Week (3) Scope of Management Lumbar Spine Disorders

Question 1

Who is part of the multidisciplinary team in treating lumbar disorders?

Answer 1

Medical
Physiotherapy and other allied health
Psychologist
Biomechanists
Neurophysiologists

Question 2

What do physiotherapists treat in lumbar spine disorders and what are the aims?

Answer 2

Patient
Pain
and physical impairments

Aims:
relieve pain
Restore movement and neuromuscular control
Return to functional activites

Question 3

Where can pain and impairments be present?

Answer 3

Articular
Neural
Muscular system

Systems inter-related

Question 4

What should physio for spinal pain provide?

Answer 4

Assurance and education

• Self management strategies
• & exercise programs (advice to prevent recurrent pain)

Resolve pain states in articular, muscular and neural systems

Restore local and global muscle function

Address deconditioning in patients with chronic pain

To assist the return to workplace/task design

Question 5

What are the physio treatment methods for back pain?

Answer 5

Assurance and education: assurance, allay fears, resume activites

Manual therapy

Therapeutic exercise

Electrotherapy

Ergonomics

Work hardening

Question 6

What is the goal of therapeutic exercise in back pain

Answer 6

decrease pain, reverse impairments

Question 7

What is the goal of manual therapy in back pain?

Answer 7

decrease pain

restore spinal movement

Question 8

What is the goal of electrotherapy in back pain?

Answer 8

decrease pain and inflammation

Question 9

What is the goal of ergonomics in back pain?

Answer 9

Reduce mechanical overload

Question 10

What is the goal of work hardening in back pain?

Answer 10

Deconditioned patients - specific job requirements

Question 11

Why is assurance and education important in management of lumbar spine disorder?

Answer 11

Allay fears, resume activity

Question 12

Why is evidence based practice important?

Answer 12

responsibility to provide proof of effectiveness for funding.

Question 13

What are evidence based treatments for LBP?

Answer 13

Manual therapy and exercise do provide benefits (spinal pain)

Evidence for multi modal treatments

Avoid prolonged passive treatments

Question 14

What are the types of studies that provide good evidence?

Answer 14

RCTs
Systematic reviews
Meta-analyses

Question 15

What should selection of manual therapy techniques for LBP be based on

Answer 15

• Nature of pain and pathology (P/I and P/E)
• Direction of movement restriction (P/E of active movements and passive movements)
• Neurophysiological/physiological/mechanical expectations of the technique.

Question 16

What are the types of techniques for LBP?

Answer 16

Segmental accessory movements (related to physiological direction of movement loss)

Segmental physiological movements

Combined physiological movements

Accessory movement in physiological position

Long axis movement (traction)

Question 17

When should posterior-anterior glides be used in LBP?

Answer 17

sagittal plane movement loss (central intervertebral joint or whole motion segment)

Question 18

What is the most common direction for LBP and what technique would be used?

Answer 18

bending forward/flexion

PA glide

Question 19

When would a unilateral posterior-anterior glide be used on lumbar spine?

Answer 19

sagittal plane movement loss that is from zygopophyseal joint

Question 20

When would segmental rotation mobilsation be used on Lx spine?

Answer 20

Loss of rot or LF

Lumbar spine: used to treat discal problems