Lumbar Spine Flashcards
Back Pain Class: Centralizes with 2 or more movements in one direction
or
Centralize with a movement in 1 direction and peripheralize with an opposite movement
Preference for one posture
Specific Exercise Classification
Manipulation/Mobilization treatment classification
Recent onset of symptoms < 16 days
No symptoms distal to the knee
Low FABQ score < 19
Stabilization classification
SLR ROM > 90 degrees
Positive prone instability test
Positive aberrant movement
Age < 40 y
3 or more previous episodes
hypermobility with spring testing
increasing episode frequency
Specific exercise LBP treatment
1-2 sets of 10-12 reps every 1-2 hours
Can be lateral shift if appropriate
Progress to phase 2- recovery of function and fitness
Mobilization LBP accompanying treatment
Manual Therapy
AROM for symptom modulation and maintenance
Active as able education
Phase 2- F and R
Stabilization
Lumbopelvic control
Progress to phase 2 as symptoms reduce
Limits of Treatment Based Classification System
10-20% don’t fit
Works less consistently with chronic pain
Doesn’t account for psychosocial factors
No self management group in original classification
Excludes other effective interventions
Mckenzie model classifications pick 4
Posture
Dysfunction
Derangement
Chronic Pain
Postural Syndrome
Prolonged end range loading of periarticular structures
No pain with activity
Patient ed, restore lumbar lordosis, avoid provocative posture, avoid prolonged postures
Dysfunction syndrome
Mechanical deformation , scar tissue, adaptive shortening
Symptoms- 8-12 weeks
Intermittent pain, end range of a restricted movement
Treatment: Repeated movements in direction of pain until pain free
Derangement syndrome
Inconsistency and change
Most common 50-75% of LBP
Influenced by posture/ daily activity
Directional Preference–> Repeated movements cause improvement in symptoms
Repeated movements exam
RFIS
REIS
RFIL
REIL
Lateral Shift Correction
