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Active Care > Low Back Assessment > Flashcards

Low Back Assessment Flashcards

1
Q

stability needs _____ and _____ to be equal

A

compression

tension forces

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2
Q

what do muscles provide for stability?

A

force transference

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3
Q

what does optimization of stabilization require?

A

adequate compression of joints

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4
Q

tensegrity

A

a force pulling in one direction is equally opposed by a force pulling in the opposite direction

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5
Q

compression is applied by?

A

gravity

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6
Q

tension is absorbed and provided by?

A

muscle
tendon
ligament
bone

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7
Q

what does spine stability depend on?

A

symmetry of muscle stiffness and forces all around the spine
no singl emuscle must exert too much force or too little, its activation level is in balance with all others
a neutral spine is required together with a broad base

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8
Q

what muscles are shortened for lumbar hyperlordosis?

A

erector spinae

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9
Q

anterior pelvic tilt has what weak muscles? tight?

A

weak gluteals, iliopsoas

tight quads, erector spinae

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10
Q

protruding abdomen is caused by weak what?

A

abdominals

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11
Q

foot flare is caused by?

A

tightness in external hip rotators

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12
Q

pain over lateral knee is caused by?

A

shortened TFL

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13
Q

hypolordosis is caused by weak what? tight?

A

weak: rectus abdominus, external oblique
tight: gluteals, hamstrings

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14
Q

anterior pelvic tilt is caused by what?

A

tight: erector spinae, rectus femoris
weak: iliopsoas

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15
Q

posterior pelvic tilt is caused by what?

A

tight: gluteus, hamstring, iliofemoral ligament
weak: rectus abdominis, external oblique

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16
Q

what are some screening methods for lower cross syndrome?

A

prone instability test
hip extension pattern
hip abduction pattern
glute bridges

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17
Q

what mobility tests are used for lumbar spine evaluation?

A

toe touch

prone instability test

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18
Q

what motor control tests are used for lumbar spine?

A

hip extension pattern
hip abduction pattern
glute bridge

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19
Q

what functional patterning tests are used for lumbar spine?

A

deadlift
lunge
deep squat

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20
Q

P-A instability test (feet down)

A

patient is prone, with legs off the end of the table

impulse at each lumbar spinous process. pain occurs at unstable segments

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21
Q

P-A instability test (feet up)

A

patient is prone on the table with the legs off the table
impulse at each lumbar spinous process. Pain lessens when legs raised as lumbar extensors are activated, stabilizing lumbar spinal segments

22
Q

hip extension proper motion pattern

A

ipsilateral hamstring
ipsilateral gluteals
contralateral spinal extensors
ipsilateral spinal extensors

23
Q

where are doctor’s hands on hip extension?

A

one hand on glutes

one hand on thoracolumbar paraspinals

24
Q

hip extension motion pattern, what happens if they can’t hold knee extension?

A

facilitated hamstrings

inhibited glutes

25
Q

hip extension motion pattern, what happens if there is forced lumbar extension?

A

facilitated thoraclolumbar extensors
inhibited glutes
hypermobile lumbar segments

26
Q

hip extension motion pattern, what happens if the thoracic spine activation first with trapezius activation?

A

evaluate contralateral latissimus dorsi

27
Q

what is the treatment for altered hip extension?

A

stretch tight muscles first

strengthen weak muscles

28
Q

what muscles do you stretch when your patient has altered hip extension pattern

A

psoas
quads
hamstrings

29
Q

what muscles do you strengthen in an altered hip extension pattern?

A 
gluteals
abdominals (curl up)
30
Q

what else can you do for altered hip extension pattern?

A

adjust thoracics
lumbars
SI

31
Q

what exercises can you use to help with hip extension?

A

quadruped leg reach

table top

32
Q

quadruped leg reach

A

get on all fours

lift one leg up without extending lumbars

33
Q

table top

A

lay top of back and head on exercise ball

lift hips up in air without extending lumbars

34
Q

proper hip abduction motor pattern

A

side lying with lower leg flexed
slowly raise leg toward ceiling
observe for normal motion
hold position and observe for drift

35
Q

altered hip abduction pattern

A 
decrease ROM
hip flexion (forward drift)
hip external rotation (foot flare)
hip hiking (bending at waist)
36
Q

decreased ROM for hip abduction pattern

A

adductor tightness

37
Q

hip flexion altered hip abduction

A

TFL substitution

38
Q

hip external rotational altered hip abduction pattern

A

piriformis substitution

39
Q

hip hiking altered hip abduction pattern

A

QL substitution

40
Q

how do you treat altered hip abduction

A

stretch TFL, QL, piriformis
strengthen gluteus medius
adjust

41
Q

how can you strengthen gluteus medius?

A

side-lying hip abduction
side plank wall press
monster walk

42
Q

segmental stabilization of glutes

A

force closure of SI
control and centralize femur in acetabulum
co-contraction with psoas major provides pelvic stability
segmental stabilizer through tensing TL fascia and triggering deep lumbar multifidus

43
Q

global stabilization of glutes

A

eccentric lengthening or isometric holding to control ROM

44
Q

how do the glutes provide eccentric lengthening or isometric holding to control ROM

A

sagittal plane stabilization of trunk during gait and standing
controls trunk rotation during gait through conecction with lat
frontal plane stabilizer during single leg (trendelenburg)

45
Q

global mobilizer of the glutes

A

produce high force or power

46
Q

how do the glutes produce high force or power?

A 
hip extension
external rotation
superior fibers (abduction)
lower fibers (adduction
47
Q

what are some lifting strategies to spare the spine?

A 
avoid end range lumbar motion
avoid lifting immediately after sitting flexed
pre-stress the system for stability
reduce the load moment
direct force vector through the navel
reduce the amount of weight lifted
48
Q

how do you avoid end range lumbar motion

A

neber flex the lumbar spine to full flexion under load

49
Q

how do you avoid pre-stressing the lumbar system for stability?

A

abdominal brace (increase intra-abdominal pressure)

50
Q

how do you reduce the load moment?

A

keep the weight in close

golfer’s lift

51
Q

lifting mechanics

A

practice lifting
avoid twisting
rolling in bed

Active Care (13 decks)

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