Tests and Measures and other Exam/Eval info

Question 1

Name the red flags for the lumbar spine.

Answer 1

1) Cancer (hx; >50yo; unexplained weight loss (>10lbs in 6mos); failure of conservative therapy; pain onset is insidious, constant, non-positional, & frequently worse at night)
2) AAA (abdominal aortic aneurysm)
3) Spinal infections
4) Compression fractures (significant trauma; >50yo; corticosteroid use; osteoporosis)
5) Inflammatory arthritis (morning stiffness, improvement with exercise, male, onset <40yo; slow onset; pain for at least 3mos)
6) Vascular/visceral etiologies (night pain; worse when lying down or not positional; pain not related to activity)
7) Neurologic compromise

Question 2

Name the 4 key questionnaires for LBP.

Answer 2

1) Global rating scale (rating overall condition now compared to when treatment began)
2) Modified low back pain disability questionnaire (how does back pain affect patients ability to manage everyday life)
3) Modified Oswestry LBP disability questionnaire (ODQ) (How pain is impacting patient’s disability perception.)
4) FABQPA & FABQW (fear avoidance regarding work and physical activity)

Question 3

What are the risk factors for LBP?

Answer 3

1) Smoking (2x; coughing, poor oxygen)
2) Spending more than 1hr/day in a car (2x)
3) Spending more than 1hr/day in activity with vibratory forces (5x)
4) Full term pregnancy with vaginal delivery (3x; hormones; therefore, decreased stability)
5) Weak increase with repetitive lifting

Question 4

Name the SI joint tests. Which is most specific? Which is most sensitive?

Answer 4

Any 2 of 4: (with +LR 4.0)

1) Thigh thrust (Sn .88)
2) Compression
3) Distraction (Sp .81)
4) Sacral springing/thrust

Or 3 or more out of 6
Also, Gaenslen’s test (L & R)

• Though not included - the FABER (or Patrick’s test) can ID SIJ involvement if pain is located at SI vs. groin (hip pathology).

Question 5

What are the neurologic red flags for LBP?

Answer 5

Neurologic compromise:

1) Sciatica - sharp, burning pain; may have dermatomal sensory loss/parethesias & localized motor weakness
2) Cauda equina - from spinal cord compression (progression of symptoms from pain to motor/ sensory dysfunction; bowel/bladder; saddle numbness)
3) Neurogenic claudication - leg pain with standing, walking or any activity where back is extended (may indicate stenosis)

Question 6

Lower quarter screen

Answer 6

Posture
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