For working muscles, effects and uses, see starting position.

(N.B. - Careful correction each time. First correct the position of the lumbar spine, then of the shoulders, and finally of the head.)

B. Exercises with principally concentric work for Extensors of Trunk-Back Muscles.

All these movements are performed by the patient from stoop position, first extending the hip joints so that the pelvis is raised, and afterwards the spinal column vertebra by vertebra, beginning with the lowest lumbar vertebra.

Working muscles, effects and uses arc principally the same as in the preceding group of movements, but the various parts of the extensors of the back and the innervation to them are more especially exercised, as also the mobility in the joints of the spinal column.

Stoop-stride-sittinG Back-raising with head support (Fig. 1)9). - The gymnast stands at the side of the patient and puts one hand on his neck, the other between the shoulders, and resists, while the patient, in the same way as in the previous exercise, raises himself up, helping himself with his arms by pressing the hands against the thighs. The patient then resists slightly, while the gymnast takes him back to the starting position.

Fig. 99.

N.B. - The movement should be done in time with breathing, inspiration during and immediately after raising, and as deep as possible, expiration while bending forward. The gymnast must watch carefully that there is no deviation from the sagittal plane, or rotation of the trunk during the exercise, also that the lumbar region is not hollowed, but held as straight as possible.

It is used for weak patients and for beginners, because the movement is facilitated by the help of the arms. (N.B. - The neck muscles also take part in the exercise.)

Wing-Stoop-Stride-Sitting Back-Raising (Fig. 100). - The gymnast stands in front of the patient and lays his hands on the upper part of the back so that the finger-tips lie near the spinous processes just above the angle of the scapulae. The movement is performed like the preceding, but the gymnast gives the patient a firm support in the back with the finger-tips during the deep part of inspiration following the raising and backward-carrying of the shoulders.

It is used perhaps more than any of the back-raisings because it is comfortable both for the patient and the gymnast, can be easily regulated if necessary, and does not require any special apparatus.

Wing-Stoop-Stride-Sitting Back-Raising With Stroking (Fig. 101)

Two gymnasts, one on each side of the patient, lay their outer hands in front of his shoulders; the inner hands between the shoulders, one over the other. The movement takes place in the same way as the preceding, but when the patient has raised the trunk the gymnasts press back his shoulders so that an expansion of the chest is produced, while the posterior hands stroke firmly down the back.

Fig. 100.

Fig. 101.

Used especially when the chest is narrow and contracted. Stretch-stoop-stride-sitting Back-raising. - Two gymnasts grasp at the wrists and between the shoulders. At the end of the raising a little over-stretching of the arms (upward and backward) with pressure in the back. May also be given with back-stroking.

Effects And Uses

Like the preceding, but the movement is more tiring.

Wing-Stoop-Leg-Lean-Standing Back-Raising

Similar to Wing-stoop-stride-sitting Back-raising.

Reach-grasp-stoop-leg -lean-standing Back-raising (Fig. 102). - The gymnast sits in front of the patient. They grasp each other's hands or wrists, after which the movement is performed in the same way as the preceding. It must be specially noticed, however, that the patient does not contract or bend the arms, and that after every raising he carries the shoulders back, making a deep inspiration.

The value of the movement is that the gymnast can give very strong resistance by pressing one foot against the boom. Used especially for strong patients.

Reach-Grasp-Stoop-Stride-Sitting Back-Raising In Different Planes

The gymnast stands in front of the patient. Grasp as in the preceding exercise. Raising takes place first in the sagittal plane, then from the right-, and then from the left-turn-stoop-stride-sitting position, and finally again in the sagittal plane, two or three times in each direction. In raising from turn-stoop position the gymnast places one foot against the patient's foot to give support. Effects and Uses. - In raising from the various turn-stoop positions the muscles on the opposite side of the back work more strongly than those on the other side. The movement therefore produces a stronger and more all round exercise for the back muscles and the joints of the spinal column than the other back raisings. Also the different parts of the chest are more strongly compressed or expanded during the various stages of the exercise, so that a more complete ventilation of the lungs is produced.

Fig. 102.

It is used on this account especially in the treatment of patients with deformity of the trunk, such as hunchback, severe scoliosis. etc., and in after-treatment of pleurisy and other diseases of the respiratory organs.

To this group also belong all Neck-raisings. They have been described above.

Among back exercises may also be reckoned those movements and positions in which the back shoulder muscles work, e.g., Plane-arm-carrying, Neck-firm position, etc. They have already been described, partly as arm exercises, partly in the "Positions derived from Standing by altering the position of the arms."