03 Thoracic and Lumbar 4 Flashcards Preview

7232 Ortho > 03 Thoracic and Lumbar 4 > Flashcards

Flashcards in 03 Thoracic and Lumbar 4 Deck (32):
1

How would you know there may be a rib issue?

if the patient has pain when they take a deep breath

2

Where can you perform a rib mobilization?

- costovertebral junction
- further out on the rib

3

For rib mobs at the costovertebral junction, which part of the hand do you use?

thumbs

4

For rib mobs further out on the rib, which part of the hand do you use?

hypothenar eminence

5

When screening for hypomobility of the rib, what are you looking for?

seeing if it replicates their pain

6

How do you know you may need to perform a manipulation?

- hypomobility
- lower cervical neck pain
- FHP

7

What can the patient do themselves if they have excessive kyphosis?

thoracic extension stretches
- foam roller
- ground
- back of chair

8

positioning for foam roller manipulation

- hands behind head
- elbows together
- tuck chin to chest
- butt stays on the ground

have them roll to position that hurts the most

9

What is the mechanism behind the foam roller manipulation?

- foam roller takes them to end range
- PT adds quick overpressure

10

What is the FABQ?

- common outcome measure for the spine
- how fearful a person feels doing an activity because of their low back pain

11

Oswestry disability

most commonly used outcome measure for back pain

12

What are the categories of treatment for LBP?

- manipulation
- stabilization
- specific exercise
- traction

13

manipulation category
- clinical findings

- hypomobility of L-spine
- no s/s distal to knee
- recent onset (less than 16 days)
- low FABQ scores (below 9)
- at least one hip has more than 35˚ of IR

14

What do low FABQ scores indicate?

not fearful

15

What are the treatments for individuals in the manip category?

- mobilizations
- manipulations

16

stabilization category
- clinical findings

- under 40 y/o
- positive aberrant movement
- hypermobility of L-spine
- pregnancy
- positive endurance and/or prone instability test
- SLR over 90˚

17

For the stabilization category, what are the positive aberrant movement signs?

- Gower's sign
- Instability catch
- Reverse lumbo-pelvic rhythm

18

Gower's sign

bend over and can't get back up without putting hands on thigh to push themselves up

19

instability catch

patient bends over but can't stand back up without a pause or "catch" that is often painful

20

reverse lumbo-pelvic rhythm

when trying to stand up from bending, hips move before moving the back (the old bend and snap)

21

treatments in the stabilization category

core strengthening

22

specific exercise category
- clinical findings

- directional preference
- symptoms distal to buttocks

23

What is directional preference?

one direction centralizes/peripheralizes symptoms

24

treatments for specific exercise category

- centralizing exercise
- avoid aggravating direction

25

traction category
- clinical findings

- negative repeated motion test
- positive distal radicular symptoms

26

treatments for traction category

- mechanical traction
- manual traction

27

Deciding on which category to place a patient in for LBP

order of findings

- specific exercise
- manipulation
- stabilization

28

For a patient to belong in the stabilization category, they should have this many of the clinical finidngs

at least 3

29

probability of success with manipulation

4+ variables present

95%

30

probability of success with manipulation

3+ variables present

65%

31

probability of success with manipulation

2+ variables present

49%

32

probability of success with manipulation

1+ variables present

46%