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PTA Ortho Exam 2 > Spine Management > Flashcards

Spine Management Flashcards

1
Q

What are serious red flags during evaluation

A

-Spinal cord symptoms
-Recent trauma where spinal fracture or instabilities have not been ruled out
-Serious pain
>Unremitting
>Night pain that wakes patient
>Can not be explained mechanically

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2
Q

Acute inflammatory stage S&S

A
  • constant pain
  • signs of inflammation
  • no position/mvmnt relieves symptoms
  • anti-inflam meds are warranted
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3
Q

Acute stage without inflammation- S&S

A
  • symptoms interemittent & related to mechanical deformation
  • signs of nerve root irritability when compressed or stretched
  • pt can be categorized into extension bias, flexion bias, or non-WB bias based on presenting posture, movement impairments, or positions of symp. relief
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4
Q

Delitto and Associates classify pts as being in this stage if they can not do the following without increasing their symptoms:

Acute stage without inflammation

A
  • Stand longer than 15 minutes
  • Sit longer than 30 minutes
  • Walk more than a ¼ mile
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5
Q

Subacute Stage S&S

A

-Certain movements or postures with some ADL’s still provoke symptoms so that a basic life style cannot fully be resumed

(Lifting, vacuuming, gardening, other activities that require repetitive movement of loads)

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6
Q

Chronic stageReturn to Function phase

S&s

A

Pain only when excessive repetitive or sustained stress is placed on vulnerable tissue for prolonged periods

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7
Q

What is the emphasis for chronic stage

A

Emphasis is placed on returning the patient to high level demand activities that require handling repetitive loads on a sustained basis over a prolonged period of time

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8
Q

What are general guidelines for managing acute spinal problems

A
  1. Establish a position of symptom relief or comfort
  2. Teach awareness of safe postures and effects of movement
  3. Teach basic stabilization
  4. Teach basic functional movements
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9
Q
  1. Establish a position of symptom relief or comfort involves?
A
  • There is constant pain yet there is often an optimal position of comfort where the least amount of stress is placed on the inflamed, irritated or swollen area (referred to as functional/ neutral position or functional range)
  • pt may have a bias (Bias can be dictated by the patient or by the condition / spine biomechanics)
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10
Q

Extension bias

A

The patient’s symptoms are lessened in positions of extension

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11
Q

Flexion bias

A

The patient’s symptoms are lessened in positions of flexion

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12
Q

Nonweightbearing bias

A

The patient’s symptoms are lessened when in nonweightbearing positions

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13
Q
  1. Teach awareness of safe postures and effects of movement involves
A

Teach the patient to identify and assume the spinal position that is most comfortable and reduces the symptoms

  • Pelvic tilts
  • Passive positioning
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14
Q

Examples of passive positioning

A
  • Supine: hook-lying flexes the spine, legs extended extends the spine
  • Prone: pillow under abdomen flexes the spine, no pillow extends the spine
  • Sitting: feet are propped up on stool to achieve flexion, a lumbar pillow or towel roll is used for extension
  • Standing: flexion is achieved by placing one foot on a stool
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15
Q
  1. Teach basic stabilization
A

Emphasis on core stability

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16
Q
  1. Teach basic functional movements
A

-Perform simple movements for ADL’s while protecting spine in the functional position
>Rolling, lying to sitting, sitting to standing, walking

17
Q

Acute patient POC/GOALS

A
  1. Learn self management
  2. Decrease acute symptoms
  3. Demonstrate awareness of pelvic position and movement
  4. Demonstrate safe postures
  5. Initiate work for stabilizing muscles
  6. Safely perform basic ADL’s
18
Q

Acute patient Summary of interventions

A

-Modalities
-Kinesthetic training
>Pelvic tilts, neutral spine
-Provide passive support or bracing if needed
-Basic stabilization exercises
-Roll, sit, stand and walk with safe postures

19
Q

Subacute stage for progression

A
  • once pain is managed, pt is progressed thru program of mvmnt to prepare the tissue for functional activities
  • Intervention is critical because patient tends to overdo activities reinjury occurs or is fearful and does not adequately resume safe activities and functional restrictions occur
20
Q

Subacute patient POC/GOALS

A
  • Learn self management and decrease episodes of pain
  • Progress awareness and control of spinal alignment
  • Increase mobility in tight muscle/joint/fascia
  • Develop neuromuscular control, strength and endurance in stabilizing muscles
  • Increase trunk and extremity strength
  • Develop general aerobic endurance
  • Learn safe body mechanics
21
Q

Subacute patient Summary of interventions

A

-Ergonomic adaptation of work or home environment
-Joint mobilization, self stretching
-Progress stabilization exercises
>Increase repetitions and challenges

22
Q

Chronic pt emphasis

A
  • healing with appropriately graded exercises should have minimal impairments preventing or restricting daily activities
  • At this stage conditioning and spinal control during high intensity and repetitive activities are emphasized
23
Q

Chronic pt POC/GOALS

A
  • Learn spinal control in high intensity and repetitive activities
  • Increase trunk and extremity strength
  • Return to high level/high intensity activities for prolonged periods of time without exacerbating symptoms
  • Develop healthy exercise habits for self-maintenance
24
Q

Chronic pt Summary of interventions

A
  • Joint mobilization and self stretching
  • Progress trunk and extremity resistance exercises emphasizing functional goals
  • Progress intensity of aerobic exercises
  • Progressive practice using activity –specific training emphasizing spinal control, endurance, timing and speed
25
Q

Summary of Treatment Options Acute

A
  • Position for symptom relief
  • Determine patient bias
  • Teach awareness of safe postures and movement
  • Passive positioning
  • Teach basic stabilization exercises
  • Teach basic functional movements
  • Modalities
  • Kinesthetic training
  • Passive support
26
Q

Summary of Treatment Options SubAcute

A
  • Ergonomic adaptation
  • Practice spinal movement in pain free ROM
  • Joint mobilization
  • Self stretching
  • Progress stabilization exercises
  • Low intensity aerobics
  • Functional exercises
  • Modalities if needed
  • Posture correction
27
Q

Summary of Treatment Options Chronic

A
  • Increase intensity of aerobic exercise
  • Teach spinal control in transitional positions
  • Increase resistance to exercise
  • Increase reps and intensity of functional activities

PTA Ortho Exam 2 (2 decks)

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