Clinical Prediction Rules/Treatment Based Classifications

Question 1

Name the treatment based classifications for the low back pain.

Answer 1

1) Manipulation
2) Specific exercise
3) Stabilization
4) Traction

Question 2

Describe Manipulation:
Factors for:
Factors against:
Intervention:

Answer 2

Factors for:

1) Sxs below knee
2) FABQW<=19
3) More hip IR
4) Hypomobility
5) Recent onset

Factors against:

1)
2)
3)

Intervention (manual therapy):

1) Manipulation/Mobilization
2)
3)

HEP:
1) Stabilization exercise
2)
3)

Question 3

Describe Specific exercise:
Factors for:
Factors against:
Intervention:

Answer 3

Factors for:

1) Postural preference
2) Centralization phenomenon with mvmt exam

Factors against:

1)
2)
3)

Intervention (manual therapy):

1) Flexion bias - CPAs/UPAs - pillow under stomach/hips
2) Extension bias CPAs/UPAs
3)

HEP:

1) Flexion bias - legs to chest
- Progression to pelvic tilts and into extension
2) Extension bias - prone press ups
- Progression to pelvic tilts and into flexion

Question 4

Describe Stabilization:
Factors for:
Factors against:
Intervention:

Answer 4

Factors for:

1) + Prone instability test
2) Aberrant motions
3) Hypermobility
4) <40yo (younger age)
5) Greater SLR ROM

Factors against:

1)
2)
3)

Intervention (manual therapy):

1)
2)
3)

HEP:
1) TrA/Multifidus
2)
3)

Question 5

Describe Traction:
Factors for:
Factors against:
Intervention:

Answer 5

Factors for:

1) Peripheralization with movement testing, but unable to centralize
2) Neurological signs
3) LE symptoms
4) Crossed straight leg raise

Factors against:

1)
2)
3)

Intervention (manual therapy):

1) Traction - BIL/Unilateral
2)
3)

HEP:

1) Home traction machine
2) Home traction - between chairs; off edge of table; lying supine with knees bent and push with UE down on thighs to manually apply traction to lumbar spine