Lumbopelvic Treatment Based classification System Flashcards
What is the Lumbar Treatment Based Classification System?
- A system that helps clinicians determine subtypes of low back pain and guides treatment decisions.
- Reset the system, specific directional exercises, reload (functional optimization), and motor control (retraining)
Why is low back pain considered complex?
Due to its multifactorial nature, including physical, psychological, and social components.
What are sub-classification systems for low back pain?
Models that help clinicians simplify and treat complex low back pain presentations by categorizing them into specific subtypes.
How do sub-classification systems help in treatment?
They guide treatment decisions by categorizing low back pain into specific subtypes, leading to more targeted and effective interventions.
What is the significance of directional preference in treatment?
It helps identify movements that reduce pain and improve symptoms, guiding the focus of treatment.
-END RANGE IS KEY
-AVOID PAINFUL MOVEMENTS
What are the main treatment approaches in this system?
- Symptom modulation,
- Movement control,
- Functional optimization
What are the key red flags to consider in low back pain?
Severe trauma, fever, recent bacterial infection, saddle anesthesia, severe or progressive neurological complaints, recent onset bladder dysfunction, unexplained weight loss, history of cancer, IV drug abuse, pain worse with recumbency, and no relief with change of position/rest.
Why is screening for pain neuro-science education (PNE) important?
It helps identify patients who need education about pain mechanisms before traditional treatment can be effective.
How to determine if a patient is appropriate for physical therapy?
By ruling out medical comorbidities and ensuring the patient has mechanical low back pain that can be addressed with physical therapy.
What are the characteristics of patients requiring unique rehab management because the presentation is complicated?
-Patients with PNE
-LBP is complicated with presence of leg pain
-you have ruled out comorbidities so PT is appropriate
What are the characteristics of straightforward therapy patients?
Patients with minimal complications who can tolerate more aggressive therapy.
What is the first step in evaluating a patient with low back pain?
Screening for red flags and determining the appropriateness of physical therapy.
What is the goal of symptom modulation in low back pain treatment?
To decrease the patient’s pain and modulate their symptoms to facilitate further rehabilitation.
How does manipulation help in symptom modulation?
By providing immediate pain relief and improving mobility through manual therapy techniques.
What are the indications for using traction in low back pain?
Traction is indicated for patients who do not centralize their pain with other treatments.
What are the predictor variables for successful manipulation?
i) Patients fitting the clinical prediction rule for manipulation, having pain with extension or unilateral rotation/sidebending, or positive SI joint cluster tests.
CPR:
- Pain does not travel below the knee
- onset </= 16 days ago
- lumbar hypomobility
- Either hip has > 35 degree of internal rotation
- FABQ - work subscale score of < 19 or positive belief manipulation will help
What are the typical symptoms of patients in the symptom modulation category?
Disabilit: High
Symptom Status: Volatile
Pain: High to Moderate
How does active rest support symptom modulation?
By avoiding activities that aggravate symptoms while staying active in other non-painful ways.
What is directional preference in low back pain treatment?
The phenomenon where certain movements reduce pain and improve symptoms, guiding treatment focus.
How does McKenzie technique apply directional preference?
By identifying and using movements that decrease, abolish, or centralize symptoms to guide treatment. Repeated movement exercises in directional preference.
What are the predictor variables for extension exercises?
Symptoms distal to the buttock, symptoms centralize with lumbar extension, symptoms peripheralize with lumbar flexion, and directional preference for extension.
What are the predictor variables for flexion exercises?
Older age (> 50 years), directional preference for flexion, and imaging evidence of lumbar spinal stenosis.
How to identify and treat lateral shift in low back pain?
By recognizing acute postural deviations and using specific exercises to correct the shift and alleviate pressure on the nerve root.
The lateral shift is named by the direction in which the upper torso is displaced.
What are the benefits of specific exercises for directional preference?
They help in reducing pain, improving function, and centralizing symptoms by focusing on movements that provide relief.
What are motor control deficits in low back pain?
Impaired ability to control and coordinate movements due to poor motor control, leading to pain and dysfunction.