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MM II > Lumbar Spine Intervention > Flashcards

Lumbar Spine Intervention Flashcards

1
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what is the ONE thing you SHOULD use for ACUTE LBP?

A

Manual therapy: Thrust or non-thrust mobilization

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2
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what are the 4 things you MAY use for ACUTE LBP?

A
  1. Exercise (w/ leg pn: mm strengthening/endurance, specific trunk activation)
  2. MT: STM, massage
  3. Classification Systems: Tx-based classification
  4. Pt education: active education/advice, biopsychosocial contributors to pn, self-management techniques, favorable natural hx
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3
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what are 2 things you CAN use for ACUTE LBP?

(single level II RCT)

A
  1. Exercise: general exercise training
  2. Classification systems: mechanical diagnosis and therapy
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4
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what are the knowledge gaps for ACUTE LBP?

(level I RCTs are needed)

A
  1. Exercise: Movement control (trunk mobility, aerobic exercises, multimodal exercises)
  2. MT: neural tissue mob, DN, traction
  3. Classification systems: cog functional therapy, prognostic risk stratification, pathoanatomic-based classification, movement system impairment
  4. Pt education: pain neuroscience education
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5
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what are 3 things you SHOULD use for CHRONIC LBP?

A
  1. Exercise
  2. MT: thrust or nonthrust joint mob
  3. Pt education: pn neuroscience educ (not as stand alone tx), active tx (yoga, stretching, pilates, strength training)
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6
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what exercise SHOULD you prescribe for CHRONIC LBP?

A
  1. General exercise training
  2. Muscle strengthening & endurance
  3. Specific trunk activation
  4. Aerobic
  5. Aquatic
  6. Multimodal

W/ Movement Control impairment:
1. Specific trunk activation
2. Movement control

For older adults:
1. General exercise training

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7
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what MAY you use for tx of CHRONIC LBP?

A
  1. Exercise: mvmt control, trunk mobility
    • W/ leg pn: specific trunk
      activation, mvmt control
  2. MT: STM, massage
    • W/ leg pn:
      thrust/nonthrust jt mob,
      neural tissue mob
  3. Classification Systems: mechanical diagnosis and therapy, prognostic risk stratification, pathoanatomic-based classification
  4. Pt Education: active education not as stand-alone tx, post-op: general education
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8
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what are treatments you CAN use for CHRONIC LBP?

A
  1. Exercise: Post-op general exercise training
  2. MT: DN
  3. Classification systems: tx-based classification, movement system impairment, cog functional therapy
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9
Q

Based off of the CPG: Interventions for the Management of Acute and Chronic LBP: Revision 2021, what treatments have knowledge gaps for CHRONIC LBP?

(level I RCTS needed)

A
  1. exercise:
    • comparisons of different
      approaches
    • optimal dosing
      parameters
    • targeted delivery
  2. MT:
    • comparisons of MT and
      active txs
    • value of MT in
      multimodal approaches
  3. Classification Systems: direct comparisons of different classification systems
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10
Q

According to the LBP Decision tree, when selecting and implementing interventions, you want to consider the pt perspective. In what 4 ways can you do this?

A
  1. Beliefs re factors causing sxs
  2. Motivations for recovery and prevention
  3. Expected and/or desired interventions
  4. Barriers and facilitators to goal attainment
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11
Q

According to the LBP decision tree, what are suggested interventions for:

ACUTE LBP W/ MOVEMENT COORDINATION IMPAIRMENTS?

A
  1. Specific trunk activation training

2.Trunk mm strengthening/endurance exercises

  1. Trust/non-thrust jt mobs, STM, massage
  2. Education & advice to pursue active lifestyle
  3. Education on favorable natural hx of acute LBP and self-management techniques
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12
Q

According to the LBP decision tree, what are suggested interventions for:

ACUTE LBP W/ RELATED COGNITIVE OR AFFECTIVE TENDENCIES?

A
  1. Prognostic risk stratification to prioritize interventions to address BPS contributors to pain
  2. Pain neuroscience education
  3. General exercise training, aerobic exercises
  4. Education and advice
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13
Q

According to the LBP decision tree, what are suggested interventions for:

ACUTE LBP W/ MOBILITY DEFICITS?

A
  1. Thrust/non-thrust jt mob, STM, massage
  2. General exercise training
  3. Education & advice to pursue active lifestyle
  4. Education on favorable natural hx of acute LBP and self-management techniques
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14
Q

According to the LBP decision tree, what are suggested interventions for:

ACUTE LBP W/ RELATED (REFERRED) LE PAIN?

A
  1. Mechanical dx and therapy interventions
  2. Progress to Acute LBP w/ movement coordination impairment intervention strategies
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15
Q

According to the LBP decision tree, what are suggested interventions for:

ACUTE LBP W/ RADIATING PAIN?

A
  1. General exercise training
  2. Neural tissue mobilization
  3. Thrust/non-thrust jt mob, STM, massage
  4. Education on favorable natural hx of acute LBP and self-management techniques
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16
Q

According to the LBP decision tree, what are suggested interventions for:

CHRONIC LBP W/ MOVEMENT COORDINATION IMPAIRMENTS?

A
  1. Specific trunk activation
  2. Movement control training!!
  3. Thrust/non-thrust jt mobs, STM, massage
  4. Education to pursue active lifestyle

(same as ACUTE LBP but + movement control training and w/o education on favorable natural hx of acute LBP)

17
Q

According to the LBP decision tree, what are suggested interventions for:

CHRONIC LBP W/ RADIATING PN?

A
  1. General exercise training
  2. Neural tissue mobilization exercises
  3. Thrust or non-thrust jt mobs, STM, massage
  4. Education to pursue an active lifestyle

(same as acute except “education to pursue an active lifestyle” instead of “education on favorable natural hx of acute LBP”)

18
Q

According to the LBP decision tree, what are suggested interventions for:

CHRONIC LBP W/ GENERALIZED PAIN?

A
  1. Prognostic risk stratification to prioritize interventions to address BPS contributors to pn
  2. Pain neuroscience education
  3. General exercise training, aerobic exercise
  4. education and advice
  5. cognitive functional therapy to address multiple components assoc w/ LBP

(same as ACUTE LBP w/ related cognitive or affective tendencies + “cognitive functional therapy to address multiple components assoc w/ LBP”)

19
Q

What 5 factors suggest that a pt would benefit from manipulation?

A
  1. sxs < 16 days
  2. FABQWK <19
  3. No sxs distal to knee
  4. hip IR > 35 deg
  5. Lumbar HYPO mobility
20
Q

What are 5 contraindications to manipulation?

A
  1. unstable fx / dislocation
  2. lig tear
  3. malignancy
  4. advanced bone disease
  5. active septic or infectious arthritis
21
Q

What are 3 indications to perform a manipulation on a pt?

A
  1. pain/mm guarding/spasms
  2. improving movement locally
  3. improving movement proximally/distally
22
Q

what are 5 indications to perform spinal traction on a pt?

A
  1. disc herniation
  2. degenerative disc disease (DDD)
  3. nerve root impingement
  4. joint hypomobility
  5. paraspinal mm spasm
23
Q

According to the TBC Traction CPR, what 3 variables are assoc w/ greater improvements w/ mechanical tx?

A
  1. nerve root compression (radiculopathy)
  2. peripheralization w/ ext movements
    • crossed SLR on non-painful side
24
Q

What are 4 contraindications for traction?

A
  1. when motion is contraindicated
  2. acute injury w/ high inflammation (fx side)
  3. jt HYPERmobility or instability
  4. peripheralization of sxs w/ traction

MM II (6 decks)

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