TBC LB

Question 1

Levels of Classification for TBC

Answer 1

First - Is patient appropriate for PT management?
Second - Level of acuity
Third - Treatment to use

Question 2

Yellow Flags for TBC

Answer 2

• Depression, anxiety
• Fear-avoidance beliefs
• Preference for passive treatments
• Low mood, social withdrawal

Question 3

FABQW Cutoff Scores

Answer 3

High - Above 34

Low - Below 29

Question 4

Stage I Classification

Answer 4

• Oswestry > 30
• Unable to sit > 30 min
• Unable to stand > 15 min
• Unable to walk > 1/4 mile

Question 5

Stage II Classification

Answer 5

• Oswestry 15-30
• Able to sit, stand, walk
• Unable to perform complex tasks
• No stage I findings

Question 6

Stage III Classification

Answer 6

• Oswestry < 15
• Able to perform complex tasks
• Unable to perform demanding tasks

Question 7

TBC Treatment Progression

Answer 7

Stage I: Assign to Stage I Classification (Manip, Specific Exercise, Stabilization, Traction

Stage II: Aerobic activity, eliminate impairments, trunk strength, general strength

Question 8

Manipulation CPR

Answer 8

> 4 present:(45% -> 92% chance of 50% decrease in ODQ over 7 days):

1) Recent onset (< 16 days)*
2) 35° IR at one or both hips* (Flynn)
3) FABQW < 19
4) symptoms not distal to knee
5) At least 1 hypo-mobile L spine seg
* Key symptoms - 91% success if both present (Fritz)

Question 9

Manipulation vs. Mobilization for Manip Subgroup

Answer 9

• Manip superior on Oswestry, not pain

- More side effects with mob

Question 10

CPR for Dramatic Success for Stabilization Subgroup

Answer 10

3 or more present (33% -> 67% chance of 50% decrease in OWD over 8 weeks):
1) + Prone instability test
2) Aberrant motions
3) Average SLR > 91
4) Age < 40
(Fritz)

Question 11

CPR for Improvement for Stabilization Subgroup

Answer 11

2 or more present (72% -> 94% success):

1) + Prone instability test
2) Aberrant motions
3) Hypermobility
4) FABQ-PA <= 8

Question 12

Criteria for Specific Exercise Subgroup

Answer 12

• Centralization phenomenon

- Postural preference

Question 13

Criteria for Traction Subgroup

Answer 13

• Neurologic signs
• Leg sx
• Peripheralization
• • Crossed SLR

Question 14

Stage II Proposed Length Tests

Answer 14

• TFL/ITB
• Rectus Femoris
• Glut Max
• Hamstrings
• Iliopsoas
• Piriformis/rotators

Question 15

Stage II Proposed Strength Tests

Answer 15

• Abdominal bracing
• Upper abs
• Lower abs
• Glut med
• Glut max
• Side support (not sure what this means)
• Sahrmann exam items

Question 16

Effect of early referral to PT for LBP

Answer 16

Lower costs for early referral

Question 17

Stabilization Classification for Postpartum Patients

Answer 17

• • Posterior pelvic pain provocation
• • ASLR
• • Modified Trenbelenberg
• • Pnful palpation of long dorsal SI ligaments, pubic symphysis