Lumbar Spine Flashcards
(37 cards)
What are normal expectations when observing LQ movement screen?
Normal Expectations:
-Touches toes?
-Reversal of Lumbar Lordosis
-Hip to Spine flexion ratios about 50% each
-Posterior hip sway
What are two constructs for scoring the Keele STARTBack Screen Tool?
1) Overall Score – if 3 or more = Medium or High Risk to develop Chronic LBP – depending on how the scores for the Psychological Items are
2) Psychological Score
Psych score 2 or less = Medium Risk
Psych score 3 or more = High Risk
Medium or High RISK = Refer to PT
What are signs of pathologic motion when observing LQ movement screen?
Non-reversal of L-Lordosis
Hinge Points
Judder and deviations
Gower’s sign (climbing up the legs to stand back up)
What are the 5 criteria for Lumbar Manipulation CPR?
Duration of Symptoms < 16 days
At least one hip > 35 of IR
Lumbar Hypo-mobility
No symptoms distal to knee
FABQ-W <19
What is the four criteria for Lumbar Stabilization Intervention CPR?
Age < 40
Avg SLR > 91
POS Prone instability test (PIT)
Aberrant movement present (instability catch, painful arc, thigh climbing, reversal of lumbo-pelvic rhythm)
Grade 1 Spondylolithesis
<25% slippage, usually not symptomatic
Grade 2 Spondylolithesis
25%-50% slippage, education to avoid extension and begin spinal stabilization. May use casting to reduce anterior shear forces and allow healing
Grade 3 Spondylolithesis
50%-75% slippage, conservative treatment may be attempted. May need surgery
Grade 4 Spondylolithesis
> 75% slippage, surgery due to neurological involvement
What 3 exercises are included in the McGill Big 3?
The Curl Up
Side Plank
Bird dog
What is the lumbar spinal stenosis CPR?
Bilat Symptoms
Leg Pain > Back Pain
Pain during walking or standing
Pain relief upon sitting
Age > 48 years
Who is more likely to experience Pelvic Girdle / SIJ Pain?
Females > Males
What is a common mechanism of injury (MOI) for Pelvic Girdle / SIJ Pain?
Recent Fall onto buttock or knee, pregnancy/childbirth (post partum or monthly cycle)
What should be ruled out (R/O) when assessing Pelvic Girdle / SIJ Pain?
Fractures – Trauma vs. Insufficiency (Osteoporosis)
How does Pelvic Girdle / SIJ Pain present in the early stages?
Hurts with Everything!
How does Pelvic Girdle / SIJ Pain present later?
Inconsistent Onset vs. Specific Motions…Movement Control
What type of pain is commonly reported in the SIJ / PSIS region?
Sharp Pain
What physical signs may indicate Pelvic Girdle / SIJ Pain?
Guarded Gait, Any Pelvic Motion, Any Lifting the LE (into the bathtub)
What sleeping issue is commonly associated with Pelvic Girdle / SIJ Pain?
Sleeping difficult, Any Rolling / Supine-Sit aggravates
What is the initial focus of physical therapy management for Pelvic Girdle / SIJ Pain when everything hurts?
Symptom Moderation – Belting to stabilize
What is the focus of physical therapy management for Pelvic Girdle / SIJ Pain with inconsistent onset?
Movement Control
What is the criteria for SIJ CPR - Provocation Test Cluster(s) ?
Distraction
Compression
Thigh Thrust
Ganslen’s
Sacral Thrust (Laslett’s)
What 3 criteria are involved in the LQ algorithm for pelvic girdle (Pelvic alignment)?
Need 2 of 3 POSITIVE for these for the Pelvic Girdle:
Motion Testing (March/Gillet and Forward bending tests)
Positional Testing – Ant/Post illia, inflare/outflares
Ligamentous Palpation Provocation Testing – Long & Short SI, Sacrospinous & Sacrotuberous ligaments
What is the forward bend PSIS test?
Left Hand on Sacral Base, R hand on PSIS; Patient FB’s watch for WHEN PSIS moves. Compare to C/L side. POS= Side that moves 1st or moves MOST w/ FB as it is more restricted or “sticking” to the spine longer. (Sacrum on Ilium)
