1Multifidus produces -
EXTENSION of the lumbar spine (bc it attaches to the SP)
2Multifidus controls...
FLEXION of the lumbar spine
3Multifidus checks....
ANTERIOR shear forces on spine during FLEXION
4Multifidus checks _______ forces of spine during ________
ANTERIOR shear forces on spine during FLEXION
5Multifidus provides...
compressive force to spine to INCREASE STABILITY
6how does the multifidus increase spinal stability???
provides compressive forces to spine
7how does the Multifidus protect the discs????
prevents wobble motion of lumbar vert during torsion and flexion
8Multifidus protects......
the discs!!! prevents wobble motion of lumbar vert during torsion and flexion
9what does contraction of the TrA do???
flattens abdominal wall and compresses the abominal vertebrae
10where does the Tra attach?
to TFL to help stabilize the spine
11what does the TrA limit
intersegmental transitional and rotational forces
12Global or local stabilizers
Rectus abdominis
External oblique
Internal oblique (anterior fibers)
GLOBAL
13global or local stabilizers
Iliocostalis
Quadratus lumborum
Erector Spinae
Global
14global or local stabilizers
multifidus (medial fibers)
Psoas major (posterior fibers)
Transveruss abdominis
Diaphragm
local
15global or local stabilizers
QL (medial Fibers)
IO (posterior fibers)
Iliocastalis and longissimus (lumbar fibers)
interspinales/intertransversi
local
16is the multifidus local or global?
local
17what's the four predictor variables for lumbar traction
1) FABQ <21
2) no neurological deficits
3) >30 years of age
4) non manual work job status
18what is multisegmental flexion assessing
flexion of HIP and SPINE
19normal findings for multisegmental flexion
Touches toes
Posterior weight shift
Uniform spinal curve
Sacral angle is GREATER than 70 degrees
Does not have any excessive effort and/ or lack of symmetry or motor control
20what is multisegmental EXTENSION assessing?
normal extension of SH, HIP and SpIN
21what are the normal findings of multisegmental extension?
UE reaches and maintains 170 degrees of SH flexion
ASIS clears the toes
Spine of the scapula clears the heels
Uniform spine curve
Does not have excessive effort and or lack of symmetry or motor control
22what is the degrees of SH flexion of multisegmental extension?
170
23more common in males or females?
ankylosing spondylitis
Males
24more common in males or females?
spondylosis
males
25more common in males or females?
spondylotlistehesis
females
26more common in males or females?
adolescent disc pathology
females
27what age and gender is most common for spondylolisthesis
females age 15-25
28rate of spontaneous regression
sequestered disc
96%
29rate of spontaneous regression
extruded disc
70%
30rate of spontaneous regression
protruded disc
41%
31rate of spontaneous regression
bulging disc
13%
32what disc has the highest rrate of spontaneous regression
sequestered (91%)
33what disc has the lowest rate of spontaneous regression
bulging disc
34where does L3-L4 disc refer to?
anterior thigh WITHOUT pain in posterior thigh or leg
35pt presents with anterior thigh pain W/o pain in posterior thigh or leg... what disc???
L3-L4 disc
36where does L4-L5 disc refer to?
anterior thigh with or without pain in posterior thigh or leg
37pt presents with anterior thigh pain with (or without) pain into posterior thigh or leg... what disc
L4-L5 disc
38where does L5-S1 disc refer to?
Posterior thigh of leg and NO pain in anterior thigh
39pt presents with posterior thigh pain and no pain in anterior thigh... what disc
L5-S1
40what disc referral is most common?
L4-L5
41what disc referral is least common
L3/L4
42Zygapophyseal Referral Patterns
L1/l2
lumbar spine
43Zygapophyseal Referral Patterns
L2/L3
lumbar spine, greater trochanter
44Zygapophyseal Referral Patterns
L3/L4
greater trochanter, lateral thigh, posterior thigh, groin
45Zygapophyseal Referral Patterns
L4/L5
lumbar spine, greater trochanter, lateral thigh, posterior thigh, groin
46Zygapophyseal Referral Patterns
L5/S1
gluteal, greater trochanter, lateral thigh, posterior thigh, groin
47pt presents with pain in gluteal, greater trochanter, lateral thigh, posterior thigh and groin... what Zygapophyseal Referral Patterns
L5/S1
48pt presents with pain in lumbar spine, greater trochanter, lateral thigh, posterior thigh, groin.... Zygapophyseal Referral Patterns
L4/L5
49Pt presents with pain in greater trochanter, lateral thigh, posterior thigh and groin... what Zygapophyseal Referral Patterns
L3/L4
50pt presents with pain in lumbar spine, greater trochanter... what Zygapophyseal Referral Patterns
L2/3
51pt presents with pain at lumabr spine... what Zygapophyseal Referral Patterns
L1/L2
52what are the 4 functions of lumbar discs?????
absorb/transmit shock forces
maintain flexibility
Stabilizes spine under high load stress
provide 25% of the height of the LS
53what are the 4 functions of lumbar discs?????
absorb/transmit shock forces
maintain flexibility
Stabilizes spine under high load stress
provide 25% of the height of the LS
54which is age related wear and tear???
disc protrusion or disc prolapse????
prolapseeeee
55who found small to moderate pain psychology/ pain neuroscience education (PNE) compared to health behavior PEI for pain severity and pain interference @ 1 mo F/U
kohns
56who found PNE resulted in small additional short term P! benefits and larger short term disability benefits when added to PT interventions
wood
57what is this the definition of: classifications upon change effect LB/LE pain sx in response to direction specific repeated LS motions
MDT
58define MDT
classifications upon change effect LB/LE pain sx in response to direction specific repeated LS motions
59what is this the definition of? classification system using a multidimensional tool
that identifies patients at varying levels of risk for chronic symptomatology
Prognostic Risk Stratification:
60define Prognostic Risk Stratification:
classification system using a multidimensional tool
that identifies patients at varying levels of risk for chronic symptomatology
61what is this the definition of? classification based upon examination findings (subgroups
identified by symptom location and response to lower quarter exam/special tests
pathoanatomic-based
62define pathoanatomic based
classification based upon examination findings (subgroups
identified by symptom location and response to lower quarter exam/special tests
63what is this the definition of: classification based upon impaired trunk
movements and postures (focuses upon movement and alignment
compensations)
Movement System Impairment
64define Movement System Impairment
classification based upon impaired trunk
movements and postures (focuses upon movement and alignment
compensations)
65what is this the definition of : classification uses an integrated behavioral
approach (includes psych, social, lifestyle, overall health, pathoanatomic probable
contributors & barriers to success)
cognitive funcitonal therapy
66define cognitive functional therapy
classification uses an integrated behavioral
approach (includes psych, social, lifestyle, overall health, pathoanatomic probable
contributors & barriers to success)
67What is this the definition of: classification based upon initial treatment approach (manip,
stabilize, specific exercise, traction)
+ treatment based
68define" + treatment based
classification based upon initial treatment approach (manip,
stabilize, specific exercise, traction)
69___% of the population experienced LBP in the prior 3 mo
26.4%
70___% of the population experienced LBP in the prior year
65%
71what is the lifetime prevalence of LBP
between 70-84%
72what is the reoccurrence rate of acute LBP within one year?
66-84%