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Spine MSK > Interventions > Flashcards

Interventions Flashcards

1
Q

A chin tuck exercise targets which musculature and is an important exercise why?

A
  • Rectus capitus anterior
  • Longus capitus
    -** Longus Colli**
  • Longus Capitus
  • Straightens the c-spine and holds it rigid
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2
Q

Your patient was able to make it to 26 mmHg with the stabilizer cuff when performing the craniocervical flexion exercises. How would you set up training them for intervention?

A

Begin at target level (26 mmHg) and progressively increase. (10 sec holds x 10 reps)

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3
Q

When performing Deep Neck Flexor training, what muscles do you want to avoid activating?

A

SCM and scalene activation

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4
Q

Is there a benefit of completing craniocervical flexion exercises over conventional cervical flexion exercise?

A

No, both show improvement

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5
Q

What is the goal of nerve mobilizations?

A

to attempt to restore the dynamic balance bteween the relative movement of neural tissues and surrounding mechanical interfaces.

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6
Q

What are the proposed mechanisms of nerve interventions?

A
  • Decrease adhesions + allow improved movement of peripheral nerves.
  • Increase neural vascularity = increased oxygenation of nerve and a decrease in ischemic pain
  • Dispersion of noxious fluids
  • Improvement of axoplasmic flow
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7
Q

Grade I Oscillation Mobilization

A

Small amplitude, beginning of range

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8
Q

Grade II Oscillation Mobilization

A

Large amplitude, within range - not limit of range (free of stiffness/muscle spasm)

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9
Q

Grade III Oscillation Mobilization

A

Large amplitude, up to the limit of the range

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10
Q

Grade IV Oscillation Mobilization

A

Small amplitude, at the limit of the range

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11
Q

Grade V Manipulation

A

high velocity thrust, at the limit of range.

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12
Q

Proposed mechanisms for joint mobilizations

A
  • Biomechanical: motion/positional improvement
  • Neurophysiologic: spinal cord, central mediated, peripheral inflammatory
  • Other: placebo, pt expectation
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13
Q

Absolute Contraindications for Manual Therapy/Passive Movements (mobilization, stretching, manually assisted movements)

A
  • Malignancy of targeted region
  • Cauda Equina Syndrome
  • Red flags that indicate neoplasm, fracture, or systemic disturbance
  • Rheumatoid collagen necrosis
  • Upper C-spine instability
  • Concern for Cervical Arterial Dysfunction (CAD)
  • Practitioner lack of ability
  • Spondylolithesis
  • Gross foraminal encroachment
  • Children/teenagers
  • Pregnancy
  • Fusions
  • Psychogenic disorders
  • Immediately post-partum
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14
Q

Relative Contraindications for Manual Therapy/Passive Movements (mobilization, stretching, manually assisted movements)

A
  • active, acute inflammatory conditions
  • Significant segmental stiffness
  • Systemic diseases
  • Neurological deterioration
  • Irritability
  • Osteoporosis
  • Condition is worsening with present treatment
  • Acute n. root irritation (radiculopathy): mismatch between subjective/objective, pt condition worsening, oral contraceptive use, long-term corticosteroid use
  • Immediately post-partum (cervical/lumbar)
  • Blood clotting disorder
  • Significant segmental stiffness
  • Systematic diseases
  • Neurological deterioration
  • Irritability
  • Osteoporosis
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15
Q

T-spine manipulations can address mechanical neck pain and give short term or long term pain relief?

A

Short Term

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16
Q

High velocity, low amplitude thrusts of C-spine and upper T-spine is associated with greater improvements in:

A
  • pain and disability
  • Passive C1/2 rotation
  • Deep c-spine flexor motor performance
17
Q

CPG for neck pain and manual therapy advocate for

A
  • Mechanical neck pain: cervical thrust and non-thrust techniques (part of POC) and Thoracic Thrust/Non-Thrust (Short term)
  • Cervicogenic HA: Mobilization/manupulation + exercises (pain reduction + functional improvement)
  • Cervical Dysfunction/Dizziness/HA: MWM
18
Q

Classifications of the Neck Pain CPG include

A
  • NP with mobility deficits
  • NP w/movement coordination impairments (incl: WAD)
  • NP w/HA
  • NP w/radiating pain
19
Q

When instructing a patient to perform a MWM for the c-spine, how do you know which way to tell them to apply force?

A

Stabilize on ipsilateral side with limited rotation, use contralateral side to push further into limited ROM

20
Q

Scheuermann’s Disease Interventions Include:

A
  • Postural control muscle performance
  • Mod of aggravating activities (FLEX)
  • Strengthen + stretch trunk
  • Bracing
21
Q

Examples of strengthening and stretching for Scheuermann’s disease

A
  • Seated rotation
  • Extension in lying
  • Thoracic extensor strengthening
  • Scapular abductor strengthening
22
Q

PT Interventions for ankylosing spondylitis include

A

Active exercises with a mobility focus
- Spine ext + peripheral joint exercises
- breathing exercises
- Prone lying several times/day
- Sleep on firm mattress + avoid SL position
- Swimming
- Pt education on active > sedentary

23
Q

Intervention for Adolescent idiopathic scoliosis

A
  • Strengthen postural muscles
  • Address muscle length impairments/strength impairments of extremity musculature
  • Maintain/improve respiration + chest mobility
  • Resume functional tasks
  • Strengthen abdominals
24
Q

T4 Syndrome Interventions

A
  • Thoracic joint manual therapy
  • Thoracic mobility exercises
  • Scapulothoracic motor performance
  • Thoracic extensor strengthening
25
Q

Traction is a suggested intervention for disc lesions of the thoracic spine. However, contraindications include

A
  • Acute LBP
  • Instability
  • Respiratory/cardiac insufficiency
  • Resp irritation
  • Painful reactions
  • Large disc extrusions
  • Medial disc herniations
  • AMS
  • Inability of pt to relax
26
Q

What is an exercise you can target mid/lower trap as well as rhomboids and levator scap?

A

Prone horizontal ABD, 90º shoulder ABD and ER (“W”)

27
Q

A prone row will target mainly the

A

mid trap, Rhomboids, and levator scap

28
Q

What does the evidence support in regars to thoracic spinal manipulation to address thoracic spine pain?

A

Limited evidence

Spine MSK (5 decks)

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