Cervical Spine Exam & Intervention part 3 Flashcards
What are some common medical diagnosis’s for patients presenting with neck pain?
- Herniated Disc
- Cervical Radiculopathy
- Stenosis
- Spondylosis
- Whiplash
- Cervicogenic Headaches
- Post- Surgical
What are the basic managing principles?
- Stage of recovery/severity/irritabilty
- Exam findings
- Patients beliefs and goals
- Evidence to support what doing
- Text-tx-retest-tx
What are some interventions PTs can elect to perform?
-Education
-Directional preference
-Hypomobility/Hypermobility
- Pain Control
- Conditioning/increase exercise tolerance
- Reduce headache
- Neuromobilization`
What should be included in patient education?
-Inform patient about their prognosis & your plan to address their problems
-Limitations concerning the stage of healing
- Learn how to manage symptoms independently
-Postural awardness
-Prevention of future episodes
- What is the patient willing to do to get better
What are the mechanical diagnosis & therapy classifications?
- Derangement
- Dysfunction
- Postural Syndrome
What is derangement syndrome?
classification defined by the presence of directional preference with RAPID change in symptoms and associated with the obstruction of a particular joint
What is dysfunction syndrome?
classification associated with symptoms from typical mechanical deformation of structurally impaired soft tissue
What is postural syndrome?
classification associated with no pathophysiological abnormalities but an abnormal stress to the tissue
What is directional preference?
-Responded favorably to repeated movement testing
-Move in direction that reduces symptoms or centralizes peripheral symptoms
-Consider patient generates forces before clinical generates forces
-Exhaust the sagittal plane before moving to coronal plane motions
Explain force progression in terms of directional preference?
-Ideally performed in sitting
-Patient generated forces before clinician generated forces
-Alternate positions include: prone & supine
-Clinician overpressure and non thrust manipulations useful to assist patient with the process
-Repetition vary based on response to movements
-HEP performed every couple of hours or PRN
What are some interventions addressing hypomobility?
-Patient Education
- Thrust and Non-Thrust manipulation to cervical spine
-Soft Tissue mobilization & stretching of restricted connective tissue
-AROM/PROM in to restricted movements
-Postural Education
What are some interventions addressing hyper mobility?
-Patient Education
-Local modalities in acute/irritable conditions
-Stabilization activities (local muscle endurance & motor control/learning)
-Address postural muscle (strength/endurance)
What are some interventions for pain/inflammation control based on the finding at the initial assessment ?
-Local modalities
-Patient education (activity awareness/modification/avoidance)
-Manual Therapy (intermittent gentle cervical traction & grade I, II non thrust manipulations)
-AROM/PROM in pain free range
-Progress towards classification when symptoms are improved
What are the symptoms for a cervicogenic HA?
-Originate from the upper cerivcal spine (OA,AA, & C2-3)
-Symptoms: in sub-occipital region temporal bone, frontal bone & orbital region
-Symptoms change with movement testing
What are some treatments for cervicogenic HA?
-Cervical spine manipulation/mobilization (upper c-spine)
-Strengthening of neck & upper quarter muscles
-Postural education
