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SMT > SMT 361-420 > Flashcards

SMT 361-420 Flashcards

1
Q
  1. What did Haskins et al 2012 concluded regarding CPR’s and LBP ?
A
  • evidence did not support clinical application -only 2 have progressed to the validation process
  • No rule has ever been investigated for clinical impact
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2
Q
  1. What were Flynn et al 2002 clinical predictors rules?
A 
Duration of sxs <16 d
FABQ <19
L/s hypomobility on spring testing
one hip >35* IR
NO sxs distal to knee
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3
Q
  1. But what was the only tech that Flynn et al 2002 applied to?
A

Chicago

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4
Q
  1. Does Chicago tech impact the Lumbar spine?
A

there is no evidence to suggest that it does not. Thus it may and is not specific to the SIJ

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5
Q
  1. What was Flynn et al 2002 success rate for random manip for w/non radic LBP?
A

45% so random manip could work 45% of the time

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6
Q
  1. What inc. the % of success from 45% -95%? (Flynn 2002)
A

4 out 5 predictors

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7
Q

397.Who validated Flynn et al 2002?

A

Child et al 2004

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8
Q
  1. Results ? (Flynn 2002)
A

pt’s with + CPR had 95% success rate chance with HVLAT, +LR 24.38

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9
Q
  1. But who were these results valid for? (Flynn 2002)
A

Military, only used Chicago, only 30 % follow up

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10
Q
  1. what did Cleland et al 2006 find using Flynn et al 2002 CPR’s ?
A

91.7 % had successful outcomes with in 2 tx of lateral recumbent lumbar roll HVLAT

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11
Q
  1. How did the results relate to CPR identification ?
A

Identified pt with LBP to benefit from any HVLA directed toward lumbar spine (Chicago or lateral recumbent roll)

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12
Q
  1. According to Flynn et al 2002 what was the best single predictor of success with manip.?
A

Duration of symptoms

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13
Q
  1. Who performed an independent evaluation of the external validity Childs eval 2004?
A

Hancock et al 2004

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14
Q
  1. Why?
A
  • CPRs had not been Indp. evaluated by other authors

- CPR’s only in US Air force not generalization

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15
Q
  1. Using Flynn et al 2002 criteria did Hancock et al 2008 find the CPR’s identified those pt’s more likely to respond to SMT?
A

No CPR’s were no better than chance in identifying its with acute - non specific LBP who would most likely respond to SMT

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16
Q
  1. What was wrong with Hancock et al 2008 method ?
A

97% only received non thrust mob only 5% got HVLA

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17
Q
  1. Diferences b/w Childs et al 2004 & Hancock et al 2008 duration symptoms ?
A

Childs et al 2004 vs Hancock et al 2008. 27 days Childs vs 5 days hancock

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18
Q
  1. what was the setting for question 407 (Childs vs Hancock)
A

Military Childs vs P=private practice hancock

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19
Q
  1. Treatment Duration? (Childs vs Hancock)
A

2 Childs vs 8-12 hancock

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20
Q
  1. Loss to follow up? (Child’s vs Hancock)
A

30 % Childs vs 2% hancock

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21
Q
  1. Who attempted to validate CPR using lateral recumbent manip & supine lumbopelvic manip?
A

clealand et al 2009

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22
Q
  1. What were Cleland et al 2009 tx groups ?
A
  1. 2 sessions HVLA supine did not choose level and 4 attempts
  2. 2 sessions HVLA side lying did not choose level
  3. 2 sessions non thrust central PA’s to L4, L5
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23
Q
  1. What else did all groups get?Cleland
A

ex pelvic tilts, TrA hallowing, quadruped arm/leg ext.

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24
Q
  1. were there differences b/w the supine or side lying thrusts? Cleland
A

No diff at any f/u

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25
Q
  1. where were differences found? Cleland
A

b/w each group and the non thrust group

26
Q
  1. what about with pain at 6 months? Cleland
A

no diff b/w the 3 groups

27
Q
  1. was there a control group? Cleland
A

No,so unable to determine if HVLA is more useful on pts with + CPR than no Tx

28
Q
  1. how did Laslet et al 2006 determine CPR inZJ?
A

intra-articular injection for ZJ or medial branch block

29
Q
  1. what % pt’s responded to the ZJ block?
A

36% of all LBP pt with > 75% pain dec.

30
Q
  1. what did Laslet et al 2006 use to rule out ZJ pain?
A

neg. ext rot test

12 % specificity, 100% sensitivity

31
Q
  1. What type of patients respond to TrA and LM focused training? According to whom?
A

According to O’Sullivan et al 1997, TrA and LM focused exercise helps SPONDYLOLYSIS and SPONDYLOLISTHESIS patients.

32
Q
  1. Hides et al 2001 found TrA and LM co-contraction training to be efficacious for what?
A

1st episode of LBP.

33
Q
  1. Who found a delayed onset of lumbopelvic muscle contraction c SIJ pain?
A

Hungerford et al 2003.

34
Q
  1. Who said that Lx stability depends on ALL trunk musculature?
A

Kavcic et al 2004.

35
Q
  1. What did Stye et al 2004/2006 conclude to be the most effective Rx for PPPP?
A

Exercise for entire spine musculature.

36
Q
  1. Does SIJ HVLAT put the joint back in place?
A
  • Radiology study by Tullberg et al 1998 says NO!
  • Cibulka et al 1988 says yes (found changes in innominate tilt p Chicago technique)
  • Childs et al 2004 says yes (4 days p Chicago found iliac crest symmetry and WB symmetry, dec pain, but was a cohort study,
37
Q
  1. Name 3 authors that agree c dec inhibitory mechanisms, dPAG, non-opioid mechanisms for HVLAT?
A
  • Skyba et al 2003
  • Parengmali et al 2004
  • Wright 1995
38
Q
  1. According to Childs et al 2007, what group was 8 times more likely to experience a worsening in disability?
A

The exercise group s manipulation.

39
Q
  1. Have SIJ symmetry and motion tests been proven reliable or valid?
40
Q
  1. What are the best diagnostic options for SIJ?
A

Multi-test regimen of pain provocation and location of pain (thigh thrust and Forten’s Area).

41
Q
  1. Is there empirical evidence to support the use of specific or global stabilization exercises for SIJ?
42
Q
  1. Is there empirical evidence that supports mobilization or HVLAT for SIJD?
A

Controlled trials, 1 cohort study.

43
Q
  1. Is there any evidence directly addressing if manipulation should precede or follow stabilization exercises for SIJ or PPPP?
44
Q
  1. According to Stuge et al 2004/2006, should form closure or force closure be performed first?
A

Form closure should be first. i.e. Manip first.

45
Q
  1. Any evidence to support specific positional fault diagnosis of sacrum or innominate gives better outcomes?
A

No. Perform sacral or innominate HVLAT irrespective of mal-alignment.

46
Q
  1. Who suggested adjusting the SIJ prior to exercise for SIJD?
A

Stuge et al 2004/2006

47
Q
  1. What did Shearer et al 2005 find between a side HVLAT or activator?
A

Both groups improved and not one was better than the other, but there was no control group.

48
Q
  1. Did Freburger & Riddle 2001 find any validity or reliability for symmetry motion tests?
49
Q
  1. Can form closure be improved s identifying symmetry?
A

Yes, according to Hartman 1997/2006.

50
Q
  1. According to Clements et al 2001, does it matter which direction you manipulate the AA into?
A

No. AA rotation asymmetry was restored regardless if HVLAT was applied unilaterally toward the restriction or away or bilaterallyl.

51
Q
  1. What is the goal of HVLAT to SIJ?
A

Dec pain, inc ROM, reduced disability.

52
Q
  1. According to Hancock et al 2007 systematic review what are potential sources for LBP?
A

Disc, facet joint, SIJ.

53
Q
  1. What 3 features on MRI produced informative +LR>2 for discogenic sxs?
A

High intensity zone, endplate changes, disc degeneration.

54
Q
  1. What 1 feature on MRI produced -LR
A

Disc degeneration (5x’s more likely to not have disc issue pain generator if no degeneration is present).

55
Q
  1. What is the only clinical finding (as determined by Hancock et al 2007) that inc the likelihood of a disc as the source of pain?
A

Centralization.

56
Q
  1. What was the +LR for centralization according to Hancock et al 2007?
57
Q
  1. What was the -LR for centralization according to Hancock et al 2007?
A

-LR = 0.6 (absence of centralization)

58
Q
  1. Was the Revel 1972 criteria informative for facet joint diagnosis?
A

There were no informative LRs.

59
Q
  1. According to Hancock et al 2007, does knowledge of the tissue source for LBP lead to better outcomes?
60
Q
  1. What was May & Rosedale 2010 conclusion regarding CPRs for LBP?
A
  • None of the CPRs for LBP can be used confidently for differential dx.
  • Spinal CPRs have verylimited support from research.
  • Several further stages are required to develop CPRs.

SMT (11 decks)

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