Treatment Based Classification

Question 1

Second Level classification stage 1

Answer 1

oswestry >30
unable to sit > 30 min
Unable to stand > 15 min
Unable to walk > 1/4 mi

Question 2

Second Level classification stage 2

Answer 2

oswestry 15-30
Able to sit, stand, walk
Unable to perform complex task
No stage 1 findings

Question 3

Second Level classification Stage 3

Answer 3

oswestry score <15
Able to perform complex tasks
Unable to perform demanding tasks

Question 4

What does SINSS stand for

Answer 4

Severity, Irritability, Nature, Stage, Stability

Question 5

Severity

Answer 5

refers to the intensity of symptoms and the extent that they limit normal activity

Question 6

Examples of severity

Answer 6

pain scale and functional limitations

Question 7

Irritability

Answer 7

Refers to the ease in which symptoms are produced and the time it takes to settle

Question 8

Examples of irritability

Answer 8

Symptom onset: immediately on movement vs. after sustained activities.
Symptom relief: “pain goes away immediately when I stand up straight” or “pain persists 10-15 min after stand up straight”

Question 9

Nature

Answer 9

Refers to the type and extent or degree of injury or illness

Question 10

Examples of nature

Answer 10

Type: aching, throbbing, burning, stabbing, sharp, dull, deep, superficial, etc.
Symptom behavior: radiating, referred, local, etc.
Tissue and injury: sprain, DJD, OCD, fracture, osteoporosis, multi-tissue trauma, neural tension
Degree of injury: 1st-3rd degree, mild-severe, etc.

Question 11

Stage

Answer 11

acute, sub-acute, chronic, acute on chronic

Question 12

Stability

Answer 12

how are the symptoms changing?
better, worse, the same?
Stable or unstable

Question 13

Criteria for a positive response (5) for manipulation

Answer 13

<16 days
no distal symptoms below the knee
FABQ WK subscale <19
At least one hypomobile segment
prone hip internal ROM > 35

Question 14

what is the strongest predictive variable for manipulation

Answer 14

duration of pain (<16 days)

Question 15

History for stabilization

Answer 15

Frequent prior episodes
Extreme fluctuation of symptoms with minimal perturbation
Transient deformity with prior episodes
Positive response to immobilization
Frequent manipulation with short-term, dramatic results
History of trauma or surgery
No clear postural preference
Difficulty with activities requiring extensor muscle activity
recent or ongoing pregnancy, use or oral contraceptives
May have distal symptoms

Question 16

Physical exam for stabilization

Answer 16

Segmental hypermobility
Instability catch or movement aberrations
Palpable step off
General ligamentous laxity

Question 17

What is the aberrant motion assessment? for stabilization

Answer 17

painful arc in flexion
painful arc on return from flexion
gower's sign
instability catch
reversal of lumbo-pelvic rhythm

Question 18

Prone posterior-anterior segmental mobility assessment. What are you looking for?

Answer 18

Segmental mobility (hyper-, hypo-, or normal)
Pain provocation (present, absent).

Question 19

Prone Instability Test

Answer 19

1. P-A test for pain provocation (identify painful segments)

2. Repeat P-A with hips extended (positive finding- previously painful segments become pain-free)

Question 20

what are the 4 things that indicate dramatic success with stabilization category (3 or more present)

Answer 20

prone instability test
abberant motions
average SLR >91
Age <40

Question 21

predicting improvement in stabilization category 4 things (2 or more present)

Answer 21

Prone instability test
abberant motions
hypermobility
FABQ-PA>8
Also look for greater general flexibility or postpartum

Question 22

What two things help categorize patients into specific exercise

Answer 22

postural preference

centralization with movement exam

Question 23

What 4 things help categorize patients into traction

Answer 23

Neuro signs
Leg Symptoms
peripheralization with movement testing
crossed straight leg raise