L7: Lateral Shift and Intro to Pelvis Flashcards
(51 cards)
How is radiculopathy diagnosed clinically?
No single tets
SLR has ____ (high/low) sensitivity, ____ (high/low) specificity. ______ (everyone/some people/very little people) with radiculopathy will have pain on SLR
high; low; everyone
_____ will sometimes be referred to as a ‘diagnostic’ test for Radiculopathy – but we use it to assess mechanosensitivity in a number of presentations
SLR
Neurological symptoms are a ______ to using Neurodynamic tests
precaution
What is assessed in the neurological assessment?
Conduction of nerves (whether they are sending messages normally)
What is assessed in the neurodynamic assessment?
mechanosensitivity
Whether your nerves are moving and how sensitive they are
What is the purposed of the neurodynamic assessment?
Used to gain an impression of neural tissue mobility and sensitivity to mechanical stress.
The presence of a ‘positive’ test in the neurodynamic exam does not enable the clinician to identify the ______ of neural tissue compromise; it indicates an increased amount of _______. It also doesn’t always accurately differentiate between _____ and _______(muscle, fascia, connective tissues) structures as these are largely a continuous system
specific site; mechanosensitivity; neural; non-neural
Patients with higher fear avoidant behaviours are more likely to have _____ (higher/lower) pain responses on neurodynamic testing
higher
A _____ is a common clinical observation associated with low back pain
lateral shift
What is a lateral shift described as?
Described as a vertebra rotated and laterally flexed (Away from the spine) in relation to the vertebra below. when the patient’s body is, either actively or reflexively, avoiding nerve root related pain through muscle spasm.
Can be towards the dominant side of pain (_____) or away (_____).
ipsilateral; contralateral
The majority of affected patients have a _____ (ipsilateral/contralateral) shift.
contralateral
Very occasionally, the lateral shift may change from __to ____.
side; side.
Must try and _______ the lateral shift when it is detected during the physical exam.
correct
The lateral shift is similar to _______ movement exam (treatment direction test).
repeated
How is the assessment of the lateral shift done?
visually assessing the patient.
Most patients respond rapidly to correction, especially if the shift is _____ (ipsilateral/contralateral)
contralateral
Correction of lateral shifts has been shown to result in superior outcomes compared to a ______ treatment of manual therapy and education
control
Why is important to correct lateral shift?
• Better short term outcome Able to manage their pain
What are 2 ways to correct a lateral shift?
- self-correction
- manual correction.
What are the 4 steps in correcting a lateral shift?
- Patient stands with side that the shift is occurring to against wall with elbow on wall (or arm by side). Opposite hand on hip
- Gently leans hips of involved side towards the wall, holds for a few seconds and then returns – preferably only back to midline.
- Likely to be uncomfortable – continue if centralisation of symptoms are occurring and increased ROM/reduction of shift
- Reassess regularly – observation and ROM – patient can self observe in mirror
What are 3 reasons why it is good to get them to self correct rather than the physio?
- Can use this as a management exercise for home program
- They can go within their own boundaries of pain (physio might aggravate symptoms)
- Can progress within boundaries
- Give them self-efficiency, give them confidence as they can self-manage
What are 3 characteristics of self-correction of lateral shift?
- Perform during the physical assessment – reassess with ROM and observation
- Get patient to self-detect using mirror and show them how to self correct
- Repetitions: consider 5-20 as needed (hold for 1-2 secs and back to normal), VERY gradual – discomfort can be ok – as long as symptoms are improving
