Final Lab Exam Flashcards
(27 cards)
Effects of distraction
- Decreased intradiscal pressure
- Increased IVD height
- Increased IVF size
- Restore facet joint ROM
Normal L3 disc pressure; recumbent to sitting
25-275 mmHg
Position 5 for 150-200 lbs then…
go up or down one lighted position for each 25 lbs more or less
Distraction LOD
2/3 I-S and 1/3 P-A
SCP
SP above the involved disc
CP
Softest part of thenar eminence
Joint play
Intrinsic movements that cannot be produced through the action of voluntary muscles
Table prep
Check thoracolumbar drop and caudal section release
Adjust table elevation
Ask patient weight and set spring tension
Patient prep
Patient unbuckles belt
Instruct patient on hoop tension and mounting table
Assist patient onto table
Position ASIS 2” above bottom of thoracolumbar cushion
Adjust ankle rest for slight plantar flexion
Adjust tiller bar for doctors arm length
Patient permission to expose lumbar region
Stabilize and release caudal section of table
Fine tune spring tension
Doctor prep
Position height of table at doctor’s mid thigh
Doctor stance one thigh on each side of patients knee
Extend and lock superior arm 30-45 degrees
Tolerance testing
- Central (hold for 4 seconds and release)
- Lateral (hold ankle uninvolved side first; hold for 4 seconds then release)
- Central w/ restraints (hold for 4 seconds and release)
Protocol 1 candidates
For sciatic patients (issues with a radicular component)
Protocol 1
3 x 20 second decompression
[5 x (2 sec down/2 sec up)]
Treat for trigger points between decompression sessions
Protocol 1 patient management
Treatment daily.
With 50% improvement treatment every other day
50% more improvement treatment 2x /week
50% more improvement treatment 1x /week
Clinical finding needing referral
Progressive loss of motor function
Acute low back patient should not…
SIT (not until 50% improvement)
Getting patient off table
Adjust table height, secure caudal section, secure lateral flexion, LOWER TILLER BAR, remove ankle cuffs, offer to assist patient, advise patient it may take them same as in the morning
Protocol 2 candidates
Patients without a radicular component
Switch from protocol 1 to 2
When patient has made 50% improvement
Protocol 2
10 x 2 second pumps (1 sec up/1 sec down) in the following ROM
flexion, lateral flexion, circumduction, extension
Protocol 2 extension LOD
2/3 PA, 1/3 IS
Protocol 1 variation used when…
- Pain prevents patient from lying prone
- Patient fails tolerance test
- Pregnancy
Protocol 1 variation
Patient chooses which side to lay on, their whole pelvis rests on caudal section, patient feet stabilized with tiller bar, doctors superior hand index and middle finger contact and stabilize SP above involved disc, doctors inferior hand stabilize SP below involved disc. Doctors inferior arm pulls patients pelvis into flexion. (Follow protocol 1 guidelines)
Protocol for spondylolisthesis
Patient lies prone, form fulcrum under segment via foam roll or elevated lumbar section, doctor contacts SP of segment ABOVE spondy (less force is needed due to fulcrum)
