Lumbar Spine Flashcards

1
Q

What are normal expectations when observing LQ movement screen?

A

Normal Expectations:
-Touches toes?
-Reversal of Lumbar Lordosis
-Hip to Spine flexion ratios about 50% each
-Posterior hip sway

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2
Q

What are two constructs for scoring the Keele STARTBack Screen Tool?

A

1) Overall Score – if 3 or more = Medium or High Risk to develop Chronic LBP – depending on how the scores for the Psychological Items are

2) Psychological Score
Psych score 2 or less = Medium Risk
Psych score 3 or more = High Risk
Medium or High RISK = Refer to PT

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3
Q

What are signs of pathologic motion when observing LQ movement screen?

A

Non-reversal of L-Lordosis
Hinge Points
Judder and deviations
Gower’s sign (climbing up the legs to stand back up)

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4
Q

What are the 5 criteria for Lumbar Manipulation CPR?

A

Duration of Symptoms < 16 days
At least one hip > 35 of IR
Lumbar Hypo-mobility
No symptoms distal to knee
FABQ-W <19

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5
Q

What is the four criteria for Lumbar Stabilization Intervention CPR?

A

Age < 40
Avg SLR > 91
POS Prone instability test (PIT)
Aberrant movement present (instability catch, painful arc, thigh climbing, reversal of lumbo-pelvic rhythm)

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6
Q

Grade 1 Spondylolithesis

A

<25% slippage, usually not symptomatic

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7
Q

Grade 2 Spondylolithesis

A

25%-50% slippage, education to avoid extension and begin spinal stabilization. May use casting to reduce anterior shear forces and allow healing

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8
Q

Grade 3 Spondylolithesis

A

50%-75% slippage, conservative treatment may be attempted. May need surgery

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9
Q

Grade 4 Spondylolithesis

A

> 75% slippage, surgery due to neurological involvement

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10
Q

What 3 exercises are included in the McGill Big 3?

A

The Curl Up
Side Plank
Bird dog

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11
Q

What is the lumbar spinal stenosis CPR?

A

Bilat Symptoms
Leg Pain > Back Pain
Pain during walking or standing
Pain relief upon sitting
Age > 48 years

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12
Q

Who is more likely to experience Pelvic Girdle / SIJ Pain?

A

Females > Males

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13
Q

What is a common mechanism of injury (MOI) for Pelvic Girdle / SIJ Pain?

A

Recent Fall onto buttock or knee, pregnancy/childbirth (post partum or monthly cycle)

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14
Q

What should be ruled out (R/O) when assessing Pelvic Girdle / SIJ Pain?

A

Fractures – Trauma vs. Insufficiency (Osteoporosis)

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15
Q

How does Pelvic Girdle / SIJ Pain present in the early stages?

A

Hurts with Everything!

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16
Q

How does Pelvic Girdle / SIJ Pain present later?

A

Inconsistent Onset vs. Specific Motions…Movement Control

17
Q

What type of pain is commonly reported in the SIJ / PSIS region?

A

Sharp Pain

18
Q

What physical signs may indicate Pelvic Girdle / SIJ Pain?

A

Guarded Gait, Any Pelvic Motion, Any Lifting the LE (into the bathtub)

19
Q

What sleeping issue is commonly associated with Pelvic Girdle / SIJ Pain?

A

Sleeping difficult, Any Rolling / Supine-Sit aggravates

20
Q

What is the initial focus of physical therapy management for Pelvic Girdle / SIJ Pain when everything hurts?

A

Symptom Moderation – Belting to stabilize

21
Q

What is the focus of physical therapy management for Pelvic Girdle / SIJ Pain with inconsistent onset?

A

Movement Control

22
Q

What is the criteria for SIJ CPR - Provocation Test Cluster(s) ?

A

Distraction
Compression
Thigh Thrust
Ganslen’s
Sacral Thrust (Laslett’s)

23
Q

What 3 criteria are involved in the LQ algorithm for pelvic girdle (Pelvic alignment)?

A

Need 2 of 3 POSITIVE for these for the Pelvic Girdle:

Motion Testing (March/Gillet and Forward bending tests)
Positional Testing – Ant/Post illia, inflare/outflares
Ligamentous Palpation Provocation Testing – Long & Short SI, Sacrospinous & Sacrotuberous ligaments

24
Q

What is the forward bend PSIS test?

A

Left Hand on Sacral Base, R hand on PSIS; Patient FB’s watch for WHEN PSIS moves. Compare to C/L side. POS= Side that moves 1st or moves MOST w/ FB as it is more restricted or “sticking” to the spine longer. (Sacrum on Ilium)

25
Q

What is the March/Gillet Test?

A

Ilium on sacrum. POS for side that moves the LEAST (L to R on March). Also view for trendelenberg and or pelvic elevation (Movement Control)

26
Q

What is the Active SLR Test (AKA “Mens” Test)?

A

Laxity with inflammation trauma vs. ligamentous laxity
Original Article tested in Post Partum Population
Stabilize the Pelvis and Repeat Active SLR; POS if pain abolished with stabilization

27
Q

What does it mean if you have a short to long leg in supine to long sit test?

A

Short to long leg = Posterior Ilial rotation

28
Q

What does it mean if you have a long to short leg in supine to long sit test?

A

Long to Short leg = Anterior Ilial rotation

29
Q

What does it mean if you have a short leg with no change in supine to long sit test?

A

Short leg with no change = Leg Length Discrepancy

30
Q

Lumbar strain/sprain symptoms

A

Diffuse pain in lumbar muscles; some radiation to buttocks

31
Q

Degenerative disk or facet process symptoms

A

Localized lumbar pain; similar findings to lumbar strain

32
Q

Herniated disk symptoms

A

Leg pain often worse than back pain; pain radiating below knee

33
Q

Osteoporotic compression fracture symptoms

A

Spine tenderness; often history of trauma

34
Q

Spinal stenosis symptoms

A

Pain better when spine is flexed or when seated, aggravated by walking downhill more than uphill; symptoms often bilateral

35
Q

Spondylolisthesis

A

Pain with activity, usually better with rest; usually detected with imaging; controversial as cause of significant pain