Orthopedic PT - Treatment of Spinal Disorders Part 3
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32 terms
Terms | Definitions |
|---|---|
 the strategy for addressing lumbar radiculopathy is to | centralize Sx, reduce pain!, Indep. management of Sx through posture, exercise |
| Tactics for addressing lumbar radiculopathy | Pt ed: stay active, open IV foramen or repeated extension and maintaining extension |
| If the usual tactics for lumbar radic do not reduce pain, centralize, try: | traction, though evidence suggests it is not useful. |
| sciatic pain with lumbar radiculopathy may be helped with | traction |
| To progress extension exercises the McKenzie way, | let pt perform extension first, then prn try PT overpressure/mobs, then if no centralization try traction or positional traction |
| first line of action for LBP with leg pain | PT, epidural injections, Meds |
| Surgery criteria for back pain | > 3 mo p!, leg pain, high disability, something to surgerize |
| the three grades of surgery | Microdiscectomies (scope), laminectomies (removes lamina to decompress), fusion |
| Sciatica with lumbar disc herniation surgery outcomes | Surgery yields better results at 1 year f/u. No difference at 4-10 year f/u between surgery and conservative approach |
| After surgery for LBP (L-spine discectomy, laminectomy or fusion), HEP vs. Supervised PT findings are | equivocal |
| at 12 mo. f/u adding specific neural mobs for post surgery LBP was found to be | not beneficial |
| Facet syndrome is a loss of | mobility asymmetrically |
| LB or buttock pain with restricted lumbar ROM Asymmetrically might mean | Facet jt syndrome |
| A R facet joint problem leads to __ sidebending problems | Left |
| Evidence indicates we can/cannot reliably detect the level of spinal dysfunction by ID'ing if the segment is painful or no | CAN |
| Can we reliably determine the quantity of motion at a segment? | no |
| evidence level for treatment of facet syndrome with McKenzie dysfunction treatment | no evidence |
| the strategy for improving Lumbar facet joint syndrome is | improve ROM, reduce p! |
| To improve joint motion in facet syndrome (lumbar) there is evidence that these techniques work | Mobilization, Manipulation, Muscle Energy, ROM/Stretching |
| To improve joint motion in Thoracic facet syndrome there is evidence that these techniques work | Mobilization, Manipulation, ROM/Stretching |
| Good outcome tools to use with Chronic LBP patients | Oswestry, Roland-MOrris, FABQ score |
| Discharge CLBP patients when | goals have been achieved, when pt doesn't require supervision for exercise, and if you have nothing left to offer |
| Facet syndrome can be lumped with these McKenzie and Pitt categories | Mobilization/manipulation (Pitt), Dysfunction |
| Lumbar radiculopathy could be lumped with these McK and Pitt categories | Specific Exercise (Pitt), Derangement |
| The three McKenzie categories | Dysfunction, Derangement, Posture |
| Three pathologies that drive treatment | Ankylosing spondylitis, spondylolisthesis, Spinal stenosis |
| If, over three weeks, the # of rest periods increases, complaints persist or worsen and analgesic use is steady or increased | This would be considered an Abnormal Course of LBP |
| WHat is prescriptive evidence? | Evidence that guides decision making and is clinically useful. It does this by defining treatment that is effective: 1) for WHOM, 2) for what group of homogenous pts (very specific like w/o Sx distal to knee and p! <16 days), 3) for WHAT clearly defined pathology |
| General advice for general Acute, SubAcute, Chronic LBP that has evidence: | Advice to stay active, Exercise (weak for Acute), Pt Ed, Manip and Mobs |
| Compared to general therapy course, the McKenzie method for L and C-spine is | better |
| McKenzie at ST and 1 year f/u compared to NSAID, Ed Booklet, general treatment approaches for LBP | McKenzie approach is better at the ST but at long term (3 to 12 months) there was no difference between McKenzie and other Rx |
| What does the general Acute and CLBP evidence show for manipulation | more research is needed. Right now some studies show benefit, some no difference |
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