Intro to Spine

Question 1

how do we determine our approach

Answer 1

ID signs and symptoms that predict responsiveness

Question 2

4 different approaches to tx

Answer 2

manipulation

stabilization

specific exercise (directional preference)

traction

Question 3

manipulation is also known as

Answer 3

mobilization

Question 4

who is most likely to benefit from manipulation according to CPR

Answer 4

sxs present for < 16 days

sxs below the knee/elbow

at least one hypomobile segment

at least 1 hip IR > 35

Question 5

FABQw score for manipulation

Answer 5

< 19

Question 6

what is FABQw

Answer 6

fear/anxiety scale

yellow flags

Question 7

at least 1 hypomobile segment –> manipulation

Answer 7

RRR

PA

PIVMT

Question 8

who would most benefit from stabilization

Answer 8

LB pt

SLR > 91

age < 40

(+) prone instability test

aberrant motions present

Question 9

stabilization in the c/s might include

Answer 9

(+) CCFT and endurance tests

headaches

dizziness

proprioceptive deficits

Question 10

aberrant motions

Answer 10

when bending into flexion –> not smooth, may put hands on knees

Question 11

what is stabilization evaluated with

Answer 11

presence of aberrant motions during AROM, spring testing reactivity, PLET, ASLR

Question 12

exercises for stabilization

Answer 12

promote stability and motor control

use of deep stabilizing muscles co-contraction

Question 13

specific exercise CPR

Answer 13

no prediction rule

whatever exercise relieves their symptoms

Question 14

what does specific exercise include

Answer 14

(+) SLR

(+) slump test for HNP

(+) sxs with extension for stenosis

Question 15

how do sxs centralize

Answer 15

w/ repeated motion or prolonged postures into a specific direction

Question 16

disc degeneration/dis derangement –> specific exercises

Answer 16

extension

lateral shift

Question 17

stenosis –> specific exercises

Answer 17

flexion

Question 18

when is traction usually used

Answer 18

neural signs and radicular sxs

Question 19

CPR –> traction

Answer 19

none

no prediction rule

Question 20

traction includes

Answer 20

(+) neural signs including SLR and crossed leg SLR

Question 21

what is traction used for

Answer 21

radicular sxs that are not relieved through directional preference specific exercise approach to tx

Question 22

how is traction evaluated

Answer 22

with attempts at centralization

neurological assessment will show hard neural signs

Question 23

what promotes centralization (lumbar)

Answer 23

static mechanic traction in prone

Question 24

what promotes centralization (cervical)

Answer 24

supine intermittent traction

Question 25

what is centralization

Answer 25

closer the pain is to the center of the body, the better pressure off the nerves

Question 26

acute injury

Answer 26

new injury or within 2-4 wks

Question 27

what do we use for an acute injury

Answer 27

spinal manipulative therapy exercise advice to remain active

Question 28

subacute injury

Answer 28

4-12 weeks

Question 29

what do we recommend for subacute injuries

Answer 29

stress importance of exercise and movement to prevent chronicity

Question 30

chronic injuries

Answer 30

12 wks +

Question 31

what do we use for chronic injuries

Answer 31

cognitive fxnal therapy -education -graded mvmt -fxnal activities -manual therapy

Question 32

other classification approaches

Answer 32

pathoanatomical based (medical model) mvmt system impairment approach mechanical dx and tx osullivan classification system

Question 33

pathoanatomical based approach

Answer 33

causative structure medical dx

Question 34

example of pathoanatomical based approach

Answer 34

disc facet stenosis myofascial SI

Question 35

problem with pathoanatomical model

Answer 35

people have pain sometimes they dont know what the cause of their plan is

Question 36

movement system impairment approach is also called

Answer 36

sahrmann - MSI

Question 37

what does MSI do

Answer 37

IDs direction of aligment or mvmt that increase sxs

Question 38

what do we tx w/ MSI

Answer 38

cumulative trauma caused by impairment in alignment stabilization of movement patterns of the spine

Question 39

what is the goal of MSI

Answer 39

balance the system

Question 40

how do we balance the system --> MSI

Answer 40

decreasing accessory motion at dysfxnal level by improving mobility at other lvls

Question 41

what does MSI allow

Answer 41

lengthening of mm to shorten and less stiffness at others

Question 42

mechanical dx and treatment is also called

Answer 42

mckenzie MDT

Question 43

what does MDT determine

Answer 43

if sxs can be reduced/centralized w/ repeated or sustained postures

Question 44

what is MDT most associated with

Answer 44

disc derangement

Question 45

what does MDT define

Answer 45

dysfxn and postural models

Question 46

what does MDT include

Answer 46

pt activated specific exercise

Question 47

osullivan classification system is also called

Answer 47

CBT

Question 48

what does CBT identify

Answer 48

mechanics considered to drive the pain

Question 49

what does CBT seek

Answer 49

to manage physical and cognitive drivers and maladaptive movement

Question 50

common pitfalls of PT (1)

Answer 50

imprecise motor skills providing inaccurate exam info inability to analyze or alter movement

Question 51

common pitfalls of PT (2)

Answer 51

absence of interviewing skills poor mastery of motor skills poor mastery of pt educating and counseling skill required to address the pts needs

Question 52

red flags (lumbar spine)

Answer 52

malignancy cauda equina osteoporotic fx back related infection ankylosing spondylitis vertebral fx aortic aneurysm sponylothesis

Question 53

red flags (c/s & t/s)

Answer 53

cervical myelopathy neoplastic conditions cervical ligamentous instability vertebral artery insufficiency inflammatory or systemic dz angina pneumonia spinal fx

Question 54

yellow flags

Answer 54

factors contributing nociplastic pain or central sensitization