L spine interventions

Question 1

____% of LBP pts get better with time

Answer 1

80%

Question 2

what is a great initial tx for acute phase?

Answer 2

walking!!

Question 3

_______ is MOST beneficial if used early in pts that present w/o radiating leg pain

Answer 3

manual therapy

Question 4

what are the 3 major protocols for LBP?

Answer 4

Williams flexion exercises
McKenzie exercises
Spinal stabilization exercises

Question 5

the ____ phase is CRITICAL in preventing chronicity and disability

Answer 5

sub-acute

Question 6

what phase is graded activity, re-assessment, and functional activity vital in?

Answer 6

sub-acute

Question 7

a ____ approach should be used for chronic LBP

Answer 7

multi-modal

Question 8

what is the hallmark of chronic pain?

Answer 8

central sensitization

Question 9

primary hyperalgesia

Answer 9

normal hyperalgesia that is protective mechanism
tissue damaged

Question 10

secondary hyperalgesia

Answer 10

adaptation of CNS
increased response to stimuli from periphery

Question 11

what is the ratio of side plank, plank, and Sorenson’s?

Answer 11

side plank = 1/2 plank
plank = 1
Sorenson’s = 1.5x plank

Question 12

_____ strength is very important to stabilization exercises

Answer 12

glute

Question 13

T/F: direction specific exercises are tissue specific

Answer 13

F

Question 14

components of a postural issue

Answer 14

• pain not reproduced with repeated measures testing
• pain present when stationary

Question 15

components of a dysfunction issue

Answer 15

pain only at end range
fixed pain pattern
radiate slightly
condition unchanged after testing

Question 16

components of a derangement issue

Answer 16

sx altered with mid-range movements
pain arc
variable pain pattern
progressive inc or dec during test
rapid & lasting changes after testing

Question 17

what is the rx for extension direction specific exercise?

Answer 17

20 times per hour while awake

Question 18

what is the rx for flexion direction specific exercise?

Answer 18

6-10 times per hour while awake

Question 19

what pathology is suspected with a lateral shift?

Answer 19

acute herniated NP

Question 20

what is the rx for lateral shift direction specific exercise?

Answer 20

10-20 times per hour while awake

Question 21

when would traction be clinically useful?

Answer 21

peripheralization of sx with extension
+ crossed SLR

Question 22

body weight supported treadmill can be effective for pts with _____

Answer 22

spinal stenosis

Question 23

initial rx for nerve glides

Answer 23

1-2 sets of 10-15 reps

Question 24

what are the most important aspects of conservative tx options for LBP?

Answer 24

mobilization/manipulation
exercise

Question 25

T/F: majority of evidence does not support the use of passive modalities

Answer 25

T

Question 26

what must be done after manual?

Answer 26

mobility exercises

Question 27

what is the best pathology for manual?

Answer 27

acute (facet dysfunction)

Question 28

how does manual inhibit increases muscle tone?

Answer 28

activating GTOs

Question 29

contras for joint manipulations

Answer 29

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

Question 30

exercise intensity for LBP without generalized pain

Answer 30

moderate to high

Question 31

exercise intensity for LBP with generalized pain

Answer 31

low

Question 32

when should dry needling not be used for LBP?

Answer 32

acute phase

Question 33

when should you start pt education?

Answer 33

DAY 1

Question 34

when is surgery indicated?

Answer 34

red flags present failed conservative tx cauda equina syndrome

Question 35

which surgical techniques are for decompression?

Answer 35

laminectomy discectomy foraminotomy

Question 36

which surgical techniques are for stabilization?

Answer 36

fusions scoliotic curve reduction kyphoplasty disc replacement

Question 37

what surgical technique is done to improve the height of vertebral bodies and is usually done in the T spine?

Answer 37

kyphoplasty

Question 38

T/F: post-op pts should be mobilized on the 1st day

Answer 38

T

Question 39

when will post-op pts present to OP?

Answer 39

~3 weeks post-op

Question 40

how long do BLT precautions apply?

Answer 40

12 weeks