LBP- exam 1 Flashcards

1
Q

What is the STarT Back Tool regarding LBP

A

determines risks of persistent disabling P! and matches treatments

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2
Q

Which vertebral spine has the smallest amount of spine-related pathology?

A

thoracic

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3
Q

______ is the leading cause of:
worldwide disability
activity limitation and work absence
half > 65 yrs. of age will have _____
______% will experience ______ in their lifetime

A

LBP; LBP; 80%

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4
Q

Prevalence of LBP:
-women ______ men
-older_____ younger age
-lower___________
-higher__________

A

women > men
older > younger ages
lower educational status
higher physical work demands

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5
Q

Risk factors of LBP:

A

previous LBP
co-morbidities (diabetes, asthma,etc.)
poor mental health
smoking, obesity, and low activity levels
awkward postures, heavy lifting, and fatigue
genetics w/age related disc changes ONLY, otherwise questionable

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6
Q

Functional ROM: sit—–stand
Picking up objects from the floor:

A

35-42º flexion
60º flexion

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7
Q

You must complete the normal range to be functional. T or F

A

False

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8
Q

LBP imagining with MRI
-1/3 of asymptomatic individuals had “abnormal” findings which are:

A

IDD
Age-related disc changes
N. compression
Facet hypertrophy

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9
Q

1/2 of __________ individuals with LBP had abnormalities

A

symptomatic

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10
Q

Imaging with CT and MRI - 2/3 of asymptomatic individuals had disc changes from __________ yrs. of age

A

30-60yrs.

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11
Q

Who should get imagining with LBP?

A

> 50yrs. of age w/ hx of cancer
saddle parathesis
bowel and bladder dysfunction
specific neurological deficits (spinal n., brain, spinal cord)
progressive/disabling symptoms
NO improvement after 6wks. of conservative Rx

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12
Q

Imagining DOES improve outcomes and guidelines consistently recommend. T or F

A

False; DOES NOT

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13
Q

Nearly all cases have an _________ source hence the term non-specific LBP

A

unidentified nociceptive

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14
Q

PT Rx:
__________ gap between evidence and_______
___________ of unsupported and _________ Rx

A

SUBSTANTIAL; practice
OVERUTILIZATION; ineffective

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15
Q

Most LBP preventions _________ evidence and _______ is largely effective in adults.

A

lack; exercise

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16
Q

First line Rx for LPB
-against
-for (6)

A

against: bed rest, in-depth explanation of the cause

:spinal and structural strength
neuroscience explanation
overall favorable prognosis
active P! coping mechanisms that decrease fear
stay active w/early resumption for ADLs
emphasis on function

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17
Q

Why is education important for LBP pts.

A

greater emotion = greater P! and persistence
improve emotion = less P! and persistence

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18
Q

Dry needling is the most beneficial PT Rx for pts. with LBP. T or False

A

false; very low to moderate evidence of benefit on P!

19
Q

What are some examples of modalities?
Are they effective?

A

heat, US, e-stim, LASER, etc
generally ineffective and NOT recommended, short-term results at best (window to begin other interventions)

20
Q

soft tissue mobilization is a long-term or short-term benefit of all LBP types?

A

short term

21
Q

What are some barriers to overcome to BEST practice?

A

increase consultation time and follow up
better incentives to return to work
PSA - the basics
reward quality and NOT volume with reimbursements

22
Q

PT Rx:
LBP Classifications into subgroups, which are:

A

mechanical traction
directional preference
mobilization/manipulation
stabilization

23
Q

The MOST beneficial traction for LBP is static tx. T or F

A

false; NO benefit

24
Q

When intermittent tx is most often beneficial

A

pts experiencing radiculopathy

25
Intermittent Tx is more supported in ______ and when _____ yrs of age _____in last 24hrs. distal to knee Oswestry questionnaire score > ______ _____ n. root compression, crossed SLR, and/or centralization
prone 18-60 paresthesias 30 (+)
26
What is centralization?
abolition of distal and/or spinal P! in a distal to a proximal direction in response to repetitive motion(s) or sustained position(s)
27
What is directional preference and where is it most commonly?
a position, motion, and/or factor that alleviates symptoms MOST common extension, may centralize LE symptoms to LB
28
What is most effective for subgroups?
Manipulation
29
Manipulation effect larger than _________ Greater effective when combined with _______ Long-term effect ______ well established
mobilization exercise NOT
30
Mobilization/Manipulation non-thrust mobilization helps:
decrease pressure P! threshold
31
Can you begin the exercise with stabilization ?
Yes, safe and effective to do it early -3x10 low resistance
32
You MUST supervise pts. with LBP. T or F
False, only if pt. NOT progressing or presistent LBP exists
33
Sub-acute and persistent LBP First Line Rx: in order is (2)
1. motor activation/coordination 2. Aquatic therapy, pilates, and yoga
34
LBP pts. get mental health benefits w/ resistance and aerobic training? T or F
True
35
__________prevents reoccurrences @ 3yrs after 4 wks of training
motor control - local mm activation
36
Motor control - local mm activation is effective for nonspecific LBP and functions in _______ or w/ other _________
isolation; therapeutic exercises
37
Diaphragmatic breathing is _________ with persistent LBP
impaired
38
Cognitive Behavioral Therapy: -first-line Rx with persistent LBP
helping pts understand and manage all biopsychological elements contributing to their symptoms
39
1. prognosis for LBP _________ 1a. _______52% _______58% 82% of pts ______________
rapid improvements within one month P! Disability return to work
40
Most pts. with LBP improve substantially in _________ wks.
6
41
MD Rx: _____________ ONLY recommended with an inadequate response to exercise and cognitive behavioral therapy
medications
42
MD Rx: _________ and _______ injections are NOT recommended for non-specific LBP
epidural; facet joint
43
What are epidural injections recommended for?
radicular P!