Lumbar TBC Flashcards
What are the favoring factors for centralization
(specific exercise classification) (3)
- preference for 1 posture
- centralization w. specific movement = better prognosis
- peripheralization w. opposite mvmt
What are the factors against for centralization
(specific exercise classification) (2)
- only present with LBP
- all mvmts are about the same
what are some extension centralization exercises?
prone press ups
CPAs w. extension mvmt
standing lumbar extension
possibly bridging
what are some flexion centralization exercises?
supine double knees to chest (KTC)
supine posterior pelvic tilt
child’s pose stretch repeated
what are some rotation centralization exercises?
LTR (supine and knees flexed moving from side to side)
lumbar roll rotation (stretch repeated)
factors favoring manipulation? (5)
- no pain distal to knee (if have referral down leg then not a candidate)
- recent onset <16 days = acute
- low FABQW score <19 (fear avoidance)
- hypomobile in lumbar spine w. PA mobs
- Hip IR >35 (if less then refer for imaging cause indicates severe OA)
factors against manipulation? (4)
- symptoms past knee
- inc episode frequency
- peripheralization w. motion
- not stiff/ no pain with PA
list contraindication for manipulation (9)
- osteoporosis
- instability (pregnant)
- fx
- pt says no
- anticoagulants
- long term steroid use
- extensive medical hx
- not na MSK prob
- too acute to evaluate
what should you perform after a manip?
10 reps of hand heel rocking “yoga flow”
factors favoring SIJ
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
factors against SIJ?
<1 SIJ test positive
treatment for SIJ?
muscle energy techniques to reset innominate
Traction is the best choice for tx of what diagnosis?
stenosis
factors favoring traction? (5)
SLR <40deg
sxs of N root involvement
signs of stenosis
distal pain doesn’t centralize w. repetition
distal symptoms
factors against traction? (2)
matches other category
no signs of N root involvement
what type of traction can you use?
long axis distraction
manual traction
positional traction
factors favoring stability classification? (7)
- aberrant (weird) mvmt when coming up from flexion back to neutral
- > 40yo
- SLR >90 deg
- 3 or more episodes of pain
- inc episode freq.
- prone instability test
- hyper mobility w. PAs
factors against stability classification? (2)
discrepancy in SLR ROM
low FABQ score <9
what muscles do we want to focus on to improve stability?
transverse abdominis
multifidus
obliques
hip muscles (abductors/flexors)
what muscles should we stretch to improve stability and movement?
rectus femoris & hamstrings
