Lumbopelvic Region Flashcards
what is the leading cause of disability, activity limitation and work absence in the world
LBP
what are 3 prognostic factors for developing recurrent LBP
- hx of previous episodes
- excessive spine mobility
- excessive mobility in other joints
what are 5 prognostic factors for developing chronic pain
- presence of symptoms below knee
- psychological distress or depression
- fear of pain, mvmt or re-injury OR low expectations of recovery
- pain of high intensity
- passive coping style
according to the video we watched, what are the 4 yellow flags for the likelihood of developing chronic LBP
- fear of mvmt
- low mood/isolation
- passive therapy
- belief that all pain is bad
according to the video, what are 4 general guidelines that are appropriate for all back pain pts
- attitude is important for outcomes
- imaging is not generally helpful
- activity is important
- small changes can make a big difference
what is the main purpose of CPG
to reduce variability in clinical practice
what 6 things are consistently recommended for LBP pts
- rule out specific pathology
- promote self management
- against imaging for nonspecific LBP
- cautious approach to use of opiods
- mngmt include psychosocial factors
what are the 6 major classification systems
- mechanical dx and therapy
- treatment based
- mvmt system impairment
- cognitive functional therapy
- prognostic risk stratification
- pathoanatomic based
which classification system is based on changes in LBP symptoms in response to direction specific repeated lumbar spine mvmts
Mechanical dx and therapy (McKenzie)
which classification system is used to guide initial treatment approach based on initial assessment findings
treatment based
which classification system is based on impaired trunk mvmts and posture associated with LBP symptoms observed during standard exam - test results are used to classify pts based on observed lumbar mvmt or alignment impairment
mvmt system impairment
which classification uses an integrated behavioral approach that includes 3 things - making sense of pain, exposure with control, lifestyle change
cognitive functional therapy
which classification system identifies pts at diff levels of risk for persistent pain
prognostic risk stratification
what does the statement of intent say in the CPG
the CPG serve as a guideline and recommendation for how to treat these pts, but they are not an end all treatment. they do not guarantee good outcome
“not a standard of care”
what are the 7 purposes of CPG
- describe EBP
- classify/define msk conditions
- identify interventions to address ICF impairments
- idenitify outcome measures
- provide description of practice to policy makers
- provide info to payers
- reference for best current practice
what are the 6 categories of LBP
- mobility deficits
- mvmt coordination impairment
- referred LE pain
- radiating pain
- relative cognitive or affective tendencies
- generalized pain
what category of LBP - symptoms:
- may report back stiffness
- onset of symptoms linked to unguarded/awkward mvmt or position
- unilateral, LB/butt/thigh pain
acute/subacute LBP with mobility deficits
what category of LBP - Impairments of body function
- ROM limitations
- restricted segmental motion
- symptoms reproduced with provocation
- possible restricted hip ROM
mobility deficit
what are the interventions for acute/subacute LBP with mobility deficits
- MT (thrust and non-thrust)
- ther ex
- pt education
what is therapeutic exsc used for in the mobility deficit pts
improve or maintain spinal mobility
What category of LBP - symptoms
- recurring LBP
- commonly associated with referred LE pain
mvmt coordination
what category of LBP - impairments
- painful arc
- excessive mvmt with provocation
- aberrant mvmt
- possible mobility deficits on thoracic spine or hip
mvmt coordination
what interventions are recommended for mvmt coordination
- NM re-education
- possible external devices for support
- postural education
- ther ex for stabilization
the following are characteristics of what muscle groups?
what muscles are in this group?
- superficial, farther from axis
- cross multiple segments
- “movers”
- guy wire
- compressive loading to vertebrae with strong contractions
global muscles - RA, EO, IO, QL, ES, iliopsoas
the following are characteristics of what group of muscles?
what muscles are in this group?
- deep, closer to axis
- attach to vertebral segment
- control segmental motion
- greater percentage of T1 fibers
core muscles - TrA, MF, IO, QL, deep rotators
what category of LBP - symptoms
- lancinating pain
- paresthesia, N/T, weakness
radiating pain
what LBP category - Impairments
- signs of nerve root involvement
- may also present with referred pain
radiating pain
what interventions are used for pts with LBP + radiating pain
- pt education on positions to reduce pain
- manual or mechanical traction
- MT
- nerve mobilization exsc
