strength 2. Speed
3. Accuracy of movement

 They should have learned :

To control pelvic tilt To automatically assume neutral position To abdominal hollowing (at 30 to 40% of max effort ) They shuld be able to voluntarily contract the multifidus They should have corrected posture They should have begun correcting muscle imbalance

Very important
For each exercises in ast patient should gently contract their deep abdominals muscles to perform ab hollowing and maintain this contraction throughout the exercise. Begin all exs in neutral position and maintain the same throughout the exercise

Superimposed limb movements

Each of the following exs involves limb movements that are superimposed on basically stable back Once the patient can hold ab hollowing for 10rep of 10sec each ,therapist should add limb movements .

Determining the starting position

An individuals starting position depends on his physical characteristics and abilities But a therapist should be flexible in choosing starting position Generally the program follows a neurodevelopemental approach We will go from : ground support ,to apparatus support , and finally to increasingly complex free exercises

Exercises in crook lying

Heel slide Leg lowering Single bent leg raises Bridging from crook lying Bridge with leg lift

Prone lying
Gluteal brace Prone bent leg lift

Exercises in four point kneeling position

Four point body sway Four point pelvic shift Four point leg flexion/extension Four point kneeling leg lift Four point kneeling arm and leg lift

Exercises in side lying position

side lying knee lift side lying leg rotation side lying leg abducion side lying spine lengthening side lying hip lift side lying body lift

Exercises in standing position

Standing sternal lift Pelvic shift with unloading Pelvic shift leg lift Standing hip abduction Standing hip hinge

Exercises in sitting position

Sitting hamstring stretch Sitting sternal lift Sitting knee raises Sitting knee and arm raise