How To Assess The Lumbar Spine Region Flashcards
What are the red flags for the lumbar spine?
CANCER- History of cancer in themselves Strong family history Unexplained weight loss INFECTION- recent surgery/open wound High temperature Generally feeling unwell MYELOPATHY- central cord compression in cervical spine
CAUDA EQUINA SYNDROME- Retention of urine Loss of anal tone Saddle anaesthesia Bilateral leg pain Erectile dysfunction
Trauma/#
Steroids
TB
How do you go about assessing the spine?
Observations AROM PROM (PPIVM’S) Accessory movements (PAIVM’s) Muscle length testing Muscle strength testing Palpation of soft tissues Function In addition- you may need to do a Neurological/ Neurodynamic assessment
What do you look at in observations when assessing the lumbar spine?
Posture Offloading or asymmetries? Centre of gravity Muscle bulk Guarding and bracing Fear avoidance
What does PPVIMs stand for?
Passive physiological intervertebral movement
Flexion
Extension
SF
Rotation
How is the flexion/extension PPIVM performed?
Patient is placed into the foetal position with knees flexed in side laying. Therapist comes in front and places hands on head of a lumbar spinous process. Patient is slid backwards and forth to assess the joint.
How is the lumbar rotation PPIVM assessed?
Same positioning as the flexion/extension PPIVM, however the therapists other hand is placed on the back of the pelvis and a sliding motion is encouraged with the elbow back and forth
What does PAIVM stand for?
Passive Accessory Intervertebral Movements
What PAIVMS Can be performed on the patient?
Central PA on spinous process
Unilateral PA on transverse process
Transverse glide on head of the spinous process
What to look for when palpating surrounding soft tissues?
Muscle tone
Bulk
Pain provocation
Hyperalgesia
What are some examples of functional assessments?
Sit to stand Bending Twisting Lifting/ Reaching Standing/Walking Sports or gym activity (be specific, which shot in tennis
