Spine Classifications

Question 1

Manipulation/Mobilization Category

5 factors:
1) Current symptom duration less than _ days

2) FABQ work subscale(W) Score less than _

3) (Hyper/Hypo)mobility of L spine (assessed with PA pressure)

4) IROT of one hip greater than _ degrees

5) Symptoms (not extending/extending) distal to knee(Non-radicular LBP)

4/5 factors present patients highly likely to improve with spinal manipulation

IROT – Have good hip mobility

FABQ – Fear Avoidance Beliefs Questionnaire

Answer 1

16; 19; Hypo; 35; not extending;

Question 2

Trying to increase the mobility of the spine

Question 3

Stabilization Category

Age less than _

SLR ROM greater than _

Aberrant movement during sagittal plane lumbar ROM

(Negative/Positive) prone instability test

Young and flexible
Bending forward and backward with aberrant motion

Answer 3

40; 90; Positive;

Question 4

Question 5

Centralization – pain centralizes. Moves from a distal location to a proximal location.
If you bend down and then as you move in the opposite direction and pain goes from proximal to distal – peripheralization

YOU WANT CENTRALIZATION

Question 6

Avoid the thing that hurts.

Centralization is good – want the pain to move more centrally!!

Question 7

Traction Category

Nerve root symptoms

Symptoms (do/do not) centralize

Peripheralization with (flexion/extension)

(Negative/Positive) Crossed SLR

Nerve root symptoms – Changes in Dermatomes, myotomes, DTRs

Move into extension and they get worse

Answer 7

do not; extension; Positive

Question 8

Question 9

Question 10

Question 11

Brain Stem Ischemia (Vertebral Basilar Insufficiency)

What are the 5Ds and 3Ns?

Answer 11

Dizziness
Diplopia - double vision or seeing double
Drop attacks - sudden falls with or without loss of consciousness, due either to collapse of postural muscle tone or to abnormal muscle contractions in the legs
Dysphagia - difficulty swallowing
Dysarthria - slurred speech

Nystagmus - An involuntary eye movement which may cause the eye to rapidly move from side to side, up and down, or in a circle, and may slightly blur vision.
Nausea
Neuro signs - ataxia, numbness, Horners sign

Question 12

Question 13

ICF Classification: Neck pain with mobility deficit

(Acute/Chronic)
ROM (gain/loss)
(Hyper/Hypo)mobile segments
(Radicular/Non radicular)

Treatment goal: improve mobility

Answer 13

Acute; loss; Hypo; Non radicular

Question 14

ICF Classification: Neck pain with radiating pain

(Non radicular/Radicular) pain - Nerve root signs possible: (dural tension, myotome and dermatome changes, diminished DTRs)

Possible HNP C spine

Treatment goal: centralize symptoms

Answer 14

Radicular

Question 15

ICF Classification: Neck pain with movement coordination impairments

Postural pain possible

Muscle imbalance: Deep Neck Flexors (DNF) often weak and Upper crossed syndrome possibly

Treatment: postural exercises and cervical stabilization to improve stability and muscle balance

Question 16

Pain Control Cervical Classification

ICF Classification: does not exist

(Moderately/Highly) irritable: High pain scores 8-10/10
Possibly WAD diagnosis or trauma

May not tolerate full exam

Treatment goal: reduce pain in order to move into another classification

Answer 16

Highly;

Question 17

ICF Classification: Neck pain with headache

OA and AA (hyper/hypo)mobility common

(Bilateral/Unilateral) headache

Treatment: improve posture, DNF strengthening, improve mobililty

Answer 17

hypo; unilateral;

Question 18