L spine interventions Flashcards
____% of LBP pts get better with time
80%
what is a great initial tx for acute phase?
walking!!
_______ is MOST beneficial if used early in pts that present w/o radiating leg pain
manual therapy
what are the 3 major protocols for LBP?
Williams flexion exercises
McKenzie exercises
Spinal stabilization exercises
the ____ phase is CRITICAL in preventing chronicity and disability
sub-acute
what phase is graded activity, re-assessment, and functional activity vital in?
sub-acute
a ____ approach should be used for chronic LBP
multi-modal
what is the hallmark of chronic pain?
central sensitization
primary hyperalgesia
normal hyperalgesia that is protective mechanism
tissue damaged
secondary hyperalgesia
adaptation of CNS
increased response to stimuli from periphery
what is the ratio of side plank, plank, and Sorenson’s?
side plank = 1/2 plank
plank = 1
Sorenson’s = 1.5x plank
_____ strength is very important to stabilization exercises
glute
T/F: direction specific exercises are tissue specific
F
components of a postural issue
- pain not reproduced with repeated measures testing
- pain present when stationary
components of a dysfunction issue
pain only at end range
fixed pain pattern
radiate slightly
condition unchanged after testing
components of a derangement issue
sx altered with mid-range movements
pain arc
variable pain pattern
progressive inc or dec during test
rapid & lasting changes after testing
what is the rx for extension direction specific exercise?
20 times per hour while awake
what is the rx for flexion direction specific exercise?
6-10 times per hour while awake
what pathology is suspected with a lateral shift?
acute herniated NP
what is the rx for lateral shift direction specific exercise?
10-20 times per hour while awake
when would traction be clinically useful?
peripheralization of sx with extension
+ crossed SLR
body weight supported treadmill can be effective for pts with _____
spinal stenosis
initial rx for nerve glides
1-2 sets of 10-15 reps
what are the most important aspects of conservative tx options for LBP?
mobilization/manipulation
exercise
T/F: majority of evidence does not support the use of passive modalities
T
what must be done after manual?
mobility exercises
what is the best pathology for manual?
acute (facet dysfunction)
how does manual inhibit increases muscle tone?
activating GTOs
contras for joint manipulations
presence of serious pathology
relative to skill and experience
fracture
ligament rupture
no working hypothesis
worsen neuro function
unremitting night pain
severe multi-direction spasm
UMN lesion
exercise intensity for LBP without generalized pain
moderate to high
exercise intensity for LBP with generalized pain
low
when should dry needling not be used for LBP?
acute phase
when should you start pt education?
DAY 1
when is surgery indicated?
red flags present
failed conservative tx
cauda equina syndrome
which surgical techniques are for decompression?
laminectomy
discectomy
foraminotomy
which surgical techniques are for stabilization?
fusions
scoliotic curve reduction
kyphoplasty
disc replacement
what surgical technique is done to improve the height of vertebral bodies and is usually done in the T spine?
kyphoplasty
T/F: post-op pts should be mobilized on the 1st day
T
when will post-op pts present to OP?
~3 weeks post-op
how long do BLT precautions apply?
12 weeks
