TSPINE/RIBS Interventions Flashcards
Select interventions for SCHEUERMANN’S DISEASE ?
- Postural control muscle performance
- Modification of aggravating activities
- Strengthening and stretching of the trunk
- Seated rotation
- Extension in lying (prone press up, prone on elbows, etc.)
- Thoracic extensor strengthening
- Scapular abductor strengthening - Bracing
Pt intervention for ankylosing spondylitis:
Active exercises with mobility focus
- Spine extension & peripheral joint exercises (hip/shoulder)
- Breathing exercises (rib mobility)
- Prone lying several times/ day for spine/ hip extension
- Sleeping on firm mattress & avoidance of SL position (not as much flexion at night)
- Swimming
T/F Limited/ Poor/ No compelling evidence regarding “correction” or limiting progression of curvature for adolescent idiopathic scoliosis.
True
Goal with thoracolumbar bracing in adolescent idiopathic scoliosis?
Prevention of curvature progression
Correction of abnormal curvature
Goals with exercise for conservative management for adolescent idiopathic scoliosis?
- Strengthen postural muscle
- Address muscle length impairments/ strength impairments of extremity musculature
- Maintain/ Improve respiration & chest mobility
- Address back pain impairments
- Resume functional tasks
- Strengthen abdominals
T/F Poor evidence that supports standardized intervention for T4 sybndrome.
True
Consider the following (based on impairments) with intervention for T4 syndrome:
- Thoracic manual therapy techniques (mobilization, thrust manipulation)
- F/b thoracic mobility exercises - Scapulothoracic motor performance
- Thoracic extensor strengthening
Traction not established with disc lesions of the T-Spine, but common practice to address what symptoms?
Radicular
Duration recommendation for traction intervention for disc lesions:
2 min - 24 hours
Contraindications for traction:
- acute lumbago (low back pain)
- instability
- respiratory or cardiac insufficiency
- respiratory irritation
- painful reactions
- large [disc] extrusion
- medial disc herniation
- altered mental state; this includes inability of the patient to relax
Common impairments due to zygapophyseal joint pain:
- Muscle Guarding
- Joint Hypomobility
- Acute irritation/ dysfunction
- Pain
- ROM: commonly motions that close joint (extension, ipsilateral flexion, rotation)
Manual therapy interventions for zygapophyseal joint pain:
- Mobilizations
- Oscillations
- Stretch mobilizations - Manipulation
- Neurophysiologic effect
- Biomechanical theories
- Follow up with ROM/AROM exercises to maintain benefits
Exercise interventions for zygapophyseal joint pain:
- Pain & guarding inhibition
2. Neuro re-education (postural stabilizers, osteokinematic mobilizers into painful planes
Manual therapy interventions for rib dysfunction:
- Rib mobilizations
- Oscillations
- Static stretch mobilizations - Rib manipulation (don’t manipulate lower floating ribs)
- Soft tissue mobilization
T/F Poor evidence that supports standardized intervention for thoracic outlet syndrome.
True
Consider the following interventions (based on impairments) for TOS:
- Work/ activity modification
- Nerve glides (easy to flair people up – in clinic and follow up -> modify if provokes)
- Shoulder, upper rib/ thoracic manual therapy techniques
- Scapulothoracic motor performance
- Address tissue extensibility anterior trunk musculature
Modalities of the Tspine:
- Ultrasound:
- Thermal
- Pain relief - Cryotherapy:
- Pain relief - E-Stim:
- Muscle activation/ neuromuscular re-education
- Pain relief (TENS)
- Aid in healing (muscle pump)
T/F E-stim is effective for preventing progression of scoliosis.
False, it is NOT
T/F Studies with Thrust demonstrate better short-term results than mobs for mechanical neck pain.
True
Seated Thoracic Extension mobilization: Rate of force - Direction of force - Target force - Relative structural movement - Patient position -
- Rate of force - low velocity/static hold
- Direction of force - anterior
- Target force -
- Mobilizing: posterior aspect of bilateral upper arms for superior thoracic segments into relative extension
- Stabilizing: dorsal surface of articular pillars (or spinous process) of thoracic segment of choice - Relative structural movement - inferior segment on superior segment
- Patient position - sitting, fingers interlocked behind head
