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FALL2 THEREX > WEEK 2: LUMBAR > Flashcards

WEEK 2: LUMBAR Flashcards

1
Q

CPR FOR MANIPULATION

A
  1. acute (less than 16 days)
  2. no symptoms beyond knee
  3. FABQ less than 19
  4. hip med rotation over 35 deg
  5. hypomobility of L spine with spring testing
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2
Q

CPR for stabilization

A
  1. young (below 40)
  2. SLR > 91 (bendy)
  3. abherrant motion “catch”
  4. positive prone instability test
  5. post partum (+ASLR, tender over long dorsal ligament, tender over pubic symph)
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3
Q

If patient has:
pain, mm guarding
pain worse in AM, better as day goes on
-pain with coughing/sneezing
-pain with flexion, SB

A

DISC! extension preference.
*acute phase, early 20-30s when degenerative changes happen due to dehydration of disc

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4
Q

If patient has…
1. symptoms distal to butt
2. symptoms centralize w extension, peripheralize w flexion
3. directional preference for extension

A

EXTENSION DIRECTION PREFERENCE

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5
Q

If someone is:
-older than 50
-directional preference for flexion
-imaging evidence for stenosis

A

DIRECTIONAL FLEXION EXERCISE BUCKET

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6
Q

Visible frontal plane deviation of the shoulders relative to the pelvis
Directional preference for lateral translation movements of the pelvis

A

lateral flexion exercise

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7
Q

What will be worse for early disc patients, SLR or slump?

A

SLR 30-60 degrees and slump are EQUALLY BAD
*hip flexion–>lumbar flexion
*lumbar flexion!

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8
Q

If someone has…
pain with mm guarding all motions
-pain worse in AM and NIGHT
-pain with transitional movements
hypermobility early, then hypomobility later
-impaired extension
flexibility or repetitive lifting HURTS

A

facet impairment!
usually more 30s, facet more involved

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9
Q

SLR vs slump in stenosis!

A

SLR more positive than slump!
slump=lumbar flexion
NERVE ROOT COMPRESSION FROM BONES/FACETS

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10
Q

If someone has pain better in AM, worse at end of day, leg pain from longtime walking/standing, and pain with extension…

A

STENOSIS (50+)

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11
Q

If ___ mm is overactive, due to guarding/tightness, it can cause hip, leg, knee or lateral glute pain!

A

QL! causes facet compression

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12
Q

3 legs of stability stool

A
  1. active mm
  2. passive ligament/joint
  3. neural CNS control
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13
Q

If someone has symptoms distal to butt (nerve) AND
1. gets worse with extension, or positive crossed SLR

A

TRACTION

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14
Q

If someone has nerve symptoms, AND
1. directional preference
2. centralization of symptoms with flex or ext

A

specific exercise DIRECTION

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15
Q

If someone does not have nerve symptoms, BUT patient has centralizing symptoms with direction

A

specific exercise! AND/OR manip/stabilize

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16
Q

If someone has symptoms less than 16 days and no nerve symptoms…

A

MANIPULATION

17
Q

If someone has 3 or more of these:
1. SLR over 91
2. positive prone instability
3. catch/abherrant movement
4. younger than 40
5. postpartum

A

STABILIZATION

18
Q

If someone has:
1. red flags
2. med problems that are bad
3. leg pain with neuro deficits

A

MEDICAL MANAGEMENT

19
Q

If someone has
1. medium/high psychosocial risks
2. low psychosocial risks with LEG PAIN
3. minor comorbidities

A

REHAB/PT

20
Q

If someone has
1. low psychosocial risks
2. mainly LBP only
3. minor comorbidities

A

self care!

21
Q

If someone has a flexion preference, they usually have….
what posture?
more ___ROM

A

more extension ROM, limited FLEXION
flexion feels better!
flat spine, lordotic/kyphotic

22
Q

What should you avoid/educate about for flexion preference

A
  1. avoid overhead/extension
  2. standing on one leg
  3. sit with knees above hips
  4. endurance good
    5.
23
Q

patient presents with flexion or flattened spine. they prob have

A

extension preference! limited extension ROM
*lumbar flexion syndrome

24
Q

hamstring stretch is good for…

A

extension preference in subacute phase with opposite leg extended to restore FLEXION AS TOLERATED

25
Q

ADL/education for extension preference

A
  1. avoid flexion
  2. avoid valsalva
  3. extension for pain control
  4. lift in neutral
  5. sit with lumbar support
  6. sleep with lumbar support
26
Q

what does the thoracolumbar fascia do for the lumbar spine?

A

stiffen lumbar spine without compression! train the lats and glutes

27
Q

What are the 3 global abdominal muscles

A

RECTUS AB
EXT OBLIQUE
ERECTOR SPINAE

28
Q

What is ADIM

A

TrA activation
1. pull ASIS together
2. hold pee (pelvic floor)
3. zip up tight pants
4. blow out candle/exhale

if you see post pelvic tilt (RA)
upper abs under ribs (compensation)
quick contraction (compensation)
pullribs down (EO)

29
Q

posterior pelvic tilt causes ____ mm activation and is best for ____ pain modulation

A

RA activation
best for flexion pain modulation

30
Q

___MM contributes to increase IAP with both isometric and active trunk flx and ext via EMG

A

transverse ABDOMINUS

31
Q

goals for stability training

A
  1. ACTIVATION
  2. STRENGTH
  3. FUNCTIONAL STABILITY

FALL2 THEREX (4 decks)

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