{"id":11791,"date":"2025-01-20T22:54:21","date_gmt":"2025-01-20T22:54:21","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/assessment-and-treatment-of-the-thoracic-spine-fr\/"},"modified":"2025-01-21T04:06:15","modified_gmt":"2025-01-21T04:06:15","slug":"assessment-and-treatment-of-the-thoracic-spine-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/assessment-and-treatment-of-the-thoracic-spine-fr\/","title":{"rendered":"\u00c9valuation et traitement du rachis thoracique"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"><b>R\u00e9dactrice originale <\/b>&#8211; <a title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\">Jess Bell<\/a> d\u2019apr\u00e8s le cours de <a class=\"external text\" href=\"https:\/\/members.physio-pedia.com\/course_tutor\/tanya-bell-jenje\/\" rel=\"nofollow\">Tanya Bell-Jenje<\/a><br \/>\n<b>Principales collaboratrices <\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell <\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Kim Jackson\" href=\"\/User:Kim_Jackson\"><bdi>Kim Jackson <\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Kirenga Bamurange Liliane\" href=\"\/User:Kirenga_Bamurange_Liliane\"><bdi>Kirenga Bamurange Liliane<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Tarina van der Stockt\" href=\"\/User:Tarina_van_der_Stockt\"><bdi>Tarina van der Stockt <\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Merinda Rodseth\" href=\"\/User:Merinda_Rodseth\"><bdi>Merinda Rodseth <\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Lucinda hampton\" href=\"\/User:Lucinda_hampton\"><bdi>Lucinda Hampton <\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Olajumoke Ogunleye\" href=\"\/User:Olajumoke_Ogunleye\"><bdi>Olajumoke Ogunleye<\/bdi><\/a> et <a class=\"mw-userlink\" title=\"User:Aminat Abolade\" href=\"\/User:Aminat_Abolade\"><bdi>Aminat Abolade<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Subjective_Assessment\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">\u00c9valuation subjective<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Objective_Assessment\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">\u00c9valuation objective<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-3\"><a href=\"#Objective_Testing\"><span class=\"tocnumber\">2.1<\/span> <span class=\"toctext\">Tests objectifs<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-4\"><a href=\"#Active_Thoracic_Movement_Tests\"><span class=\"tocnumber\">2.2<\/span> <span class=\"toctext\">Tests de mouvements actifs thoraciques<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-5\"><a href=\"#Thoracic_Flexion_and_Extension\"><span class=\"tocnumber\">2.2.1<\/span> <span class=\"toctext\">Flexion et extension thoraciques<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-6\"><a href=\"#Thoracic_Rotation\"><span class=\"tocnumber\">2.2.2<\/span> <span class=\"toctext\">Rotations thoraciques<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-7\"><a href=\"#Thoracic_Side_Bend_\/_Lateral_Shift\"><span class=\"tocnumber\">2.2.3<\/span> <span class=\"toctext\">Flexions lat\u00e9rales thoraciques <\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Treatment\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Traitement<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Sleep\"><span class=\"tocnumber\">3.1<\/span> <span class=\"toctext\">Sommeil<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Thoracic_Manipulation\"><span class=\"tocnumber\">3.2<\/span> <span class=\"toctext\">Manipulation thoracique<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Postural_Correction_and_Motor_Control\"><span class=\"tocnumber\">3.3<\/span> <span class=\"toctext\">Correction posturale et contr\u00f4le moteur<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-12\"><a href=\"#Iliocostalis_Release\"><span class=\"tocnumber\">3.4<\/span> <span class=\"toctext\">Rel\u00e2chement du muscle iliocostal<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-13\"><a href=\"#Posterior-Anterior_Glides\"><span class=\"tocnumber\">3.5<\/span> <span class=\"toctext\">Glissements post\u00e9ro-ant\u00e9rieurs<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-14\"><a href=\"#Exercise_Therapy\"><span class=\"tocnumber\">3.6<\/span> <span class=\"toctext\">Exercices th\u00e9rapeutiques<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-15\"><a href=\"#Types_of_Exercises\"><span class=\"tocnumber\">3.6.1<\/span> <span class=\"toctext\">Types d&rsquo;exercices<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-16\"><a href=\"#A_Lot_is_Unknown\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">On ignore beaucoup de choses<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-17\"><a href=\"#Summary\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">R\u00e9sum\u00e9<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-18\"><a href=\"#References\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"Subjective_Assessment\" class=\"mw-headline\">\u00c9valuation subjective <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Subjective Assessment\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=1\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Subjective Assessment\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=1\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>De plus amples informations sur l&rsquo;\u00e9valuation du rachis thoracique sont disponibles <a title=\"Thoracic Examination\" href=\"\/Thoracic_Examination\">ici<\/a>, mais les questions sp\u00e9cifiques \u00e0 aborder lors de l&rsquo;\u00e9valuation subjective comprennent : <sup id=\"cite_ref-:0_1-0\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Comment le probl\u00e8me a-t-il commenc\u00e9 ? Depuis combien de temps ce probl\u00e8me est-il pr\u00e9sent ?<\/li>\n<li>Comment la douleur a-t-elle \u00e9volu\u00e9 dans le temps ?<\/li>\n<li>Y a-t-il des ant\u00e9c\u00e9dents de surmenage ou de traumatisme ?<\/li>\n<li>Le patient souffre-t-il de douleurs en respirant ? Et si oui, dans quelle phase de la respiration survient-elle ?<\/li>\n<li>Quel est l&rsquo;effet de la toux et\/ou des \u00e9ternuements ?<\/li>\n<li>Le patient peut-il se coucher sur le c\u00f4t\u00e9 affect\u00e9 la nuit ?<\/li>\n<li>Comment la douleur se manifeste-t-elle et quel est le degr\u00e9 d&rsquo;irritabilit\u00e9 ?\n<ul>\n<li>Y a-t-il une raideur pendant une p\u00e9riode prolong\u00e9e le matin ?<\/li>\n<li>Y a-t-il \u00e9galement des ant\u00e9c\u00e9dents d&rsquo;enth\u00e9sopathies ?\n<ul>\n<li>NB : les enth\u00e9sopathies sont des affections qui affectent les enth\u00e8ses (c&rsquo;est-\u00e0-dire, les sites d&rsquo;insertion osseuse des <a title=\"Tendon Anatomy\" href=\"\/Tendon_Anatomy\">tendons<\/a>et des <a title=\"Ligaments\" href=\"\/Ligament\">ligaments<\/a>) <sup id=\"cite_ref-2\" class=\"reference\"><a href=\"#cite_note-2\">(2)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<li>Ces ant\u00e9c\u00e9dents pourraient indiquer que le patient souffre d&rsquo;une <a title=\"Comorbidit\u00e9s et manifestations extra-articulaires de la spondylarthropathie\" href=\"\/Co-morbidities_and_Extra-articular_Manifestations_of_Spondyloarthropathy\">spondylarthropathie <\/a> s\u00e9ron\u00e9gative. <sup id=\"cite_ref-:0_1-1\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1) <\/a><\/sup><sup id=\"cite_ref-3\" class=\"reference\"><a href=\"#cite_note-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<li>Quelles sont les d\u00e9ficiences fonctionnelles du patient ?\n<ul>\n<li>Il faut prendre en compte les <a title=\"Activities of Daily Living\" href=\"\/Activities_of_Daily_Living\">activit\u00e9s de la vie quotidienne<\/a> et sportives du patient.<\/li>\n<\/ul>\n<\/li>\n<li>Quels sont les ant\u00e9c\u00e9dents m\u00e9dicaux du patient ?\n<ul>\n<li>Il est essentiel de bien comprendre ces ant\u00e9c\u00e9dents, car un certain nombre d&rsquo;affections peuvent <a title=\"Clinical Reasoning and Pathologies of the Thoracic Spine\" href=\"\/Clinical_Reasoning_and_Pathologies_of_the_Thoracic_Spine\">se pr\u00e9senter<\/a> sous la forme de douleurs musculosquelettiques thoraciques.<\/li>\n<\/ul>\n<\/li>\n<li>Y a-t-il des facteurs psychosociaux qui contribuent \u00e0 la douleur ?<\/li>\n<li>Y a-t-il des <a title=\"Une introduction aux drapeaux rouges pour les pathologies graves\" href=\"\/An_Introduction_to_Red_Flags_in_Serious_Pathology\">signaux d&rsquo;alerte (\u00ab\u00a0red flags\u00a0\u00bb) <\/a>? <sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup><\/li>\n<\/ul>\n<p>Les informations subjectives peuvent donner des indications assez pr\u00e9cises sur la cause potentielle de la douleur (c&rsquo;est-\u00e0-dire <a title=\"Inflammation Acute and Chronic\" href=\"\/Inflammation_Acute_and_Chronic\">inflammatoire<\/a>, m\u00e9canique ou non m\u00e9canique) : <sup id=\"cite_ref-:0_1-2\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>La douleur des racines nerveuses et la <a title=\"Facet Joints\" href=\"\/Facet_Joints\">douleur facettaire <\/a> peuvent \u00eatre d\u00e9crites comme lancinantes\/naus\u00e9euses. Elle peut irradier et suivre l&rsquo;angle de la c\u00f4te.<\/li>\n<li>La <a title=\"Costochondritis\" href=\"\/Costochondritis\">costochondrite <\/a> est g\u00e9n\u00e9ralement d\u00e9crite comme une douleur profonde, t\u00e9r\u00e9brante et sourde au niveau de la paroi thoracique, qui peut irradier (souvent vers l&rsquo;arri\u00e8re ou vers le cou).<\/li>\n<li>La <a title=\"Rib Fracture\" href=\"\/Rib_Fracture\">fracture des c\u00f4tes<\/a> et l&rsquo;<a title=\"Intercostal Muscle Strain\" href=\"\/Intercostal_Muscle_Strain\">\u00e9longation intercostale<\/a> sont g\u00e9n\u00e9ralement d\u00e9crites comme une douleur soudaine, vive et per\u00e7ante, qui est aggrav\u00e9e par le rire, les \u00e9ternuements, la toux, les respirations profondes ou tout type d&rsquo;effort ou d&rsquo;\u00e9tirement.<\/li>\n<li>Une douleur constante et de type \u00ab br\u00fblure \u00bb peut \u00eatre un signe d&rsquo;inflammation.\n<ul>\n<li>Cela peut \u00eatre d\u00fb \u00e0 une <a title=\"Autoimmune Disorders\" href=\"\/Autoimmune_Disorders\">maladie auto-immune<\/a>, \u00e0 une articulation gravement affect\u00e9e ou provenant d&rsquo;une autre structure (par exemple, un ulc\u00e8re duod\u00e9nal peut provoquer une douleur constante et de type \u00ab br\u00fblure \u00bb dans la r\u00e9gion thoracique).<\/li>\n<\/ul>\n<\/li>\n<li>Lorsque les patients sont immobilis\u00e9s, ils ont tendance \u00e0 rapporter des raideurs, des mouvements limit\u00e9s ou une sensation de \u00ab coincement \u00bb.<\/li>\n<\/ul>\n<h2><span id=\"Objective_Assessment\" class=\"mw-headline\">\u00c9valuation objective <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Objective Assessment\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=2\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Objective Assessment\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=2\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;\u00e9valuation objective est fond\u00e9e sur les r\u00e9sultats de l&rsquo;\u00e9valuation subjective. \u00c0 retenir : <sup id=\"cite_ref-:0_1-3\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Il est essentiel de comprendre quelles structures sont sollicit\u00e9es lors de chaque test.<\/li>\n<li>Il faut limiter les tests autant que possible.\n<ul>\n<li>\u00ab\u00a0Moins, c&rsquo;est mieux\u00a0\u00bb pour \u00e9viter d&rsquo;irriter le patient.<\/li>\n<li>On peut envisager des combinaisons de tests.<\/li>\n<\/ul>\n<\/li>\n<li>Le meilleur \u00ab test sp\u00e9cial \u00bb est celui que le patient vous d\u00e9montre.<\/li>\n<li>Il ne faut pas oublier le <a title=\"L'anatomie du diaphragme et le diagnostic diff\u00e9rentiel\" href=\"\/Diaphragm_Anatomy_and_Differential_Diagnosis\">diaphragme<\/a> .<\/li>\n<\/ul>\n<h3><span id=\"Objective_Testing\" class=\"mw-headline\">Tests objectifs <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Objective Testing\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=3\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Objective Testing\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=3\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Adapted_Bigstock_Image_-_Spine_Diseases_-_ID_129611492.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/40\/Adapted_Bigstock_Image_-_Spine_Diseases_-_ID_129611492.jpg\/300px-Adapted_Bigstock_Image_-_Spine_Diseases_-_ID_129611492.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/40\/Adapted_Bigstock_Image_-_Spine_Diseases_-_ID_129611492.jpg\/450px-Adapted_Bigstock_Image_-_Spine_Diseases_-_ID_129611492.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/4\/40\/Adapted_Bigstock_Image_-_Spine_Diseases_-_ID_129611492.jpg\/600px-Adapted_Bigstock_Image_-_Spine_Diseases_-_ID_129611492.jpg 2x\" alt=\"\" width=\"300\" height=\"221\" data-file-width=\"1350\" data-file-height=\"996\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 1. Dysfonctions posturales fr\u00e9quentes<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>L&rsquo;\u00e9valuation objective du rachis thoracique devrait comprendre les tests suivants : <sup id=\"cite_ref-:0_1-4\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>\u00c9valuation posturale statique et dynamique :\n<ul>\n<li>Observer la mani\u00e8re dont le patient bouge\/d\u00e9place son poids\/ s&rsquo;incline<\/li>\n<li>Envisager diff\u00e9rents <a title=\"Postural Changes Affecting Voice Production\" href=\"\/Postural_Changes_Affecting_Voice_Production\">types de dysfoncrions posturales <\/a><sup id=\"cite_ref-5\" class=\"reference\"><a href=\"#cite_note-5\">(5)<\/a><\/sup> (voir figure 1)<\/li>\n<li>Le changement <a title=\"Posture\" href=\"\/Posture\">postural<\/a> est-il un probl\u00e8me primaire ou secondaire (par exemple, dysfonctionnement lombopelvien) ?<\/li>\n<\/ul>\n<\/li>\n<li><a title=\"Assessment of Breathing Pattern Disorders\" href=\"\/Assessment_of_Breathing_Pattern_Disorders\">Patron respiratoire<\/a><\/li>\n<\/ul>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Dermatomes_for_Thoracic_Spine_Course.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/9a\/Dermatomes_for_Thoracic_Spine_Course.jpg\/300px-Dermatomes_for_Thoracic_Spine_Course.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/9a\/Dermatomes_for_Thoracic_Spine_Course.jpg\/450px-Dermatomes_for_Thoracic_Spine_Course.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/9\/9a\/Dermatomes_for_Thoracic_Spine_Course.jpg\/600px-Dermatomes_for_Thoracic_Spine_Course.jpg 2x\" alt=\"\" width=\"300\" height=\"250\" data-file-width=\"1800\" data-file-height=\"1500\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 2. Dermatomes<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Tests de <a title=\"Range of Motion\" href=\"\/Range_of_Motion\">mobilit\u00e9 articulaire<\/a> \u00e0 partir de la position neutre<\/p>\n<ul>\n<li>Il faut rechercher les restrictions intersegmentaires.<\/li>\n<li>\u00c9valuer le patient de dos<\/li>\n<\/ul>\n<ul>\n<li>Durant le mouvement, palper les anneaux thoraciques et les articulations<\/li>\n<li>Tests de contr\u00f4le moteur et de force\n<ul>\n<li>Position assise<\/li>\n<li>Appui sur les avant-bras<\/li>\n<li>Position \u00e0 quatre pattes<\/li>\n<\/ul>\n<\/li>\n<li><a title=\"Neurodynamic Assessment\" href=\"\/Neurodynamic_Assessment\">Tests neurodynamiques<\/a>\n<ul>\n<li>Tests de tension neurodynamiques des membres sup\u00e9rieurs pour le <a title=\"Raisonnement clinique et pathologies de la colonne vert\u00e9brale thoracique\" href=\"\/Clinical_Reasoning_and_Pathologies_of_the_Thoracic_Spine\">syndrome du d\u00e9fil\u00e9 thoracique<\/a> (voir les vid\u00e9os ci-dessous) <sup id=\"cite_ref-6\" class=\"reference\"><a href=\"#cite_note-6\">(6)<\/a><\/sup> <sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7)<\/a><\/sup> &#8211; NB : ces tests ne sont pas toujours positifs chez les patients souffrant de syndrome du d\u00e9fil\u00e9 thoracique, mais ils doivent \u00eatre \u00e9valu\u00e9s en d\u00e9tail.<sup id=\"cite_ref-:0_1-5\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<li>Neurologique\n<ul>\n<li><a title=\"Dermatomes\" href=\"\/Dermatomes\">Test de dermatomes<\/a> thoraciques (voir figure 2)<\/li>\n<\/ul>\n<\/li>\n<li>Palpation, y compris des clavicules et des premi\u00e8res c\u00f4tes<\/li>\n<\/ul>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/fhsrNKWVh0s?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-8\" class=\"reference\"><a href=\"#cite_note-8\">(8)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/VngRTMhAlGE?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-9\" class=\"reference\"><a href=\"#cite_note-9\">(9)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<h3><span id=\"Active_Thoracic_Movement_Tests\" class=\"mw-headline\">Tests de mouvements actifs thoraciques <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Active Thoracic Movement Tests\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=4\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Active Thoracic Movement Tests\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=4\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Pendant les tests de mouvement actif : <sup id=\"cite_ref-:0_1-6\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>\u00c9valuer le patient en position assise afin d&rsquo;isoler le rachis thoracique (cette position verrouille le rachis lombaire)<\/li>\n<li>\u00c9valuer l&rsquo;asym\u00e9trie des mouvements et toute restriction segmentaire\n<ul>\n<li>Ne pas oublier que le contr\u00f4le moteur est \u00e9galement important dans la r\u00e9gion thoracique, et pas seulement les raideurs.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4><span id=\"Thoracic_Flexion_and_Extension\" class=\"mw-headline\">Flexion et extension thoraciques <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Thoracic Flexion and Extension\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=5\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Thoracic Flexion and Extension\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=5\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Flexion : sentir si les <a title=\"Ribs\" href=\"\/Ribs\">c\u00f4tes<\/a> font une rotation ant\u00e9rieure<\/li>\n<li>Extension : sentir si les c\u00f4tes font une rotation post\u00e9rieure<\/li>\n<li>N.B. L&rsquo;extension est le mouvement le plus limit\u00e9 au rachis thoracique. <sup id=\"cite_ref-10\" class=\"reference\"><a href=\"#cite_note-10\">(10)<\/a><\/sup><\/li>\n<\/ul>\n<h4><span id=\"Thoracic_Rotation\" class=\"mw-headline\">Rotations thoraciques <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Thoracic Rotation\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=6\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Thoracic Rotation\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=6\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Le test des rotations est l&rsquo;un des tests les plus utiles pour le rachis thoracique. Lors des mouvements de rotation, il est possible d&rsquo;identifier : <sup id=\"cite_ref-:0_1-7\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>de la raideur;<\/li>\n<li>des probl\u00e8mes dans la s\u00e9quence des mouvements.<\/li>\n<\/ul>\n<h4><span id=\"Thoracic_Side_Bend_.2F_Lateral_Shift\"><\/span><span id=\"Thoracic_Side_Bend_\/_Lateral_Shift\" class=\"mw-headline\">Flexions lat\u00e9rales thoraciques <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Thoracic Side Bend \/ Lateral Shift\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=7\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Thoracic Side Bend \/ Lateral Shift\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=7\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>\u00c9valuer le patient en l&rsquo;observant de dos &#8211; il n&rsquo;est n\u00e9cessaire d&rsquo;\u00e9valuer le patient par devant que si l&rsquo;on souhaite examiner sp\u00e9cifiquement les c\u00f4tes \u00e0 partir de cette position. Lors de la flexion lat\u00e9rale thoracique, il se produit : <sup id=\"cite_ref-:0_1-8\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>un rapprochement des c\u00f4tes du c\u00f4t\u00e9 ipsilat\u00e9ral;<\/li>\n<li>un \u00e9cartement des c\u00f4tes du c\u00f4t\u00e9 controlat\u00e9ral;<\/li>\n<li>une translation des c\u00f4tes du c\u00f4t\u00e9 controlat\u00e9ral.<\/li>\n<\/ul>\n<h2><span id=\"Treatment\" class=\"mw-headline\">Traitement<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Treatment\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=8\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Treatment\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=8\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span id=\"Sleep\" class=\"mw-headline\">Sommeil<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Sleep\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=9\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Sleep\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=9\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Le <a title=\"Th\u00e9orie, fonction et physiologie du sommeil\" href=\"\/Sleep:_Theory,_Function_and_Physiology\">sommeil<\/a> est l&rsquo;antioxydant le plus puissant. <sup id=\"cite_ref-:0_1-9\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> Il est reconnu qu&rsquo;il existe une relation bidirectionnelle entre la douleur et le sommeil. <sup id=\"cite_ref-11\" class=\"reference\"><a href=\"#cite_note-11\">(11)<\/a><\/sup><\/p>\n<h3><span id=\"Thoracic_Manipulation\" class=\"mw-headline\">Manipulation thoracique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Thoracic Manipulation\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=10\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Thoracic Manipulation\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=10\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>On ne sait pas encore si la manipulation thoracique est efficace ni pourquoi elle l&rsquo;est, mais on a constat\u00e9 qu&rsquo;elle peut diminuer la douleur, am\u00e9liorer la mobilit\u00e9 et renforcer le sentiment de sant\u00e9 du patient.<sup id=\"cite_ref-12\" class=\"reference\"><a href=\"#cite_note-12\">(12)<\/a><\/sup><\/p>\n<ul>\n<li>Cependant, il n&rsquo;existe aucune preuve indiquant qu&rsquo;une manipulation est meilleure qu&rsquo;une autre.<\/li>\n<li>Il n&rsquo;existe aucune preuve que la manipulation thoracique ait un effet \u00e0 long terme. Par cons\u00e9quent, si elle est utilis\u00e9e, elle doit \u00eatre associ\u00e9e \u00e0 des exercices de r\u00e9\u00e9ducation sp\u00e9cifiques.<\/li>\n<li>La position de l&rsquo;articulation, la direction, la v\u00e9locit\u00e9 et la force sont autant de variables \u00e0 prendre en compte. <sup id=\"cite_ref-:0_1-10\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Postural_Correction_and_Motor_Control\" class=\"mw-headline\">Correction posturale et contr\u00f4le moteur <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Postural Correction and Motor Control\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=11\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Postural Correction and Motor Control\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=11\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>La correction de la posture d&rsquo;un patient peut \u00e9galement avoir un impact positif sur sa douleur.<sup id=\"cite_ref-:0_1-11\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Il faut tenir compte du <a title=\"Centre of Gravity\" href=\"\/Centre_of_Gravity\">centre de gravit\u00e9. <\/a><\/li>\n<li>Rechercher des spasmes et hyperactivit\u00e9s musculaires (par exemple, au niveau du muscle <a title=\"Iliocostalis Lumborum\" href=\"\/Iliocostalis_Lumborum\">iliocostal<\/a>).<\/li>\n<\/ul>\n<h3><span id=\"Iliocostalis_Release\" class=\"mw-headline\">Rel\u00e2chement du muscle iliocostal <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Iliocostalis Release\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=12\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Iliocostalis Release\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=12\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Le muscle iliocostal est le plus lat\u00e9ral des muscles \u00e9recteurs du rachis. <sup id=\"cite_ref-13\" class=\"reference\"><a href=\"#cite_note-13\">(13)<\/a><\/sup> Les patients pr\u00e9sentant une cyphose thoracique et une lordose lombaire significatives peuvent pr\u00e9senter une activit\u00e9 accrue du muscle iliocostal. Ce muscle peut \u00eatre rel\u00e2ch\u00e9 sous les 10e et 11e c\u00f4tes.<sup id=\"cite_ref-:0_1-12\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h3><span id=\"Posterior-Anterior_Glides\" class=\"mw-headline\">Glissements post\u00e9ro-ant\u00e9rieurs <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Posterior-Anterior Glides\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=13\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Posterior-Anterior Glides\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=13\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Les patients pr\u00e9sentant une inversion de la courbure thoracique (\u00ab\u00a0lordose thoracique\u00a0\u00bb), une rotation du rachis et\/ou une <a title=\"Thoracic Hyperkyphosis\" href=\"\/Thoracic_Hyperkyphosis\">cyphose accentu\u00e9e<\/a> sont susceptibles de trouver d\u00e9sagr\u00e9able les glissements post\u00e9ro-ant\u00e9rieurs (PA) sur les apophyses \u00e9pineuses, car ils sont fortement nociceptifs. <sup id=\"cite_ref-:0_1-13\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<p>\u00c0 la place, il peut \u00eatre b\u00e9n\u00e9fique d&rsquo;effectuer un glissement PA sur l&rsquo;angle des c\u00f4tes (ce qui entra\u00eene une mobilisation de 13 articulations pour chaque anneau thoracique). Pour les personnes pr\u00e9sentant une inversion de la courbure thoracique, cela entra\u00eene un mouvement ant\u00e9ropost\u00e9rieur (AP) de l&rsquo;apophyse \u00e9pineuse. <sup id=\"cite_ref-:0_1-14\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> Pour les patients pr\u00e9sentant une cyphose accrue, un glissement PA sur l&rsquo;angle costal, avec un glissement AP simultan\u00e9 sur la partie ant\u00e9rieure de l&rsquo;\u00e9paule\/coraco\u00efde, peut \u00eatre efficace. Chez les patients pr\u00e9sentant une hypercyphose, une technique de rotation peut \u00eatre efficace.<sup id=\"cite_ref-:0_1-15\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h3><span id=\"Exercise_Therapy\" class=\"mw-headline\">Exercices th\u00e9rapeutiques <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Exercise Therapy\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=14\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Exercise Therapy\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=14\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Une enqu\u00eate sur les tendances en mati\u00e8re de prise en charge du rachis thoracique au Royaume-Uni a r\u00e9v\u00e9l\u00e9 que les <a title=\"Therapeutic Exercise\" href=\"\/Therapeutic_Exercise\">exercices <\/a> sont largement utilis\u00e9s comme modalit\u00e9 de traitement malgr\u00e9 des preuves limit\u00e9es. <sup id=\"cite_ref-14\" class=\"reference\"><a href=\"#cite_note-14\">(14)<\/a><\/sup> La vitesse, les positions de d\u00e9part, le dosage et la progression de la charge n&rsquo;ont pas \u00e9t\u00e9 \u00e9tudi\u00e9s, mais les exercices qui visent \u00e0 <a title=\"\u00e9tirement;\" href=\"\/Stretching\">\u00e9tirer<\/a>, mobiliser et stabiliser le rachis thoracique peuvent \u00eatre b\u00e9n\u00e9fiques dans la pratique clinique.<sup id=\"cite_ref-:0_1-16\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h4><span id=\"Types_of_Exercises\" class=\"mw-headline\">Types d&rsquo;exercices <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Types of Exercises\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=15\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Types of Exercises\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=15\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Des \u00e9tirements du rachis thoracique sont pr\u00e9sent\u00e9s dans la figure 3. La figure 4 montre des \u00e9tirements qui peuvent sp\u00e9cifiquement traiter une inversion de la courbure thoracique.<\/p>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 787px;\"><a class=\"image\" href=\"\/File:Thorax_exercises_stretch.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e9\/Thorax_exercises_stretch.png\/785px-Thorax_exercises_stretch.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/e\/e9\/Thorax_exercises_stretch.png 1.5x\" alt=\"\" width=\"785\" height=\"456\" data-file-width=\"1132\" data-file-height=\"657\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 3 \u00c9tirements du rachis thoracique (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 787px;\"><a class=\"image\" href=\"\/File:Thoracic_stretch_out_of_inverted_position.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/c0\/Thoracic_stretch_out_of_inverted_position.jpg\/785px-Thoracic_stretch_out_of_inverted_position.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/c\/c0\/Thoracic_stretch_out_of_inverted_position.jpg 1.5x\" alt=\"\" width=\"785\" height=\"155\" data-file-width=\"871\" data-file-height=\"172\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 4. \u00c9tirements thoraciques pour \u00ab\u00a0sortir\u00a0\u00bb d&rsquo;une inversion de la courbure thoracique (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>Les figures 5 et 6 pr\u00e9sentent des exercices de mobilisation du rachis thoracique, tandis que la figure 7 se concentre sp\u00e9cifiquement sur les exercices de rotation du rachis thoracique.<\/p>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 897px;\"><a class=\"image\" href=\"\/File:Thoracic_spine_exercises_-_mobilise.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/42\/Thoracic_spine_exercises_-_mobilise.png\/895px-Thoracic_spine_exercises_-_mobilise.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/4\/42\/Thoracic_spine_exercises_-_mobilise.png 1.5x\" alt=\"\" width=\"895\" height=\"501\" data-file-width=\"1179\" data-file-height=\"660\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 5. Exercices de mobilisation du rachis thoracique (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 827px;\"><a class=\"image\" href=\"\/File:Right_side_flexion_rotation_translation_extension.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/f\/f3\/Right_side_flexion_rotation_translation_extension.jpg\/825px-Right_side_flexion_rotation_translation_extension.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/f\/f3\/Right_side_flexion_rotation_translation_extension.jpg 1.5x\" alt=\"\" width=\"825\" height=\"426\" data-file-width=\"866\" data-file-height=\"447\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 6. Exercices de mobilisation du rachis thoracique &#8211; flexion lat\u00e9rale droite, \u00ab\u00a0shift\u00a0\u00bb lat\u00e9ral droit, rotation droite et extension (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 832px;\"><a class=\"image\" href=\"\/File:Exercises_to_enhance_thoracic_rotation.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a1\/Exercises_to_enhance_thoracic_rotation.jpg\/830px-Exercises_to_enhance_thoracic_rotation.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/a\/a1\/Exercises_to_enhance_thoracic_rotation.jpg 1.5x\" alt=\"\" width=\"830\" height=\"301\" data-file-width=\"868\" data-file-height=\"315\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 7. Exercices de rotation thoracique (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>Des exercices de stabilisation du rachis thoracique sont pr\u00e9sent\u00e9s dans les figures 8, 9 et 10. Au d\u00e9but, il est b\u00e9n\u00e9fique d&rsquo;utiliser des exercices en cha\u00eene cin\u00e9tique ferm\u00e9e (figures 8 et 9) avant de viser \u00e0 augmenter la force dans toute l&rsquo;amplitude (figure 10).<\/p>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 595px;\"><a class=\"image\" href=\"\/File:Thoracic_motor_control.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/f\/fc\/Thoracic_motor_control.jpg\" alt=\"\" width=\"593\" height=\"300\" data-file-width=\"593\" data-file-height=\"300\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 8. Exercices de contr\u00f4le moteur (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 713px;\"><a class=\"image\" href=\"\/File:Thoracic_motor_control_2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e4\/Thoracic_motor_control_2.jpg\/711px-Thoracic_motor_control_2.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/e\/e4\/Thoracic_motor_control_2.jpg 1.5x\" alt=\"\" width=\"711\" height=\"394\" data-file-width=\"891\" data-file-height=\"494\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 9. Exercices de contr\u00f4le moteur (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 736px;\"><a class=\"image\" href=\"\/File:Thorax_exercises_strengthen_through_range2.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/f\/fd\/Thorax_exercises_strengthen_through_range2.png\/734px-Thorax_exercises_strengthen_through_range2.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/f\/fd\/Thorax_exercises_strengthen_through_range2.png\/1101px-Thorax_exercises_strengthen_through_range2.png 1.5x, https:\/\/www.physio-pedia.com\/images\/f\/fd\/Thorax_exercises_strengthen_through_range2.png 2x\" alt=\"\" width=\"734\" height=\"426\" data-file-width=\"1200\" data-file-height=\"697\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figure 10. Exercices de renforcement dans toute l&rsquo;amplitude (Avec l&rsquo;aimable autorisation de Grooviphysiosoftware)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h2><span id=\"A_Lot_is_Unknown\" class=\"mw-headline\">On ignore beaucoup de choses <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: A Lot is Unknown\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=16\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: A Lot is Unknown\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=16\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li>La plupart des \u00ab\u00a0recherches\u00a0\u00bb sont anecdotiques, ou trouv\u00e9es sur les m\u00e9dias sociaux ou sur YouTube.<\/li>\n<li>Des informations provenant d&rsquo;autres r\u00e9gions du rachis ont \u00e9t\u00e9 \u00ab\u00a0transpos\u00e9es\u00a0\u00bb au rachis thoracique.\n<ul>\n<li>Les singularit\u00e9s du rachis thoracique ne sont souvent pas reconnues.<\/li>\n<\/ul>\n<\/li>\n<li>Il existe de nombreux muscles thoraciques profonds dont la contribution au contr\u00f4le moteur thoracique est inconnue, tels que les muscles semi-\u00e9pineux thoraciques et les muscles rotateurs.<\/li>\n<li>On ne sait pas non plus quel est le r\u00f4le du rachis thoracique dans la <a title=\"Proprioception\" href=\"\/Proprioception\">proprioception.<\/a><\/li>\n<\/ul>\n<h2><span id=\"Summary\" class=\"mw-headline\">R\u00e9sum\u00e9<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Summary\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=17\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Summary\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=17\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>\u00c9valuation : <sup id=\"cite_ref-:0_1-17\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Il est b\u00e9n\u00e9fique d&rsquo;utiliser les connaissances anatomiques et biom\u00e9caniques pour \u00e9valuer les habitudes de mouvement inappropri\u00e9es.<\/li>\n<li>Il ne faut pas focaliser sur les petits d\u00e9fauts de mouvement.<\/li>\n<\/ul>\n<p>Prise en charge : <sup id=\"cite_ref-:0_1-18\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Il peut \u00eatre utile d&rsquo;utiliser des techniques manuelles sp\u00e9cifiques pour mobiliser les zones dont la mobilit\u00e9 est restreinte, mais cela n&rsquo;entra\u00eenera pas de changements globaux.<\/li>\n<li>Les ajustements posturaux peuvent toutefois \u00eatre utilis\u00e9s pour modifier les syst\u00e8mes et apporter des changements globaux.<\/li>\n<li>La rotation thoracique est indispensable au mouvement, au sport et \u00e0 la performance.\n<ul>\n<li>Employer des exercices qui favorisent la rotation, la stabilit\u00e9 (contr\u00f4le moteur) et la force.<\/li>\n<\/ul>\n<\/li>\n<li>Les exercices th\u00e9rapeutiques devraient \u00eatre utilis\u00e9s en combinaison avec la th\u00e9rapie manuelle pour obtenir un r\u00e9sultat optimal.<\/li>\n<li>La prise en charge ne doit pas se limiter au traitement de la raideur thoracique &#8211; il pourrait \u00eatre plus important de s&rsquo;int\u00e9resser au contr\u00f4le moteur thoracique et \u00e0 la stabilit\u00e9 segmentaire.<\/li>\n<\/ul>\n<h2><span id=\"References\" class=\"mw-headline\">R\u00e9f\u00e9rences<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;veaction=edit&amp;section=18\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Assessment_and_Treatment_of_the_Thoracic_Spine&amp;action=edit&amp;section=18\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:0-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_1-0\">1.00<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-1\">1.01<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-2\">1.02<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-3\">1.03<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-4\">1.04<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-5\">1.05<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-6\">1.06<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-7\">1.07<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-8\">1.08<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-9\">1.09<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-10\">1.10<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-11\">1.11<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-12\">1.12<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-13\">1.13<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-14\">1.14<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-15\">1.15<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-16\">1.16<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-17\">1.17<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-18\">1.18<\/a><\/sup><\/span> <span class=\"reference-text\">Bell-Jenje T. Assessment and Treatment of the Thoracic Spine Course. Plus , 2021.<\/span><\/li>\n<li id=\"cite_note-2\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-2\">\u2191<\/a><\/span> <span class=\"reference-text\">Alvarez A, Tiu TK. Enthesopathies. (Updated 2021 Jul 18). In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559030\/<\/span><\/li>\n<li id=\"cite_note-3\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-3\">\u2191<\/a><\/span> <span class=\"reference-text\">Martey C. Co-morbidities within Spondyloarthritis Course. 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Musculoskelet Sci Pract. 2019;39:58-66. <\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20240310075533 Cache expiry: 0 Reduced expiry: true Complications: (show\u2010toc) CPU time usage: 0.097 seconds Real time usage: 0.101 seconds Preprocessor visited node count: 376\/1000000 Post\u2010expand include size: 126\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/100 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 4487\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 12.108 1 Special:Contributors\/Assessment_and_Treatment_of_the_Thoracic_Spine 100.00% 12.108 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>R\u00e9dactrice originale &#8211; Jess Bell d\u2019apr\u00e8s le cours de Tanya Bell-Jenje Principales collaboratrices &#8211; Jess Bell , Kim Jackson , Kirenga Bamurange Liliane, Tarina van der Stockt , Merinda Rodseth , Lucinda Hampton , Olajumoke Ogunleye et Aminat Abolade Contenu 1 \u00c9valuation subjective 2 \u00c9valuation objective 2.1 Tests objectifs 2.2 Tests de mouvements actifs thoraciques [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-11791","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/11791","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/comments?post=11791"}],"version-history":[{"count":1,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/11791\/revisions"}],"predecessor-version":[{"id":11792,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/11791\/revisions\/11792"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=11791"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}