1CPR: list the 5 predictor variables for acute LBP response to manipulation
1) sx duration less than 16 days
2) sx NOT below knee
3) FABQ work subscale <19 points
4) either hip has more than 35 degrees of int rotation
5) lumbar HYPOmobility
3/5 tests are positive = 68% success
4/5 tests are positive = 95% success
21) sx duration less than 16 days
2) sx NOT below knee
3) FABQ work subscale <19 points
4) either hip has more than 35 degrees of int rotation
5) lumbar HYPOmobility
3/5 tests are positive = 68% success
4/5 tests are positive = 95% success
CPR: list the 5 predictor variables for acute LBP response to manipulation
3CPR: list the 4 things for lumbar stabilization for LBP
1) under 40 years old
2) SLR above 91 degrees
3) ABERRANT movt with FORWARD beninging
4) + prone instability
41) under 40 years old
2) SLR above 91 degrees
3) ABERRANT movt with FORWARD beninging
4) + prone instability
CPR: list the 4 things for lumbar stabilization for LBP
5which outcome measure is the ONLY one to want a HIGHER score????
Medical Outcomes Survey Short-Form-36 (SF-36)
6higher or lower score is better for:
Medical Outcomes Survey Short-Form-36 (SF-36)
HIGHERRRRRRRR
7what is restricted in acute low back pain with mobility deficits
spinal range of motion and segmental mobility
8what is the sx of acute LBP with mobility deficits
reduced with PROVOCATION of involved segments
9what is the interventions of sx of acute LBP with mobility deficits
focused on reducing pain and improving mobility of involved spinal segments
10name the ICF/ICD:
pain that occurs with initial to mid-ranges of active OR passive motion
Acute low back pain with movement coordination impairments
and
acute low back pain with radiating pain,
11what are the intervention strategies for
Acute low back pain with movement coordination impairments and acute low back pain with radiating pain
focused on movements that limit pain or increase the pain-free movement in the mid-ranges
12what ICF/ICD category is high irritability
Acute low back pain with related (referred) lower extremity pain,
13what is the intervention strategy for Acute low back pain with related (referred) lower extremity pain,
focused on CENTRALZING or ABOLISHING the pts sx
14pt presents with
pain taht does NOT follow the initial, mid-range, or end-range movement/ pain relations reflective of tissue stress, inflammation, and irritability
what ICF/ICD category???
acute and subacute low back pain with related cognitive and affective tendencies and chronic low back pain with generalized pain categories
15what is the intervention strategies for: acute and subacute low back pain with related cognitive and affective tendencies and chronic low back pain with generalized pain categories
addressing the relevant cognitive and affective tendencies and pain behaviors with patient education and counseling
16pt has pain that occurs with mid- to end-ranges of active or passive motions,
ICD/ICF
subacute low back pain with radiating pain,
17pt has pain that occurs with sustained end-range movements or positions
ICD/ICF
chronic low back pain with radiating pain,
18what are the intervention strategies for chronic LBP
movt that increase movt tolerances in end ROM
19tight or weak with lower crossed
erector spinae
multifidus
quadratus lumborum
TIGHTTTTT
20tight or weak with lower crossed
latissimus dorsi
iliopsoas
tensor fasciae latae
TIGHT
21tight or weak with lower crossed syndrome
rectus abdominis
external and interal obliques
trnsverse addominis
WEAKKKK
22tight or weak with lower crossed syndrome
glute max, med and min
weakkkkk
23what do we need to strengthen with lower crossed
rectus abdominis
obliquus internus abdominis
obliquus externus abdominis
transversus abdominis
gluteus maximus,
gluteus medius
gluteus minimus
24what do we need to stretch with lower crossed
Erector spinae
Multifidus
quadratus lumborum
latissimus dorsi
iliopsoas
tensor fasciae latae
25CPR for manipulation:
sx duration:
Sx location:
less than 16 days
not below knee
26extension oriented exercises CPR
1) sx distal to buttock
2) centralization w extension
27traction CPR
1) sx distal to buttock
2) peripheralize w extension
3) + crossed SLR
28what exercise for
anterior disc displacement
flexion
29what exercise for
posterior disc displacement
prone lying sequence
30what exercise for
poster laterally displaced
correction of the lateral shift with the EIL with hips off center sequence
31what kind of exercises for stenosis??
exercises that increase lumbar spine support
32CHRONIC IN OLDER ADULTS General Exercise training focus...
Strength/ endurance of UE/ LE/ Trunk and major mm groups
Exercise for flexibility/mobility, aerobic / conditioning exercise
33thrust and non thrust mobs to treat chronic LBP??? yay or nay
yay
34when is LBP stiffness common
AM
35pt has morning stiffness longer than 15 minutes
what is it
inflammation
36pt has morning stiffness that is relieved quick with motion
what is it
mechanical factors more than inflammatory ones
37Dics and DJD are more or less aggravated as the day progresses
MOREEEE
38DJD and Stensosis are irritated with what activity???
extension
39what has afternoon pain as mm that stabilize become fatigued and slip?
instability, ligament injury, and spondylolisthesis
40injured mm are more symptomatic in the _____
afternoon!! bc tis forced to work instead of rest
41pt reports pain moving in bed.... what is it?
disc and stenotic change
42pt reports pain due to static positioning at night... what is it??
spondylolisthesis or instability
43what is nocturnal pain an indicator of??
visceral pathology and cancer (red flags)!!!
44what is two non pharm treatments are STRONGLY recommended???
continue use physical activities
exercises therapy (strength and stability focus over cardio)
45Non pharm treatment strongly recommends which over the other??
cardio or strength/stability
strength/stability!!!!
46Non pharm treatment recommendations - WEAKLY recommended
2 things
progressive mm relaxation
rehab sports/functional training
47what should be OPEN as a nonpharm treatment
Self administered heat, mobilization and manipulation, massage, ergotherapy, "back school", acupuncture
48what is NEGATIVEEEEE as a non pharm treatment
Interferential stim, Kinesiotape, SWD, laser, magnet, medical aids, TENS, traction, cryotherapy, US
49weakly or strongly recommended as a non pharm treatment???
Progressive mm relaxation
weakly
50weakly or strongly recommended as a non pharm treatment???
rehab sports and functional training
weakly
51weakly or strongly recommended as a non pharm treatment???
continue use of physical activities
strongly
52weakly or strongly recommended as a non pharm treatment???
exercise therapy
STRONGLY
strength over cardio!!!1
53list the 7 MQIC things
adults with LBP or back related LE symptoms < 6 weeks
no red flags (90% episodes resolve in 6 weeks with or without treatment)
advise flare up may occur for a year
eval: detailed hx and PE focus of strength, spine percussion, segmental mobility
assess pain and functional capacity
diagnostic tests usually not indicated
screen for depression
54what are the 4 treatment recommendations for MQIC???
stay active, avoid rest
injury prevention (proper body mechanics, sage back exercises)
heat, stretching, manual therapy
spinal stabilization exercise comparable to manual therapy intervention and BETTER then general exercise in terms of reducing pain and improving function
55according to MQIC, what is better in terms of reducing pain and improving function ???
spinal stabilizaition/manual therapy
or
general exercise
spinal stabilizaition/manual therapy
56list the MQIC red flags
unexplained wt loss
fever
sudden bowelladder dysfunction
abnormal spinal or perineal reflexes
hx of cancer
perineal hypoesthesia
57what are the three goals of MDT?
alleviate pain
restore function
prevent recurrent episodes
58what three things is repeated movt testing (MDT)
1) diagnostic
2) prognostic
3) therapeutic
59posture syndrome: end range stress on ______
normal structures
60what is posture syndrome
END RANGE stress on normal structures
61posture syndrome:_____ _____ stress in _______ ______
end range stress on normal structures
62posture syndrome
mechanical deformation due to prolonged stress can what???
eventually produce pain
63what can posture syndrome lead to?
DERANGEMENT!!!!!!!
64we suspect pt has posture syndrome... will repeated exercises change the sx of these patients
NOPEEE
repeated movt do not change sx of patients with posture syndrome
65what is the pt presentation of posture syndrome???
sedentary and feels better with physical activity
66what does derangement syndrome involve
mechanical obstruction (disc protrusion) to movt within the joint
67centralization and peripheralization occur only in what MDT syndrome????
Derrangement!!!!!
68pts with derangement syndrome have a preference for what????
specific movements
69what should we focus on with pts with derangement syndrome
FOCUS on REDUCTION of the DERANGEMENT