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MSK 3 > Lumbar Exam/Interventions > Flashcards

Lumbar Exam/Interventions Flashcards

1
Q

special tests for ruling out lumbar radiculopathy

A
  • slump test
  • straight leg raise test
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2
Q

special tests for ruling out z joint pain

A

extension rotation test

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3
Q

+ slump test results

A

pt has symptoms provoked during motion and symptoms relieved when neck is extended while in slumped position

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4
Q

What are potential position for sensitizing the straight leg raise test?

A
  • cervical flexion
  • Hip IR
  • Hip ADD
  • Ankle DF
  • Ankle DF and inversion for sural nerve bias
  • PF and inversion for fibular nerve bias
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5
Q

how to bias sural nerve on SLR test

A

SLR + ankle DF and inversion

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6
Q

how to bias fibular nerves on SLR test

A

SLR + PF and Inversion

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7
Q

CPR for lumbar stenosis

A
  • bilateral symptoms
  • Leg pain > back pain
  • pain with walking/standing
  • pain relieved with sitting
  • age > 48 y/o
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8
Q

special tests for confirming discogenic symptoms and/or lumbar radiculopathy

A

centralizations with repeated motions

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9
Q

special tests for confirming lumbar radiculopathy

A
  • well leg raise test
  • femoral nerve tension test
  • CPA/spring testing
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10
Q

special tests for confirmation of neuromuscular instability

A
  • catch sign
  • passive lumber extension test
  • prone instability test
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11
Q

+ test for well leg raise test

A

lift non-involved side and + test if symptoms are reproduced on involved side

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12
Q

What is the Revised Oswestry Disability Index?

A

10 item self-report questionnaire that is designed to measure disability related to LBP
- higher score = higher disability
- lower score = lower disability

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13
Q

MDIC of Revised Oswestry Disability index

A

30% from baseline score

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14
Q

What is the Roland-Morris Disability Questionnaire? What are scores?

A

24-item questionnaire that measures physical disability secondary to LBP
- 0 (no disability) - 24 (max disability)

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15
Q

MCID of Roland-Morris Disability Questionnaire (RMDQ)?

A

changes of 2-3 points
- change in baseline by 30% (5 point improvement)

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16
Q

interventions for spondylolysis/spondylolysthesis

A
  • address muscle guarding w/ AROM, soft tissue mobs, low intensity-high frequency
  • stretching of shortened hip musculature
  • progress lumbar stabilization exercises
17
Q

interventions for disc pain

A

Will see multidirectional ROM limitations

  • address muscle guarding
  • low intensity-high frequency exercises
  • progress lumbar stabilization
18
Q

interventions for radiculopathy/radicular pain

A
  • AROM exercises
  • neuro mobilizations
  • progress lumbar stabilization exercises

want to centralize symptoms

19
Q

interventions for lumbar spine stenosis

A
  • sustained hold mobs for hypomobile segments
  • oscillations for muscle guarding and pain
  • muscle performance tests
20
Q

interventions for z-joint arthropathy

A
  • address muscle guarding
  • low-intensity/high frequency and duration exercises
  • joint mobs
21
Q

best intervention for acute LBP

A

thrust and non-thrust mobs
- pt education

22
Q

best intervention for chronic LBP

A
  • exercise training interventions
  • trust and non-thrust mobs
  • pain neuroscience pt education
23
Q

How to determine if a patient fits into LBP with cognitive or affective tendencies?

A

patient will have the presence of fear avoidance, pain catastrophizing, or depression

24
Q

Patients who have chronic LBP with related generalized pain

A

chronic is > 3 months
- patient will have the presence of fear avoidance, pain catastrophizing, or depression

25
Q

treatment for chronic LBP with related generalized pain

A
  • prioritize interventions to address biopsychosocial contributors to pain
  • pain neuroscience education
  • general exercise training, aerobic exercises, and active education and advice
  • cognitive functional therapy
26
Q

how to rule in acute/chronic LBP with movement coordination impairments

A
  • symptoms reproduced with mid-range motion and worse with end-range motion
  • observed gowers sign or hitch in giddy up (movement coordination impairments)
  • diminished strength and endurance
  • mobility deficits
  • lumbar hypermobility
27
Q

how to rule out acute/chronic LBP with movement coordination impairments

A
  • adequate L/R passive straight leg raise and thorax rotation
  • normal trunk flexor, trunk extensors, lateral abdominals, hip abductors, hip and thigh muscle performance
28
Q

interventions for acute/chronic LBP with movement coordination impairments

A
  • specific trunk activation training
  • trunk muscle strengthening and endurance exercises
  • thrust and non-thrust joint mobs, soft tissue mobs, and massage
  • pt education to purse an active lifestyle
29
Q

how to rule in acute LBP with related radiating LE pain

A

centralized pain with positioning, manual procedures, and/or repeated movements

30
Q

how to rule in actue LBP with radiating pain

A

symptoms reproduced with mid-range and worsen with end-range testing

31
Q

how to rule in chronic LBP with radiating pain

A

symptoms reproduced with sustained end-range lower-limn nerve tension/straight leg raise and/or slump test

32
Q

How to rule in acute LBP with mobility deficits

A
  • Pt reports “tweaked my back when I did….”
  • lumbar ROM limitations
  • onset of symptoms often linked with recent awkward movement
33
Q

interventions for acute mobility deficits

A
  • thurst, non-thrust joint mobs, soft tissue mobilization and massage
  • general exercise training
34
Q

cluster that best determines if a patient would benefit from a spinal manip

A
  • duration of symptoms </= 16 days
  • no symptoms distal to the knee
  • FABQ score < 19
  • at least one hip > 35 deg IR ROM
  • hypomobility in lumbar spine

MSK 3 (13 decks)

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