Segmental Facilitation

1
Segmental Facilitation

• The concept of segmental facilitation was
  formulated and researched originally by Denslow
  Korr at the osteopathic college in Kirksville MO.
• Original observation was based on palpatory data
• these dysfunctional (lesioned) segments were
  palpable

2
Segmental Facilitation

• Normal vertebrae
• When pressure was applied to the spinous
  processes, up to 7 Kg of pressure would elicit a
  minimal response in the adjacent paraspinal
  muscles
• Abnormal vertebrae
• Much lower pressure (1-3 Kg) would elicit an
  exaggerated response in the adjacent paraspinal
  muscles

3
Segmental facilitation

• In addition exaggerated responses in the adjacent
  paraspinal muscles to the lesioned segment could
  be observed when decreased pressure was applied
  to normal spinous processes at levels above or
  below the lesioned segment without that level
  responding. (key finding)

4
Segmental facilitation

• Lesioned segments shows both exaggerated ventral
  horn activity, but also intermediolateral horn
  activity, which is the site of preganglionic SNS
  neurons. (C8-L3)
• Additional studies confirmed the presence of
  sympathicotonia (hyperactivity of the SNS) at the
  level of the segmental facilitation
• decreases galvanic skin resistance associated
  with increased sweat gland activity

5
Segmental facilitation-end points

• Red reaction (SNS)
• Galvanic skin resistance (SNS)
• Sweat gland activity (SNS)
• EMG (skeletal muscle)

6
Segmental facilitation

• Clinical significance
• The facilitated segment acts as a focusing lens
  and bombards its targets with an exaggerated
  neural traffic.
• This increased neural segment outflow can result
  from any increased cord traffic either afferent
  or efferent
• results in increased local muscle spasm and
  hyperactive SNS activity
• Long term effects may result in premature
  dysfunction of tissues or organs as the tissue
  tries to override the effects of increased SNS
  activity