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MSK 1 > T-Spine Interventions > Flashcards

T-Spine Interventions Flashcards

1
Q

describe general intervention strategies for treating Scheurmann’s Disease

A
  1. postural control muscle performance
  2. activity modifications (aggravating)
  3. strengthen and stretch the trunk
    • seated rotation
    • extension in lying/prone
    • thoracic extensor strengthening
    • scapular abductor strengthening
  4. Bracing may be utilized
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2
Q

describe PT interventions that may be utilized when treating a patient with Ankylosing Spondylolitis

A
  1. spine extension and peripheral joint exercises
  2. breathing exercises
  3. prone lying (multiple times a day, 10 min at a time)
    • for spine and hip extension
  4. sleep on firm mattress, avoid SL position
  5. swimming
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3
Q

T/F: Scoliosis is a condition that can be reveresed with rigorous PT

A

FALSE

we cannot correct the posture only manage/limit progression of curvature

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4
Q

List goals for conservative management of scoliosis

A
  1. strengthen postural muscles
  2. address muscle length/strength impairments of extremity muscles
  3. maintain/improve respiration and chest mobility
  4. address back pain
  5. resume functional tasks
  6. strengthen abdominals
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5
Q

T/F: there are standarized supported treatment protocols for T4 syndrome

A

FALSE

poor evidence supports standarized intervention

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6
Q

describe general intervention strategies for T4 syndrome

A
  1. thoracic manual techniques
    • mobilizations
    • thrust manipulations
  2. scapulothoracic motor performance
  3. thoracic extensor strengthening
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7
Q

what specific intervention may be used to treat disc lesions in the T-Spine?

A

Traction (used to address radicular symptoms)

continous or intermittent

pt positioned sitting or lying

duration: 2 min - 24 hours

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8
Q

list contraindications to traction at the T-Spine

A
  1. acute lumbago
  2. instability
  3. respiratory or cardiac insufficiency
  4. respiratory irritation
  5. painful reactions
  6. large (disc) extrusion
  7. medial disc herniation
  8. altered mental state
    • includes pt being unable to relax
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9
Q

list common impairments that may be observed in zygopophyseal joint pain

A
  1. muscle guarding
  2. joint hypomobility
  3. acute irritation/dysfunction
  4. pain
  5. ROM: commonly motions that close joint
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10
Q

List interventions that may be used to treat zygopophyseal joint pain

A
  1. Manual therapy
    1. mobilizations
      1. oscillations
      2. stretch mobilizations
    2. manipulations
  2. Exercise
    1. targeting pain and guarding inhibitions
    2. neuro re-education
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11
Q

what types of interventions may be used in the managment of rib dysfunction?

A
  1. rib mobilizations
    • oscillations
    • static stretch mobilizations
  2. rib manipulations
  3. soft tissue mobilizations
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12
Q

when treating TOS how should we approach treatment?

A

consider impairments and determine treatment goals based on ICF model

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13
Q

list interventions that may be used in the management of TOS

A
  1. Nerve glides
  2. work/activity modifications
  3. shoulder, upper rib/thoracic manual therapy
    • T/S manipulations are great here
  4. scapulothoracic motor performance
  5. address tissue extensibility anterior trunk musculature
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14
Q

List 5 generalizations for treatment/intervention planning

A
  1. Stability vs Mobility
  2. Patient education
  3. Reduce pain
  4. address impairments
  5. improve functional activity performance and participation
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15
Q

List some examples of exercises that may help improve thoracic mobility

A
  1. quadruped thoracolumbar AROM
    • flexion/extension
    • rotation reaching diagonally in front/OH
  2. lying thoracic extension
    • prone press up
    • prone on elbows
    • supine over soft object
  3. sitting rotation, extension
  4. assisted extension w/towel
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16
Q

what muscle groups should be targeted in resistance training for T-Spine related conditions?

A

peri-scapular musculature

thoracic paraspinals

17
Q

what muscles will be targeted during a prone row?

A

Mid trapezius

Rhomboids

levator scapulae

18
Q

List specific exercises that target the Lower Trap

A
  1. prone full can
  2. prone shoulder ER at 90º of shoulder abduction
  3. prone horizontal abduction with 90º shoudler abduction and ER
  4. bilteral shoulder ER in shoulder neutral
19
Q

list specific exercises that target the rhomboids and levator scapula

A
  1. prone extension with shoulder ER
  2. prone row
  3. prone horizontal abduction with 90º shoulder abduction and ER
20
Q

List modalities that may be used in treatment of T-Spine conditions

A
  1. Ultrasound
    1. thermal
    2. pain relief
  2. Cryotherapy
    1. pain relief
  3. E-Stim
    1. muscule activation/neuromuscular re-education
    2. pain relief (TENS)
    3. aid in healing (muscle pump)
21
Q

List manual therapy mobilizations techniques that can be used at the T-Spine

A
  1. Prone Thoracic PA mobs
  2. Seated Thoracic extension mobilization
  3. Supine 1st rib mobilization
  4. Costotransverse mobilization
22
Q

list manipulations that can be performed at the T-spine

A
  1. “The Screw” Mobilization/Manipulation Thrust
  2. Facet Gapping in Supine (“Pistol”)
  3. Seated Lower Thoracic Traction Thrust
  4. Upper Thoracic Distrction Thrust
23
Q

what is moving on what during a prone thoracic PA mobilization?

A

spine segment on adjacent segments

24
Q

what is moving on what during a seated thoracic extension mobilization?

A

inferior segment on superior segment

25
Q

describe the target force for the seated thoracic extension mobilizations

A

Mobilizing → posterior aspect of bilateral upper arms for superior T segments into relative extension

Stabilizatin → dorsal surface of articular pillars (or spinous processes) of T segments of choice

26
Q

describe the target force and relative structural movement during the “Screw” manipulation

A
  1. Mobilizaing
    • cranial segment → dorsal surface ipsilateral articular pillar
    • caudal segment → dorsal surface contralateral articular pillar
  2. Structural movment
    • cranial segment facet on caudal segment facet

MSK 1 (17 decks)

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