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MS 2 Exam 1 > Lecture 6: Neck Classifications and Interventions > Flashcards

Lecture 6: Neck Classifications and Interventions Flashcards

1
Q

What are two types of clinical yellow flags?

A
  1. attitudes and beliefs

2. Behaviors

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2
Q

What are examples of attitudes and beliefs which are yellow flags?

A

pain is disabling, all pain must be gone before beginning activity, expectation of pain with activity, pain is uncontrollable, expecting the worst

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3
Q

What are examples of behaviors which are clinical yellow flags?

A

extended rest, reduced activity, high pain, poor sleep, reliance on bracing, ETOH/smoking use

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4
Q

What are the four ICD classifications of neck pain?

A
  1. cervicalgia
  2. Headaches or crevice cranial syndrome
  3. Spain or strain of cervical spine
  4. Spondylosis with Radiculopathy or cervical disc disorder with radiculopathy
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5
Q

What are the four ICF classifications of neck pain?

A
  1. neck pain with mobility impairments
  2. neck pain with HA
  3. Neck pain with movement coordination impairments
  4. neck pain with radiating pain
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6
Q

What neck pain with mobility impairments what are 2 diagnostic criteria?

A
  1. Cervical AROM

2. cervical and thoracic segmental mobility

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7
Q

What neck pain with HA what are 3 diagnostic criteria?

A
  1. C AROM
  2. cervical segment mobility
  3. cranial cervical flexion test
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8
Q

What neck pain with movement coordination impairments what are 2 diagnostic criteria?

A
  1. Cranial cervical flexion test

2. deep neck flexor endurance

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9
Q

What neck pain with radiating pain what are 3 diagnostic criteria?

A
  1. upper limb tension test
  2. Spurling’s
  3. Distraction
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10
Q

What are common clinical findings in patients with mobility deficits?

A

usually below 50 years old, acute neck pain under 12 weeks, Sx isolated to neck, restricted cervical ROM

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11
Q

What are common clinical findings for patients with neck pain and headaches?

A

unilateral HA, associated with neck/suboccipital area aggravated by neck movements, restricted C ROM, restricted cervical segment ROM, abnormal CC flexion test

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12
Q

What are common clinical findings for patients with movement coordination impairments?

A

chronic neck pain over 12 weeks, abnormal CC flexion test, abnormal DNF test, weakness in neck and upper quarter muscles, tight upper quarter muscles, ergonomic inefficiencies

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13
Q

What are common clinical findings for patients with movement coordination impairments?

A

UE sx referred or radicular pain, decreased cervical rotation toward involved side, signs of nerve root compression, reduction in sx with first tx or intervention

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14
Q

What are interventions for pts with mobility deficits?

A

C and T spine mobilization/manipulation, AROM exercise

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15
Q

What are potentially 6 variables to identify if a patient is appropriate for a manipulation?

A

sx less than 30 days, no sx distal to shoulder, looking up does not aggravate sx, FABQPA less than 12, diminished upper thoracic kyphosis, cervical ext ROM less than 30

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16
Q

What are interventions to centralize radiating pain?

A

repeated movement to centralize sx, Traction

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17
Q

What are the four directions for related movement?

A
  1. retraction
  2. retraction with extension
  3. Protraction
  4. Flexion
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18
Q

What happens at C spine with retraction?

A

upper flexion and lower extension

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19
Q

What happens at c spine with retraction and extension?

A

upper and lower c spine extension

20
Q

What happens at c spine with protraction?

A

upper cervical extension and lower cervical flexion

21
Q

What is the purpose of repeated movement testing?

A

way of testing tissue response to loading or unloading by repeating a movement one direction multiple times

10-15 times needed of movement

22
Q

What is the desirable outcome with repeated movement?

A

to centralize sx, controlled AROM at end range, may still have pain but peripheral sx should abolish

23
Q

What are 3 types of cervical traction?

A

positional, manual, mechanical

24
Q

What are 2 modes of cervical traction?

A
  1. static- joint and nerve root irritability/severe arm pain

2. Intermittent- acute joint derangement or patients need jt mob, duty cycle 1:1, 1:3

25
Q

What are the advantages of manual traction?

A

more specific, easier to adjust force

26
Q

What are mechanical effects of traction?

A

separation of vertebral bodies, distraction of facet joints, increased ligamentous, muscle and tendon stretch, widening of intervertebral foramen, straightening of spinal curves

27
Q

What are physiological effects of cervical traction?

A

increase circulation, mechanoreceptor, decrease pain

28
Q

When is traction indicated?

A

HNP, DJD, joint/facet hypo mobility, muscle guarding

29
Q

What are contraindications for traction?

A

structural disease- tumor, fx, severe osteoporosis

vascular compromise, claustrophobia, impaired cognitive function

any time movement is compromised- recent fusion, ligaments rupture, evidence of instability

30
Q

How much time and force should be used for traction?

A

actue/ HNP- 5-10 minutes
other conditions- 15-30

Force- 8-10 pounds of 7-10% of pts body weight

31
Q

What angle of pull should be used for traction?

A

c1-5- 0-5 degrees of flexion and HNP

c5-7- 25-30 degrees of flexion

have pt flex hip and knees

32
Q

What are clinical predictor rules to see if patient will benefit from cervical traction?

A
  1. peripheralization with lower cervical spine mobility testing c4-7
  2. positive shoulder ABD test
  3. age over 55
  4. positive UTIL A
  5. positive neck distraction test
33
Q

What are best interventions for movement coordination impairments?

A

increased conditioning and increasing exercise tolerance, body mechanic education

34
Q

What are examples of exercises to improve motor coordination?

A
  1. DNF in supine
  2. C spine isometrics
  3. prone T’s and Y’s
  4. SA strengthening
35
Q

What are some other techniques to help with motor control impairments?

A

mulligan techniques, muscle energy, STM, strain-counter strain

36
Q

What are mulligan techniques?

A
  1. movement with mobilization
  2. natural apophyseal glides
  3. sustained natural apophyseal glides
37
Q

What is MVM?

A

sustained accessory mobilization from PT and active physiological motion of patient to end range and possible over pressure

38
Q

What are there vital parameters for MVM?

A
  1. pain free
  2. instant result
  3. long lasting
39
Q

What are SNAGS and NAGS??

A

PT applies either sustained or oscillating accessory facet joint glide while patient performs painful movements

40
Q

What are muscle energy techniques?

A

use of voluntary contractions exerted against a precise counter force to increase jt ROM

41
Q

How do muscle energy techniques work?

A

like PNF, joint mob force, autogenic inhibition and reciprocal inhibition

42
Q

What is procedure for muscle energy techniques?

A

engage restrictive range, provide iso resistance, hold 5-10 seconds, wait for relaxation and move into new range

43
Q

What is a popular outcome measure used for neck pain?

A

Neck disability index

MCID- 5-9.5 points for neck pain
7-8.5 points for cervical radic.

44
Q

What are scores for NDI?

A 
0-4 no disability
5-14- mild
15-24 - mod
25-34- severe
35-50 complete
45
Q

What are other outcome measures and their MCID?

A

PSFS- 2 points for cervical radic

GROC

NPRS- 2 points

46
Q

What is typical criteria for discharge summary?

A 
functional stability/ endurance
pain 2/10
80% ROM
strength 4/5
premorbid activity level
indt with HEP
balance posture

MS 2 Exam 1 (9 decks)

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