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Exam III > L/S Practical Skills > Flashcards

L/S Practical Skills Flashcards

1
Q

Standing Extension

A

for extension classification

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2
Q

Prone Extension Progression

A

for extension classification

  1. Pillows under pelvis (remove one at a time)
  2. Prone without pillows
  3. Prone prop (may have to do small holds at first)
  4. Prone press-ups
  5. Prone press-ups with sag (deep inhale, exhale, muscles relax and sink down)
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3
Q

Lateral Shift Wall Progression

A

for lateral shift classification

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4
Q

Prone Lateral Shift Correction

A

for lateral shift classification

pt prone, PT moves hips to neutral, ends with prone prop for extension

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5
Q

Manual Correction for Lateral Shift

A

for lateral shift classification

PT standing beside pt, ends with extension

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6
Q

Flexion Mobility Progression

A

for flexion classification

  1. knee rock warm up (pt hooklying, keep knees together, can hold stretch at end range)
  2. hooklying (posterior pelvic tilt)
  3. SKTC (towel under knee if needed to pull)
  4. DKTC
  5. crunch/curl-up with hands sliding up legs in hooklying
  6. child’s pose
  7. camel
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7
Q

Sidelying Open Mob

A

for flexion classification

very tough to isolate, probably addressing more soft tissue than bones

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8
Q

Positional Distraction/Release Over Roll

A

for flexion classification

gaps top facet and opens the IVF

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9
Q

Lumbopelvic Manipulation

A

AKA Chicago or Banana

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10
Q

Opening Mobs to Promote Lateral Flexion (4 options)

A
  1. mob in prone through leg abduction
  2. mob in sidelying lifting legs
  3. mob in sidelying through pelvis to open bottom facet
  4. mob in sidelying through pelvis to open top facet
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11
Q

MET to open bottom facet

A

pt sidelying

  1. flex LEs up to level
  2. flex trunk down to level
  3. rotate top shoulder back and have pt hold on to other side of table
  4. PT grasps pt’s ankles
  5. lift ankles to barrier and have pt pull legs down for 6 count; move to new barrier and repeat

5x 5 sec to begin with

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12
Q

MET to close top facet

A

pt sidelying

  1. introduce extension at waist
  2. slide trunk back
  3. extend lower leg
  4. rotate top shoulder back to level and have pt hold on to other side of table
  5. PT lifts top leg to barrier and has pt pull down for 6 sec

**could also do in prone and abduct leg just like joint play assessment position

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13
Q

Lumbar Rotational Mob/Manip

A

AKA Million Dollar Roll

gaps the top segment

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14
Q

Rotation Mobs in Prone

A
  1. prone with knees bent, use rule of the legs

2. lumbrical grip under opposite ASIS

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15
Q

Direction Rotation Mob in Prone

A

L2: start far side, thumb down back and angle with ribs
L3: hand straight across back
L4: in line with iliac crest
L5: opposite crest

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16
Q

Thoracolumbar Mob

A
  • pt hugs themselves
  • pisiform over CL tp and rotate pt to IL side
  • can take to end range and perform small force for manip
  • straddle table
17
Q

Bridging Stabilization Progression

A

pt hooklying

  1. tighten TA’s and glutes
  2. add bridge
  3. add march
  4. add SLR

other options: add swiss ball or rhythmic stabilization

18
Q

Supine Stabilization Progression

A
  1. find pt’s neutral in hooklying, tighten TA/brace
  2. heel slides
  3. marching (alternate clearing each foot)
  4. single leg fallouts
  5. TA/brace with alternating arm flexion
  6. TA/brace with alternating LE extension
  7. combine UE and LE movements
  8. dead bugs (knees bent and don’t go back on to table)
19
Q

Supine Stabilization using Stabilizer

A
  • place under L/S
  • inflate to 40 mmHg
  • TA activation “draw in”
  • reading should stay same or increase by only 2-3mmHg, no more than 10 mmHg
  • pt should hold for 10 sec with min fluctuation
  • 10 reps for 10 sec holds
  • add arm and leg movements as able while maintaining stability
20
Q

Prone Stabilization Progression

A

pt starts in prone and ends in quadraped

  • tighten TA and glutes in neutral
  • tighten thigh via hip adduction (towel between legs)
  • add small hip extension (just clear leg)
  • TA and glute squeeze with alternating arm lift
  • quadraped arm lift
  • quadraped leg lift
  • combined UE and LE movements in quadraped “bird dogs”

**could put stick or ball on back in quadraped and say “don’t let this move”

21
Q

Sitting Stabilization

A
  • *often start on swiss ball if appropriate (A/P, M/L, CW/CCW), find neutral
    1. TA and glute set
    2. arm lifts
    3. leg lifts (knees bent)
    4. combined alternating arm and leg lifts (opp hand to opp knee)
22
Q

Transfers Progression

A
  1. sit to stand
  2. side lunges
  3. “trips” while holding swiss ball
  4. add perturbations to swiss ball (rhythmic stabilization)
23
Q

Initial Core Contraction Instruction

A
  1. pelvic floor contraction
  2. TA contraction (draw in maneuver)
  3. Multifidi contraction

10x10sec
**can easily palpate all 3 in quadraped (however can be performed in sitting, supine, prone, or quadraped)

24
Q

Lumbopelvic Spinal Stabilization (Olson) Phase I

A
  1. TA activation in hooklying
  2. TA marches in hooklying
  3. single leg bent knee fallouts (other leg ext. on table)
  4. SLR with other leg bent
  5. prone over pillow hip extension with TA
  6. sidelying “clamshells”
25
Q

Lumbopelvic Spinal Stabilization (Olson) Phase II

A
  1. quadraped over swiss ball, lift one leg straight while maintaining TA activation
  2. quadraped without swiss ball, same leg lifts, can put cane on back for feedback
  3. sidelying hip abduction, bottom leg flexed at hip and knee
  4. standing theraband GH extension with diagonal stance
  5. standing theraband GH horizontal abduction with athletic stance
  6. wall slide
  7. seated marches on swiss ball (caution: discogenic pathologies may peripheralize in sitting)
  8. seated on swiss ball: theraband scaption
  9. theraband resisted side stepping with theraband above knees (go until fatigue noted with hip abduction)
26
Q

Lumbopelvic Spinal Stabilization (Olson) Phase III

A
  1. forward lunge with weighted ball reach to knee
  2. lateral lunge with weighted ball reach to bent knee
  3. wall slide squat with swiss ball
  4. sit squat with hip hinge and forward reach with ball to facilitate glute action; knees pressed apart against theraband to assist glute med
  5. lifting training with weighted crate and diagonal movement pattern
27
Q

“shotgun approach”

A

for pubic dysfunction

28
Q

upslip correction

A

pt coughs while PT pulls via long axis, block other foot with your body

29
Q

Laslett Cluster

A
  1. thigh thrust/P4
  2. distraction (supine)
  3. compression (sidelying)
  4. sacral thrust
30
Q

Supine to Sit Test

A

long to short –> anterior innominate

short to long –> posterior innominate

31
Q

Correction for Posterior Innominate

A
  • Supine: use RA to bring pelvis anteriorly, pt in Gaenslen position and PT resists extended hip for 5 sec count
  • Prone: PT pulls affected LE into hip ext and pt pulls down towards table, PT “coaxes” iliac crest during muscle contraction
32
Q

Cibulka Cluster (posterior innominate)

A
    • standing flexion test
  2. ASIS high and PSIS low on + standing flexion test
  3. supine to sit short to long on involved side
  4. Greater ER than IR on posterior innominate side
33
Q

Correction for Anterior Innominate

A
  • Supine: flex affected knee and hip up, have pt push against you into hip extension
  • Sidelying: PT stands between pt’s legs, affected LE on top, pt “squeezes” PT and PT guides manually
34
Q

General Innominate Correction

A

pt hooklying, PT’s arm under one thigh and over other

35
Q

Correction for Anterior Torsion

A

Left on Left

  1. pt sidelying on R side
  2. flex B hips
  3. rotate back
  4. pt holds on
  5. PT lifts up feet
  6. Resist feet pushing down

monitoring bottom sacral base trying to get it to come back

36
Q

Correction for Backward Torsion

A

Left on Right

  1. pt sidelying on R side
  2. rotate down
  3. pt holds on
  4. extend bottom leg
  5. drop top leg
  6. resist lifting top leg

monitoring top sacral base to feel it come forward

37
Q

Correction for Unilateral Flexion

A

15 deg abduction of leg
3-5 “sips” while PT puts pressure on posterior ILA of affected side
Repeat 3-4 times
Apply downward pressure with heel of hand toward umbilicus

38
Q

General SI Approach (Jackson)

A
  1. Correct Superior Shear (upslip): 2-3 leg pulls
  2. Mobilization of Ilium in Sagittal Plane: with pt in supine and hips at 90, alternating push/pull holds 2-3 times for 2-3 sec each
  3. Mobilization of Ilium in Transverse Plane: 2 part –> 1. hip in 90, stabilize opp hip, push medially with body. 2. hip in 45 and slight add, pull towards ext
  4. Mobilization of Sacrum in Transverse Plane: sidelying with top hip 90, mod trunk rotation, push trunk away and pull pelvis forward, push knee down to activate piriformis
  5. Sacral Mobilization in Sagittal Plane: prone, heel of hand on sacral base, exhale, hold pressure while inhaling. Then inhale and hold pressure into exhale. Repeat several times.

Exam III (2 decks)

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