Lumbar TBC

Question 1

What are the favoring factors for centralization
(specific exercise classification) (3)

Answer 1

1. preference for 1 posture
2. centralization w. specific movement = better prognosis
3. peripheralization w. opposite mvmt

Question 2

What are the factors against for centralization
(specific exercise classification) (2)

Answer 2

1. only present with LBP
2. all mvmts are about the same

Question 3

what are some extension centralization exercises?

Answer 3

prone press ups
CPAs w. extension mvmt
standing lumbar extension
possibly bridging

Question 4

what are some flexion centralization exercises?

Answer 4

supine double knees to chest (KTC)
supine posterior pelvic tilt
child’s pose stretch repeated

Question 5

what are some rotation centralization exercises?

Answer 5

LTR (supine and knees flexed moving from side to side)
lumbar roll rotation (stretch repeated)

Question 6

factors favoring manipulation? (5)

Answer 6

1. no pain distal to knee (if have referral down leg then not a candidate)
2. recent onset <16 days = acute
3. low FABQW score <19 (fear avoidance)
4. hypomobile in lumbar spine w. PA mobs
5. Hip IR >35 (if less then refer for imaging cause indicates severe OA)

Question 7

factors against manipulation? (4)

Answer 7

1. symptoms past knee
2. inc episode frequency
3. peripheralization w. motion
4. not stiff/ no pain with PA

Question 8

list contraindication for manipulation (9)

Answer 8

1. osteoporosis
2. instability (pregnant)
3. fx
4. pt says no
5. anticoagulants
6. long term steroid use
7. extensive medical hx
8. not na MSK prob
9. too acute to evaluate

Question 9

what should you perform after a manip?

Answer 9

10 reps of hand heel rocking “yoga flow”

Question 10

factors favoring SIJ

Answer 10

if 2/4 tests are positive
1. ASIS compression/distraction
2. thigh thrust
3. sacral thrust test
4. not centralizing only referring pain to butt

Question 11

factors against SIJ?

Answer 11

<1 SIJ test positive

Question 12

treatment for SIJ?

Answer 12

muscle energy techniques to reset innominate

Question 13

Traction is the best choice for tx of what diagnosis?

Answer 13

stenosis

Question 14

factors favoring traction? (5)

Answer 14

SLR <40deg
sxs of N root involvement
signs of stenosis
distal pain doesn’t centralize w. repetition
distal symptoms

Question 15

factors against traction? (2)

Answer 15

matches other category
no signs of N root involvement

Question 16

what type of traction can you use?

Answer 16

long axis distraction
manual traction
positional traction

Question 17

factors favoring stability classification? (7)

Answer 17

1. aberrant (weird) mvmt when coming up from flexion back to neutral
2. > 40yo
3. SLR >90 deg
4. 3 or more episodes of pain
5. inc episode freq.
6. • prone instability test
7. hyper mobility w. PAs

Question 18

factors against stability classification? (2)

Answer 18

discrepancy in SLR ROM
low FABQ score <9

Question 19

what muscles do we want to focus on to improve stability?

Answer 19

transverse abdominis
multifidus
obliques
hip muscles (abductors/flexors)

Question 20

what muscles should we stretch to improve stability and movement?

Answer 20

rectus femoris & hamstrings