Classification Systems Flashcards
what are the 3 most common treatment classification systems for LBP
McKenzie
Sahrmann’s mvmt impairment based classification
Delitto’s treatment based classification
what treatment classification is best used for acute LBP
McKenzie
what treatment classification is best used for instability and chronic LBP
sahrmann’s mvmt impairment based
what treatment classification is best used for acute to subacute LBP
Delitto’s treatment based
what is the foundation of McKenzie approach
directional preference - centralization and peripheralization
what McKenzie syndrome is this describing?
- caused by over stretching/mechanical deformation of normal tissues from static loading
postural syndrome
what are the effects of repeated mvmt - McKenzie postural syndrome
- pain is not reproduced
- pain is present when stationary but not during testing
what are the 3 syndromes that Mckenzie describes?
postural, dysfunction, and derangement
what McKenzie syndrome is this describing?
- loss of mvmt caused by adaptive shortening of ST provoked by mvmt that deforms the adaptively shortened tissue
dysfunction syndrome
what is the effect of repeated mvmt - McKenzie dysfunction syndrome
- pain at end range
- stops shortly in release of end range
- fixed pain pattern
- slight radiating pain
- no better or worse after testing
what McKenzie syndrome is this describing?
- caused by mechanical disturbance of IV disc; consequence of change in disc shape with relevant misalignment of mobile segment and associated abnormal stress
derangement syndrome
what is the effect of repeated mvmt - derangement syndrome?
- symptoms within mvmt range
- painful arc
- variable increase or decrease with testing
**Centralization/peripheralization during testing
what is the basis for Sahrmann’s mvmt impairment based classification
does not matter what the cause is, all treatment is based on primary mvmt problem
what 5 mvmts are used for Sahrmann’s
flexion
ext
rotation
rot + flex
rot + ext
what are the 4 treatment based classification subgroups for pts with LBP
manipulation
stabilization
specific exsc
traction
what are the criteria pts must meet to get manipulation as a treatment - how many do they need?
MUST MEET AT LEAST 4
- duration of symp < 16 days
- at least 1 hip with > 35 IR
- lumbar hypomob
- no symp distal to knee
- Fear avoidance beliefs - work subscale < 19
What criteria must pts meet to receive stabilization treatment for LBP - how many must they meet?
must meet 3 or more
- age < 40
- avg SLR > 91
- aberrant mvmt
- positive prone instability test
what must a pt demonstrate to receive specific exsc at treatment for LBP
demonstrate centralization or directional pref during repeated mvmt testing in and y position
what criteria must pts meet for traction - how many must they meet?
all criteria
- s/s o n root compression
- pain or numbness distal to buttocks in previous 4 hrs
peripheralization of pain with ext
what are the 6 categories for Impairment Based Classification of LBP according to ICF
- acute/subacute + mobility deficits
- A/SA/C + mvmt coordination impairment
- acute + related/referred LE pain
- A/SA/C + radiating pain
- acute/SA + cognitive or affective tendencies
- CLBP + generalized pain
if a pt has a mobility deficit, what is the most likely presentation
restriction of mvmt
if a pt has mvmt coordination impairments, what is the most likely presentation
abnormal mvmt pattern associated with instability
