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Flashcards in [MDDR] Lower Back Assessment Deck (18):
1

The movement examination of the lower back consists of?

Individual movements and repeated movements

2

What would you see in the movement examination for the 'reducible disc' diagnostic category?

Centralisation or directional preference (DP)

3

What would you see in the movement examination for the 'Tissue Dysfunction' diagnostic category?

- Restricted ROM
- Pain reproduced at the end of the available ROM
- No significant change in site or intensity of pain
- No significant change in ROM

4

What would you see in the movement examination for the 'Movement Control Impairment' diagnostic category? Ft

- Painful arc without centralisation or DP
- Deviation from plane of movement
- Use of hands to return from FIS
- Moves through range that causes pain despite pain

5

What would you see in the movement examination for the 'Postural Syndrome' diagnostic category? AC

- Full and painless ROM in all directions
- No aberrant movement patterns

6

What would see in the movement examination for the 'Category Indeterminate' diagnostic category?

- Fear of movement
- Splinting, guarding
- Sudden onset of acute pain early in ROM
- Pain limits movement

7

What should the neurological examination include?

Motor testing
Sensory testing
Reflex testing
Neurodynamic testing

8

If LBP is of a chemical nature, what factors/symptoms would you expect?

- Pain easily aggravated by activity
- Pain not readily eased by rest or change of position
- Typically constant pain
- Pain & stiffness that lasts >60 minutes after waking

9

If you suspect the pain is of chemical nature, what should you do?

Reconsider red flags or inflammatory conditions (i.e. Reiters, Ank) or consider post-traumatic inflammation even

10

What conditions with particular relevance to the lumbar spine should been screened for medical referral?

Cauda Equina Syndrome
Cancer
Infection
Fracture

11

How many repetitions is suggested for the reacted movement examination?

5-20 reps

12

What must you ensure during repeated movements?

That the patient is progressively going further into the ROM so they reach EROM

13

The physical examination in order should include?

- Observation & Postural Analysis
- Individual Movements
- Repeated Movements
- Palpation
- Passive Movements (PPIVMs & PAVIMs)
- Functional tests (i.e. stairs, in/out chair, hop)
- Special Tests (i.e. prone instability test, SIJ pain provacation tests)

14

What are the 5 diagnostic categories for lower back pain

Reducible Disc
Tissue Dysfunction
Movement Control Impairment
Postural Syndrome
Category Indeterminate

15

Physiological & Accessory movements are assessed during the manual examination.

What are the lumbar spine PPIVM's?

1) Flexion
2) Extension
3) Side-Flexion

These are side-lying tests

16

Physiological & Accessory movements are assessed during the manual examination.

What are the lumbar spine PAIVM's?

1) Spring Test
2) Caudal/Cranial Glides
3) Rotation

These are prone lying tests

17

Briefly, therapists perform PPIVM's and PAVIM's to determine:

1) The ROM of the segment
2) The stiffness of the motion segment
3) Does the movement reproduce the patients pain

18

A neurological exam should be performed on any patient that complains of or exhibits:

- Altered sensation (paraesthesia, numbness, hypersensitivity, tremor)
- Referred pain below the buttock crease or distal to the shoulder
- Weakness, heaviness, clumsiness (tripping over things)
- Muscle atrophy