Lumbar/SIJ - CC's and other LBP Resources

Question 1

This is found when there is a high T2 signal in and near the vertebral endplate. It is believed to represent disruption of the end plate with subsequent bone marrow edema

Answer 1

Modic Sign

Question 2

What is a blue flag?

Answer 2

describe a patients perception of work and work conditions - examples include low job satisfaction

Question 3

What is the clinical premise for using motor control exercises?

Answer 3

individuals with LBP have altered muscle control of the trunk and back muscles that leads to inappropriate loading on painful lumbar motion segments.

Question 4

What is graded exposure?

Answer 4

asks pts with LBP to generate a hierarchy of feared activities and then to gradually progress through these in attempt to reduce activity related anxiety

Question 5

what is Graded activity?

Answer 5

uses an operant condition to reinforce healthy behaviors and progress the patient through different levels of functional activity.

Question 6

CPR for SIJ?

Answer 6

Thigh thrust
Gaenslan
Compression
distraction
sacral thrust

Question 7

What is the ASLR test?

Answer 7

Perform a SLR and then stabilize the pelvis. If the strength improves with stabilization then its an SIJ issue

Question 8

How do you screen the hip joint when evaluating SIJ patients?

Answer 8

Sign of buttock, then scour, FADIR, FABER, hip OA CPR

Question 9

For those patients who are classified as “manipulation”, what interventions should be performed?

Answer 9

Manipulation
AROM

Question 10

For those patients who are classified as “stabilization”, what interventions should be performed?

Answer 10

promoting isolated contraction and co contraction of the deep stabilizing muscles - TA, multifidus

strengthening of the large spinal stabilizers - erectors, obliques

Question 11

For those patients who are classified as “specific exercise - extension”, what interventions should be performed?

Answer 11

end range extension exercises
mobilization to promote extension
avoid flexion activities

Question 12

Pathophysiology of DDD:

Answer 12

The degenerative processes involve the structural damage of the intervertebral disc and the changes in number and composition of cells. The main factor in the degeneration of the intervertebral disc is the loss of proteoglycans. Degenerative changes of the disc are connected to damage of adjacent structures, leading to functional changes, higher susceptibility to injuries and clinical signs and symptoms

Question 13

When do you perform a tensioner and when do you perform a slider? for nerve mobes

Answer 13

Tension: reduce intraneural swelling, fluctuating effects, chronic injury

Slide: less aggressive, acute injury, post op