RBA Flashcards
how common is myotomal deficit in spine Drg?
difference in lumbar vs cervical?
common
more so in cervical
can stenosis symptoms be radicular and referred? What areas of the spine?
only see radicular in cervical
lumbar both
can stenosis have an acute onset? how common?
yes, trauma can reveal stenosis
can NRE have an acute onset? how common?
No
what provokes stenosis symptoms? How quickly?
extension activities of course
- can be immediate or require sustained to expose in lumbar
- typically immediate in C/S
how to confirm or rule out stenosis diagnosis in lumbar spine
IF patient denies obstruction... - go RFISit or RFIL to provoke if no... - go REIS over fulcrum, look for NE or P, NW - then test over 48-72 hours to R/O Drg
how long does a NRE take to develop
12 weeks, longer than other fixed lesions
Do you see obstruction with nerve root entrapment?
No, maybe minimal. but, will see some temporary “stiffness” after sitting due to creep loading.
Never will fully obstruct after prolonged sitting
are nerve root entrapment symptoms constant or intermittant
constant.
-sometimes only proximal pain is constant, and limb symptoms are intermittent
what is the minimum time for onset of ANR or dysfunction?
at least 8 weeks, shorter than NRE
uni- or multi-directional for dysfunction?
can be multi-directional, but one will dominate
with dysfunction, does patient have PDM or ERP? Describe
ERP, but at a premature end range
mechanically inconclusive- radicular, referred, or local pain?
referred and local primarily
radicular is rare
mechanically inconclusive- chronic, acute, subacute
primarily chronic
-occasionally see acute or subacute
mechanically inconclusive- intermittent or constant?
both
mechanically inconclusive- what makes them worse?
usually all movements and positions make them worse over time
- rarely a clear pattern
mechanically inconclusive- can they be obstructed?
NO, they will not have any functional deficit when their pain is worse
mechanically inconclusive- typical ROM loss?
none, nonspecific
mechanically inconclusive- PDM or ERP?
usually multidirectional ERP, less PDM
mechanically inconclusive- nerve tension?
No
mechanically inconclusive- space occupation producing limb symptoms?
no
RBA approach for suspected mechanically inconclusive
1 focus on RFISit/RFIL to eliminate Drg
- if they can’t tolerate, or yellow flags dominate
- –> give SOC for 48 hours
Must have general baselines in an IMC RBA
- spine and extremity
ERP or PDM with ROM (or space occupation) functional complaint nerve tension (esp. L/S) myotomes (esp. C/S)!! postural correction!! extremity baselines b4 spinal screen
must have baselines for an RBA of the shoulder
- besides the obvious (ROM of course, but what specifically is often missed)
resisted movements
- OP to ROM, esp. flexion, abduction
must have baselines for an RBA of the elbo- besides the obvious (ROM of course, but what specifically is often missed)
- resisted movements of elbow, wrist, grip
- OP extension, compare sides