L4/5/6 Lumbar Interventions

Question 1

HVLA

Answer 1

can be distraction or parallel to joint plane

indicated for talocrural joint if limited/painful ankle DF and other patholgies ruled out

does appear to stretch the capsule without stressing the ATF and CF ligaments. Slight PF to avoid stress

Question 2

Lumbosacral Regional Manipulation Treament

Answer 2

L side bend and R rotation – treats the L side

Question 3

Neutral Gapping Manip

Answer 3

treatment side is the side that is up

Question 4

Grade 2 General Lumbar Rotation Mobilization

Answer 4

Indicated for patients with higher SINSS presentation

PT flexes hips until motion felt at:
1. Lower lumbar and direction of force is in line with lower lumbar vert (L4-L5)
2. Mid lumbar and direction of force is in line with mid lumbar vert (L2-L3)
3. upper lumbar and direction of force is in line with mid lumbar vert (T12-L1)

Question 5

Thoracoloumbar CPA/UPAs

Answer 5

assessment of pain and movement

Question 6

Indications for Mobilization

Answer 6

1. No symptoms distal to knee
2. Recent onsent <16 days
3. Low FABQ <19
4. lumbar hypomobility
5. hip IR PROM >35°

interventions include mob, manip, AROM, address regional deficits, stabilziation

Question 7

Lumbar Extension Closing Manipulation

Answer 7

Indicated for Loss of extension, SB, rotation

Treating the side that is UP

helping to glide facet joints

lack of rotation in this position helps with opening

Question 8

Long Axis Hip Distraction Manip

Answer 8

indicated for hip pain, loss of hip motion

need to screen for knee history and hypermobility before using the ankle

Question 9

Thoracolumbar Junction Seated Gapping Manip

Answer 9

indicated to improve flexion/SB/rotation at the TL junction

treating the side that you rotate on