MOD 3 Lumbar Manual Therapy

Question 1

What is the CPG for manual therapy for back pain with mobility deficits?

Answer 1

Level A: clinicians should provide manual therapy procedures (thrust and nonthrust) to diminish pain and improve segmental spinal lumbopelvic motion

Question 2

What is the CPG for manual therapy of back pain with movement coordination impairments?

Answer 2

level A: clinicians should provide a multimodal intervention approach including manual therapy procedures and therapeutic exercises to address identified thoracic spine, ribs, lumbopelvic, or hip mobility deficits

Question 3

What is the CPG for manual therapy for back pain with radiating (radicular) pain?

Answer 3

level B: clinicians should provide manual or mechanical traction and manual therapy to mobilize the articulations and soft tissues adjacent to the involved nerve root(s) or nerves that exhibit mobility deficits?

Question 4

What is the CPG for manual therapy for back pain with related (referred) LE pain?

Answer 4

level B: clinicians should provide therapeutic exercises, manual therapy, or traction procuedures that promote centralization and improve lumbar extension mobility

Question 5

What are the CPGs of manual therapy for acute LBP?

Answer 5

• should use thrust and non thrust joint mob to reduce patient pain and disability (A)
• may use massage or soft tissue mob (B)
• combined with active techniques

Question 6

What are the CPGs of manual therapy for chronic LBP?

Answer 6

• should use thrust or non thrust joint mob to reduce pain and disability (A)
• may use massage or soft tissue mob (B)
• may use thrust or non thrust joint mob, neural mob in conjunction with other treatment to reduce pain and disability (B)
• combined with active techniques

Question 7

What are the strong recommendations for diagnostic and therapeutic aspect of LBP?

Answer 7

diagnostic
- conduct focused history
- assess red flags
- assess prognostic factors
- do not obtain imaging

therapeutic
- spinal mobilization

Question 8

What is the clinical prediction rule for lumbar manipulation?

Answer 8

• recent onset (<16 days)
• low FABQW (<19)
• no symptoms below knee
• lumbar stiffness
• good hip IR (>35 deg)

Question 9

What are augmented lumbopelvic exercises to follow CPA and UPA mobilization?

Answer 9

• supine; patient bends knees with feet on floor
• patient bend their low back and tilt pelvis backward into floor and then tilts forward, starting position and repeats

Question 10

What is augmented lumbar flexion exercise?

Answer 10

• supine; seated in a chair knees apart
• bend forward and let arms hang until stretch in lower back
• movement should be slow and controlled
• repeat for desired effect
• done after flexion CPA with pillow

Question 11

What is an augmented lumbar extension exercise?

Answer 11

• standing or seated extend and hold

Question 12

What is the augmented lumbar rotation exercise?

Answer 12

• upper trunk rotation or lower trunk rotation with legs bent swaying side to side