Low Back Pain (AOTA)

Question 1

when does LBP generally resolve for 90% of clients

Answer 1

within 6 weeks; 12 weeks for 5%

Question 2

causes of LBP

Answer 2

poor physical fitness
obesity
reduced muscle strength and endurance
poor endurance
rarely the result of serious spinal diseases; less than 5% true nerve root pain

Question 3

sciatic pain

Answer 3

when sciatic nerve is trapped by herniated disc

Question 4

spinal stenosis

Answer 4

narrowing of vertebral foramen

Question 5

facet joint pain

Answer 5

inflammation of changes of the spinal joints

Question 6

spondylosis

Answer 6

stress fracture of the dorsal to transverse process

Question 7

spondylolisthesis

Answer 7

slippage of vertebra out of position

Question 8

herniated nucleus pulposis

Answer 8

stress tearing of the fibers of a disc, causing an outward bulge pressing on spinal nerves

Question 9

Eval for LBP

Answer 9

occupational profile
questionnaire to identify performance areas affected
determine occupational performance by observing tasks or simulated tasks

Question 10

OT interventions for LBP

Answer 10

1. education regarding anatomy and movements related to pt’s occupational performance
2. use of neutral spine back stabilization techniques to promote decreased pain
3. body mechanics education
4. training in AE and modified tasks
5. task analysis and introducing ergonomic design
6. training in energy conservation
7. use of occupation to increase strength and endurance
8. education for pain management, stress reduction, and coping

Question 11

standards of body mechanics

Answer 11

1. maintain straight back; minimize lumbar lordosis
2. bend from hip and knee
3. avoid twisting
4. maintain good posture
5. carry loads close to body
6. lift with legs
7. lift with wide base of support
8. lift in sagittal plane
9. lift slowly

Question 12

semisquat lift

Answer 12

safest for back; ideal for heavy loads

Question 13

squat lift

Answer 13

alternative to semisquat when space is limited; often preferred by people with LBP

Question 14

stoop lift

Answer 14

used only for light loads under 20 lbs

Question 15

bathing with LBP

Answer 15

1. shower is generally better for maintaining neutral spine
2. all items should be kept within reach using shower caddy or alternative device
3. handheld shower reduces unnecessary movements and twisting
4. bath mat should be used to decrease chance of slipping

Question 16

dressing with LBP

Answer 16

1. minimize bending
2. client should sit while dressing
3. lie flat on bed when pulling clothes up
4. sock are donned/doffed by crossing foot over knee
5. encourage slip on shoes
6. thread belt through loops prior to donning pants

Question 17

functional mobility with LBP

Answer 17

1. logrolling for bed mobility
2. to sit up, client should bend knees and push with arms
3. to lie down, bring legs up and use arms to lower body to bed
4. to sit on toilet, lower body while maintaining straight back and neutral spine
5. use armchairs to assist with sit stand
6. do not sit for longer than 15-20 min

Question 18

personal hygiene with LBP

Answer 18

1. use kitchen sink when possible, as bathroom sink is generally too low in height
2. place foot inside base cabinet while bending hips and keeping back straight to reduce stress on lower back

Question 19

sexual activity with LBP

Answer 19

1. keep lower back in neutral position; can use rolled towel for assistance
2. stretching and warming up muscles can prevent further injury
3. warm shower can relax muscles and reduce pain

Question 20

sleep with LBP

Answer 20

1. firm, supportive mattress is important
2. pillow should support neck and head without causing neck flexion; foam pillows are helpful
3. pillow under knees while sleeping on back
4. pillow between knees in sidelying
5. pillow under feet in prone

Question 21

toileting with LBP

Answer 21

1. reach between legs for hygiene rather than reaching back to avoid twisting
2. straddle back of toilet to widen base of support and provide strong base to help push up for transfer

Question 22

child care with LBP

Answer 22

1. avoid sudden movements
2. use elevated changing table
3. bath infant in kitchen sink rather than bathtub

Question 23

computer use with LBP

Answer 23

1. monitor at eye level; should be able to view screen without neck flexion
2. chair height should allow feet to be flat on floor
3. wrists neutral and forearms parallel to floor when typing
4. elbows 90* while typing
5. use document holders to prevent twisting

Question 24

driving with LBP

Answer 24

1. when entering/exiting car, sit on seat first, then turn entire body to avoid twisting
2. place towel roll in lumbar area
3. schedule rest breaks to change position
4. use cruise control when safe to allow for more frequent change in seating position

Question 25

home care with LBP

Answer 25

1. organize work space to allow for minimal twisting and bending 2. use golfer's lift (lift opposite leg of arm used in reach) to remove laundry from machine 3. use long handled brush to clean tubs

Question 26

shopping with LBP

Answer 26

1. rest on one knee and keep back straight when retrieving items from low shelves 2. carry items in child's seat of cart rather than in basket 3. evenly distribute packages between arms by weight

Question 27

goals of LBP rehab

Answer 27

1. reduce pain 2. education in use of back stabilization techniques 3. education in use of AE 4. incorporation of body mechanics 5. incorporation of ergonomic techniques 6. education in adapting learning to future applications