Classification Systems

Question 1

what are the 3 most common treatment classification systems for LBP

Answer 1

McKenzie
Sahrmann’s mvmt impairment based classification
Delitto’s treatment based classification

Question 2

what treatment classification is best used for acute LBP

Answer 2

McKenzie

Question 3

what treatment classification is best used for instability and chronic LBP

Answer 3

sahrmann’s mvmt impairment based

Question 4

what treatment classification is best used for acute to subacute LBP

Answer 4

Delitto’s treatment based

Question 5

what is the foundation of McKenzie approach

Answer 5

directional preference - centralization and peripheralization

Question 6

what McKenzie syndrome is this describing?
- caused by over stretching/mechanical deformation of normal tissues from static loading

Answer 6

postural syndrome

Question 7

what are the effects of repeated mvmt - McKenzie postural syndrome

Answer 7

• pain is not reproduced
• pain is present when stationary but not during testing

Question 8

what are the 3 syndromes that Mckenzie describes?

Answer 8

postural, dysfunction, and derangement

Question 9

what McKenzie syndrome is this describing?
- loss of mvmt caused by adaptive shortening of ST provoked by mvmt that deforms the adaptively shortened tissue

Answer 9

dysfunction syndrome

Question 10

what is the effect of repeated mvmt - McKenzie dysfunction syndrome

Answer 10

• pain at end range
• stops shortly in release of end range
• fixed pain pattern
• slight radiating pain
• no better or worse after testing

Question 11

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

Answer 11

derangement syndrome

Question 12

what is the effect of repeated mvmt - derangement syndrome?

Answer 12

• symptoms within mvmt range
• painful arc
• variable increase or decrease with testing
  **Centralization/peripheralization during testing

Question 13

what is the basis for Sahrmann’s mvmt impairment based classification

Answer 13

does not matter what the cause is, all treatment is based on primary mvmt problem

Question 14

what 5 mvmts are used for Sahrmann’s

Answer 14

flexion
ext
rotation
rot + flex
rot + ext

Question 15

what are the 4 treatment based classification subgroups for pts with LBP

Answer 15

manipulation
stabilization
specific exsc
traction

Question 16

what are the criteria pts must meet to get manipulation as a treatment - how many do they need?

Answer 16

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

Question 17

What criteria must pts meet to receive stabilization treatment for LBP - how many must they meet?

Answer 17

must meet 3 or more

• age < 40
• avg SLR > 91
• aberrant mvmt
• positive prone instability test

Question 18

what must a pt demonstrate to receive specific exsc at treatment for LBP

Answer 18

demonstrate centralization or directional pref during repeated mvmt testing in and y position

Question 19

what criteria must pts meet for traction - how many must they meet?

Answer 19

all criteria

• s/s o n root compression
• pain or numbness distal to buttocks in previous 4 hrs
  peripheralization of pain with ext

Question 20

what are the 6 categories for Impairment Based Classification of LBP according to ICF

Answer 20

• 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

Question 21

if a pt has a mobility deficit, what is the most likely presentation

Answer 21

restriction of mvmt

Question 22

if a pt has mvmt coordination impairments, what is the most likely presentation

Answer 22

abnormal mvmt pattern associated with instability