Treatment based classification for the lumbar region Flashcards
clinical findings for medical management
Red flags
Medical comorbidities, precluding rehabilitation
Leg pain with progressive neurologic deficits
clinical findings for rehabilitation management
Medium to high psychosocial risk status
low psychosocial risk status with predominantly leg pain
Minor or controlled medical comorbidities
clinical findings for self-care management
Low psychosocial risk status
Predominantly axial low back pain
Minor or control medical comorbidities
symptom modulation Clinical findings
Disability- high
Symptom status - volatile
Pain - high to moderate
symptom modulation treatments
Directional preference exercises
Manipulation or mobilization
Traction
Active rest
movement control clinical findings
Disability- moderate
Symptoms status - stable
Pain - moderate to low
Movement control treatments
sensorimotor exercises
stabilization exercises
Flexibility exercises
functional optimization clinical findings
Disability- low
Symptom status - controlled
Pain - low to absent
functional optimization treatments
strength and conditioning exercises
Work or sport specific tasks
Aerobic exercises
General fitness exercises
what do you do if your patient centralized with two or more movements in the same direction
or
centralized with the movement in one direction and peripheralize with an opposite direction
specific exercise classification
if your pt has symptoms below the knees — centralize first
have a recent onset of symptoms less than 16 days
no symptoms distal to the knee
manipulation classification
no symptoms below the knee, manual therapy/ manipulation- good evidence
pt has
average SLR ROM- greater than 90
positive prone instability test
positive aberrant movement
less than 40 yrs
stabilization classification
if pt has these findings, movement control indicated
favoring manipulation subgroup
more recent onset of symptoms
hypomobility with spring testing
LBP without no distal symptoms
low FABQ score less than 19
against manipulation subgroup
symptoms below knee
increasing episode frequency
peripheralization with motion testing
no pain with spring testing
favoring stabilization subgroup
younger age
positive prone instability test
aberrant motions present
greater SLR ROM
hypermobility with spring testing
increasing episode frequency
3 or more prior episodes
