Lumbar radiculopathy/ Cauda Equina Flashcards
mobility rule of 3: lumbar radiculopathy
1/3 hr mobility
1/3 hr pos of releif
1/3 hr of ADL
Flexion-distraction cox goals (how low does it drop pressure and how wide does it open foramina %)
- Drops intradiscal pressure to as low as -192mmHg in the lumbar spine
- Widening the spinal canal foramina area by 28%
- Reducing pressure on the spinal nerves
- Returning motion to the spinal jts
What is the goal of williams flexion exercises
-To reduce lumbar lordosis or flatten the back
- strengthening the abdominal mm
- Strenthen the gluteal mm
A posterolateral disk bulge at L4/5 affects what nerve root
L5
A far lateral disc bulge at L4-5 affects what nerve root
l4
Repeated flexion distraction motion helps do what (cox)
helps restore jt mechnics
normalize reflex activation of jt receptors
Diminish segmental reflex activation and mm hypertonus
What is the 50% rule in Cox
When pt has 50% less symptoms reduce tx by 50%
What is the 3 syndromes in mckenzie
Postural syndrome
Dysfunctional syndrome
Derangement syndrome
What is postural syndrome
Poor posture
flexed habits
stretching and minor pain
Mechanical stress leads to: soft tissue change, end range pain, postural changes, structural changes
tx of postural syndrome
Ergonomics
postural training
stabilization exercises
etc
What is dysfunctional syndrome
-Adaptive shortening (end range stress of shortened structures)
- occures w age
- cummulative spinal degen
- persistent poor posture
Tx of dysfunction syndrome
mobilize in the direction that recreates pain of soft tissue restrictions
- goal is to remodel the tissue shortening/adhesions
- should not peripheralize pain
What is derrangement syndrome and when can it be reducable
progressive internal disc disruption
usually younger can be reversed
what are the theraputic goals to centralize pain in mckenie
- current posture
- stretch (short contracted mm)
- Apply reductive pressures to relocate nuclear material
red flags for lumbar disc
bilateral leg signs recent sig traua bowel + bladder symptoms Older pt 50> w progressive nerve signs Thoracolumbar pain + groin pain Abdominal pain