Lumbar Spine Flashcards
Acute/Chronic LBP CPG: Exercise for acute LBP
C level - use exercises including specific trunk m activation
Acute/Chronic LBP CPG: Exercise for acute LBP with leg pain
B level - trunk m stregthening and endurance, specific m activation
dec pain and disability
Acute/Chronic LBP CPG: Exercise for chronic LBP
A level - use exercise training intervention - trunk m strengthening/endurance, multimodal exercise interventino, specific trunk m activation, aerobic exercise, aquatic exercise, general exercise
Acute/Chronic LBP CPG: Exercise for Chronic LBP
B level - provide movement control exercise or trunk mobility exercise
Acute/Chronic LBP CPG: Exercise for chronic LBP with leg pain
B level - use exercise training interventions, specific trunk m activation and movement control
Acute/Chronic LBP CPG: Exercise for chronic LBP with movement control impairment
A level - use specific trunk muscle activation and movement control exercise
Acute/Chronic LBP CPG: Exercise for chronic LBP in older adults
A level - general exercise training to decrease pain and disability
Acute/Chronic LBP CPG: Exercise for postoperative LBP
C level - general exercise trianing following lumbar spine surgery
Acute/Chronic LBP CPG: Manual and other directed therapies for acute LBP
A level - thrust or nonthrust joint mobilization to decrease pain and disability
Acute/Chronic LBP CPG: manual and other directed therapies for acute LBP
B level - massage or STM for short term pain relief
Acute/Chronic LBP CPG: Manual and other directed therapies for chronic LBP
A level - thrust or nonthrust jt mob to decrease pain and disability
Acute/Chronic LBP CPG: Manual and other directed therapies for chronic LBP
B level - thrust or nonthrust jt mobs to decrease pain and disability in patients with LBP AND leg pain
Acute/Chronic LBP CPG: Manual and other directed therapies for chronic LBP
C level - consider dry needling in conjunction with other tx for short term pain and disability decrease
Acute/Chronic LBP CPG: Manual and other directed therapies for chronic LBP
B level - neural mob in conjunction with other tx for short term decrease in pain and disability for patients with CLBP and leg pain
Acute/Chronic LBP CPG: Manual and other directed therapies for chronic LBP
D level - should NOT use mechanical traction for pts with CLBP plus leg pain. lack of benefit when added with other interventions
Acute/Chronic LBP CPG: Classification systems for acute LBP
B level - use tx based classification to reduce pain and disability
Acute/Chronic LBP CPG: Classification systems for acute LBP
C level - mechanical diagnosis and therapy to decrease pain and disability
Acute/Chronic LBP CPG: Classification systems for chronic LBP
B level - MDT, prognostic risk stratification, or pathoanatomic-based classification to reduce pain and disability
Acute/Chronic LBP CPG: Classification systems for chronic LBP
C level - use TBC, cognitive functional therapy, or mvmt system impairment to reduce pain and disability
Acute/Chronic LBP CPG: Education for acute LBP
B level - active education strategies vs passive: one-on-one ed
biopsychosocial contributors to pain
self management techniques: remain active, pacing strategies, back protection techniques.
Counseling on favorable natural history of acute LBP
Acute/Chronic LBP CPG: Education for chronic LBP
B level - standard ed strategies but NOT as a standalone tx.
Advice related to exercise and staying active
Acute/Chronic LBP CPG: Education for Chronic LBP
A level - pain neuroscience education alongside other PT interventions (exercise, manual)
Acute/Chronic LBP CPG: Education for chronic LBP
A level - active treatments (yoga, stretching, Pilates, strength training) instead of stand along education interventions
Acute/Chronic LBP CPG: Education for post-op LBP
B level - use general education (post surgical precautions, exercise, and resuming physical activity) for discectomy or decompression surgery.
Spinal Stenosis vs Intermittent Vascular Claudication:
Posture
SS: flex improves, ext worsens
IC: no affect
Spinal Stenosis vs Intermittent Vascular Claudication:
Walking
SS: distance varies
IC: consistent distance
Spinal Stenosis vs Intermittent Vascular Claudication:
Pain Relief
SS: must sit to get relief
IC: stop activity to get relief
Spinal Stenosis vs Intermittent Vascular Claudication:
Pulses
SS: present
IC: diminished or absent
Spinal Stenosis vs Intermittent Vascular Claudication:
Back pain
SS: common
IC: uncommon
Spinal Stenosis vs Intermittent Vascular Claudication:
Leg pain
SS: bilateral (usually)
IC: May be unilateral or asymmetric
Spinal Stenosis vs Intermittent Vascular Claudication:
Weakness
SS: occasionally
IC: uncommon
Spinal Stenosis vs Intermittent Vascular Claudication:
Walking downhill
SS: worse
IC: unchanged or better
Spinal Stenosis vs Intermittent Vascular Claudication:
Walking uphill
SS: better
IC: unchanged or worse
L1 dermatome/myotome/reflex
Derm: iliac rest and groin
Myo: psoas
Reflex: none
L2 dermatome/myotome/reflex
Derm: ant thigh
Myo: psoas
Reflex: none
L3 dermatome/myotome/reflex
Derm: ant lower thigh and shin
Myo: quads
Relfex: patellar tendon
L4 dermatome/myotome/reflex
Derm: medial calf and big toe
Myo: tib ant
reflex: patellar tendon
L5 dermatome/myotome/reflex
Derm: lateral leg and ant foot
Myo: extensor hallucis longus
Reflex: none
S1 dermatome/myotome/reflex
Derm: lower half of post calf, sole of foot, lateral two toes
Myo: Flex hallucis longus, gastroc
Reflex: achilles
S2 dermatome/myotome/reflex
Derm: post thigh, sole and plantar aspect of heel
Myo: hamstrings
Reflex: lateral hamstring
