03 Thoracic and Lumbar 2 Flashcards Preview

7232 Ortho > 03 Thoracic and Lumbar 2 > Flashcards

Flashcards in 03 Thoracic and Lumbar 2 Deck (47):
1

What category does repeated motion testing correspond to?

specific exercise

2

What are the repeated motion tests for lumbar spine?

- repeated flexion
- repeated extension

3

loaded position for repeated motion testing

standing

4

unloaded position for repeated motion testing

lying down (gravity minimized)

5

Though research doesn't suggest that this is pain generator, we talk about it as if it were

disc

6

In a posterior derangement, the nucleus goes in which direction?

posterior
posterolateral

7

In a posterior derangement, what motion will make symptoms worse? Why?

- flexion
- pushing the NP posteriorly

8

In a posterior derangement, which motion will make symptoms lessen?

repeated extension

9

Do patients who have anterior derangements have radicular symptoms?

- no
- may have referred symptoms or generalized back pain, but no nerves are being compressed

10

With an anterior derangement, which movement worsens symptoms?

extension

11

With an anterior derangement, which movement lessens symptoms?

flexion

12

What types of patients might present with anterior derangement?

gymnasts - frequent extension

13

What sleeping positions may exacerbate posterior derangement?

- supine on a soft mattress
- fetal position

14

How does flexion change ROM in patients with posterior derangement?

- NP migrates backwards, causing mechanical block
- limits extension ROM

15

How should you assess extension ROM for repeated motion? Why?

- do a gross assessment of ROM before and after repeated ROM
- repeated motion should slide the NP anteriorly, allowing extension to improve

16

What should you do if you suspect posterior derangement?

- visual extension ROM test, have them bend all the way forward and stand up
- repeat 10x
- do 10x extensions to (ideally) restore full ROM

17

Do you have to go all the way to 10 during repeated flexion if it hurts halfway through?

no, go into extensions

18

During repeated flexion, do you need to be concerned with isolating hip movement?

no, just have them go as far forward as they can

19

What should you do if you suspect anterior derangement?

opposite of posterior (extensions » flexions)

20

For repeated motion tests, how many reps will you do?

10

21

unloading tests for posterior derangement

What are the steps?

- pt prone, hands under shoulders, check extension (hips down)
- supine » 10x double knees to chest
- prone » 10x extensions

22

unloading tests for anterior derangement

What are the steps?

- check flexion first
- do 10x repeated extensions
- 10x repeated flexion

23

Should you do both loaded and unloaded repeated motions?

generally yes

- usu loaded flexion makes them worse than unloaded, but unloaded extension makes them better than loaded

24

positive repeated motion test

peripheralization or centralization

25

negative repeated motion test

no change

26

What are the lumbar endurance tests?

- Sorensen
- supine bridge
- prone bridge
- side bridge

27

What is the Sorensen test assessing?

lumbar extensors

28

Sorensen test position

- prone with superior margin of iliac crests aligned with edge of the table
- stabilize pt legs
- have them hold position

29

Sorensen test
- male norm

146 sec

30

Sorensen test
- female norm

181 sec

31

Sorensen test
- average for all

171 sec

32

supine bridge test position

- feet hip distance apart
- hooklying position
- push off so that shoulders, pelvis, and knees are in straight line

33

supine bridge test
- male asymptomatic norm

188 sec

34

supine bridge test
- male symptomatic norm

77.9 sec

35

supine bridge test
- female asymptomatic norm

152 sec

36

supine bridge test
- female symptomatic norm

75.7 sec

37

prone bridge test position

- just a plank on toes and elbows
- maintain a straight line
- elbows shoulder width apart

38

prone bridge tests which muscles?

trunk flexors

39

prone bridge test
- male asymptomatic norm

92.9 sec

40

prone bridge test
- male symptomatic norm

33.4 sec

41

prone bridge test
- female asymptomatic norm

51.2 sec

42

prone bridge test
- female symptomatic norm

24.3

43

side bridge tests which muscles?

lateral flexors

44

side bridge position

- prop up on elbow and toes
- raise to straight line

45

side bridge norms
- males

R: 94 sec
L: 97 sec

46

side bridge norms
- females

R: 72 sec
L: 77 sec

47

What should you do if you notice shaking/visible fatigue?

- document
- could be another sign of progression if they can do it later without shaking