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Msk Spine > (6) Cervical Spine Treatment > Flashcards

(6) Cervical Spine Treatment Flashcards

1
Q

What are treatment approaches for pain?

A
  • exercise rehab
  • advice & education
  • manual therapy (joint & soft tissue)
  • meds?
  • electrotherapy?
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2
Q

What are the treatment approaches for joint dysfunction?

A
  • exercise rehab
  • manual therapy
  • advice & education
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3
Q

What are the treatment approaches for muscle dysfunction?

A
  • exercise rehab
  • manual therapy
  • advice & education
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4
Q

What are the treatment approaches for neural dysfunction?

A
  • exercise rehab
  • manual therapy
  • advice & education
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5
Q

What are the treatment approaches for cognitive affective behavioural dysfunction?

A
  • ‘Counselling’, education
  • Exercise rehabilitation
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6
Q

What are the main areas of rehab?

A
  • pain
  • muscle
  • joint
  • nerve
  • lifestyle
  • cognitive-affective-behavioural
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7
Q

When would you use manual therapy on the cervical spine?

A
  • Pain (maitland mobs I-II)
  • Joint dysfunction (maitland mobs III-IV)
  • Muscle dysfunction (Therapeutic massage & trigger points)
  • Neural dysfunction (mobs)
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8
Q

What are some contraindications for performing manual therapy on the cervical spine?

A
  • fracture
  • active cancer
  • recent relevant trauma
  • UMNL
  • Worsening neuro condition
  • ligamentous rupture
  • instability
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9
Q

What are some precautions for manual therapy on cervical spine?

A
  • inflammatory disease
  • RA
  • Hx cancer
  • OP
  • infection
  • long term steroid use
  • blood clots
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10
Q

What are Sustained Natural Apophyseal Glides (SNAGs)

A

Therapist applies the appropriate
accessory facet joint glide while the patient performs the symptomatic movement

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11
Q

What is a neural mobilisation test for the cervical spine?

A
  • adverse neural dynamics
  • brachial plexus tension test
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12
Q

What are the principles of neural dynamics for the cervical spine?

A
  • start movements away from site of presumed pathology
  • through range v end range techniques
  • add/subtract load as required
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13
Q

What are the outcomes of manual therapy?

A
  • biomechanical effects supporting increased mobility
  • decreased activation of regions responsible for pain
  • decreased spinal activity via dorsal root ganglion
  • increased production dopamine
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14
Q

What does the evidence say about manipulation & mobilisation?

A
  • low moderate evidence
  • reduce pain and improve function in chronic non specific neck pain
  • multimodal approach has best impact
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15
Q

What should you consider when carrying out exercise rehab?

A
  • SIN
  • Comorbidities
  • Contraindications
  • Warnings
  • Group or individual
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16
Q

What exercise rehab should be used for joint dysfunction (hypomobility)?

A
  • Mobilising (increase ROM)
  • Flex, ext, rotation, lat flex
  • Active / assisted
17
Q

What are some strengthening / activating exercises for the cervical spine?

A
  • isometric resisted
  • Flexion
  • extension
  • lat flexion
  • rotation
18
Q

What are some muscle endurance exercises for the cervical spine?

A
  • contract at 50-70% 1RM for high reps
  • motivation
  • goal-orientated
  • general rule 2-3 times a week
19
Q

What should be focused on for muscle instability in the cervical spine?

A
  • deep neck flexors
  • long cervical extensors
  • co-contraction (multiple groups)
20
Q

What does the evidence say about exercise rehabilitation for cervical spine injuries?

A
  • there is a role for strengthening exercises in the treatment of chronic neck pain, cervicogenic headache and cervical radiculopathy if these exercises are focused on the neck, shoulder and shoulder blade region
  • Minimal effect on neck pain and function when only stretching or endurance are used
21
Q

What should you consider when ‘counselling’ or advising?

A
  • Health literacy
  • Personalised
  • Invite questions
  • Positive but honest
22
Q

What are the key areas of advising or ‘counselling’?

A
  • Guidance based (+ve, remain active etc)
  • Pain management
  • Recording
  • Dysfunction (explain the why, compliance)
23
Q

What is ergonomics and why is it important?

A
  • relationship of the worker and the job
  • focuses on design of work areas or work tasks to improve job performance
24
Q

What lifestyle dysfunction should be addressed as part of advice & education?

A
  • Inactivity
  • ergonomics
  • weight
  • smoking
  • ‘make every contact count’
25
Q

What is the MOA of advice & education?

A
  • alter experience/perception
  • self-efficacy -> behaviour change
  • psychological
  • pain modulation
26
Q

What does the evidence say for advice and education for the cervical spine?

A
  • structured patient education was equal or less effective than other conservative treatments including massage, supervised exercise, and physiotherapy
  • may provide more benefits when combined with physio
27
Q

What are some outcome measures for cervical spine injuries?

A
  • ROM
  • Endurance test
  • Pain scale
  • Function/disability index
  • Psychological attributes (anxiety & depression)

Msk Spine (9 decks)

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