Expanding Panjabi’s stability model to express movement: A theoretical model

Abstract

Novel theoretical models of movement have historically inspired the creation of new methods for the application of human movement. The landmark theoretical model of spinal stability by Panjabi in 1992 led to the creation of an exercise approach to spinal stability. This approach however was later challenged, most significantly due to a lack of favourable clinical effect. The concepts explored in this paper address and consider the deficiencies of Panjabi's model then propose an evolution and expansion from a special model of stability to a general one of movement. It is proposed that two body-wide symbiotic elements are present within all movement systems, stability and mobility. The justification for this is derived from the observable clinical environment. It is clinically recognised that these two elements are present and identifiable throughout the body in different joints and muscles, and the neural conduction system. In order to generalise the Panjabi model of stability to include and illustrate movement, a matching parallel mobility system with the same subsystems was conceptually created. In this expanded theoretical model, the new mobility system is placed beside the existing stability system and subsystems. The ability of both stability and mobility systems to work in harmony will subsequently determine the quality of movement. Conversely, malfunction of either system, or their subsystems, will deleteriously affect all other subsystems and consequently overall movement quality. For this reason, in the rehabilitation exercise environment, focus should be placed on the simultaneous involvement of both the stability and mobility systems. It is suggested that the individual's relevant functional harmonious movements should be challenged at the highest possible level without pain or discomfort. It is anticipated that this conceptual expansion of the theoretical model of stability to one with the symbiotic inclusion of mobility, will provide new understandings on human movement. The use of this model may provide a universal system for body movement analysis and understanding musculoskeletal disorders. In turn, this may lead to a simple categorisation system alluding to the functional face-value of a wide range of commonly used passive, active or combined musculoskeletal interventions. Further research is required to investigate the mechanisms that enable or interfere with harmonious body movements. Such work may then potentially lead to new and evolved evidence based interventions.

Evaluation of early musculoskeletal disease in patients with haemophilia

“…1). In addition to structural components of the joint, the model also focusses on functional components as both are essential for optimal joint health [8–10,51]. In patients with haemophilia, joint function is affected by biomechanical factors including a passive component (e.g.…”

Effects of Fourteen-Day Bed Rest on Trunk Stabilizing Functions in Aging Adults

“…Trunk and spinal stability have been proposed as an important factor for preventing spinal injuries and disease [ 1 , 2 ]. Passive (i.e., skeletal and connective tissue system), active (i.e., muscular system), and neural (i.e., central and peripheral nervous system) systems have been proposed to be fundamental for preserving posture and stabilizing the spine [ 3 ].…”

“…Passive (i.e., skeletal and connective tissue system), active (i.e., muscular system), and neural (i.e., central and peripheral nervous system) systems have been proposed to be fundamental for preserving posture and stabilizing the spine [ 3 ]. Hoffman and Gabel [ 2 ] extended this model arguing that a stable spine is important for effective and injury-free movements of the limbs. For more than twenty years different training intervention strategies have emerged, focusing on improving spinal and trunk stability [ 4 , 5 ].…”

Impact of a Four-Session Physical Therapy Program Emphasizing Manual Therapy and Exercise on the Balance and Prosthetic Walking Ability of People with Lower-Limb Amputation: A Pilot Study

“…43,44 The sequence of specific interventions was guided by the spinal stability model proposed by Panjabi, 45 popularized by Lee,46 and expanded to include movement by Hoffman. 47 Briefly summarized, when passive joint structures either (a) insufficiently stabilize or (b) excessively restrict normal movement, active muscular structures deviate from the normal pelvic stability and hip mobility functions-observed as weakness and dysfunctional movement. 47 For example, a hypomobile hip joint limits hip extension range of motion and inhibits hip extensor muscle activation; thus, lumbar muscles provide compensatory extension at lumbosacral joints-observed as excessive anterior pelvic tilt and lumbar lordosis typical in dysfunctional prosthetic gait.…”