Rehab for LBP

Question 1

Lancet recomended tx for acute LBP

Answer 1

• Advice pt to stay active
• Education
• Exercise therapy

Question 2

lancet recoended 2nd line tx for acute LBP

Answer 2

superficial heat
smt
massage
acu
muscle relaxants

Question 3

New zealand approach for LBP

Answer 3

• advise to stay active
• manip
• multidisiplanary care approach

Question 4

New zealand approach still needs more reseach on these topics

Answer 4

modalities

trunk stabalization exercises

Question 5

LBP tx goals for acute and chronic indv

Answer 5

acute- decrease pain, increase ROM, maintain flexability, return to ADLs

Chronic- maintain flex, increase strength, endurance, improve jt function

Question 6

Mckenzie protocol is

Answer 6

evalauation of pain location + maneuvers that change the pain location from reffered to centralized using extension type exercises

Question 7

indications for a McKenzie type protocol

Answer 7

• Sustained or repetative extension maneuvers reduce or relieve symptoms
• discogenic LBP with radiation into lower extremities

Question 8

contraindications for a mckenzie type protocol

Answer 8

• no pos or movement decreases of centralizes described pain
• saddle anesthesia
• pt in extreme pain + rigidity

Question 9

indication (conditions) for flexion bias exercises

Answer 9

Stenosis
DDD
Facet irritation/syndrome
sprain/strain
spondylosthesis

Question 10

contraiondications for flexion type movements

Answer 10

ext relieves symptoms

flex movement increase pain and peripherlize them

Question 11

Identification of indv with clinical spinal instability

Answer 11

1. Quality of movement- ROM, abrupt mvmts
2. lack of control of deep mm. - TA + multifidus
3. Low endurance of ant, post, lat trunk mm

Question 12

what is used to predict success w stabalization (5)

Answer 12

3+ are most likely to benifit

• Age <40
• Abnormal mvmts present
• Average SLR >91
• Hypermobility
• Pos prone instability test

Question 13

Tests w high inter rater reliability for lumbar instability

Answer 13

Beighton lig laxity scale
prone instability test
abrant motion w trunk ROM

Question 14

Trunk endurance ratios
r side bridge;L side bridge
flex;ext
side;ext

Answer 14

r;l= >.05

flex;ext= >1.0

Side;ext= >.75

Question 15

in a dysfunctional state TA changes its role to

Answer 15

fron support to trunk mvmt

Question 16

how to activate and isolate the TA

Answer 16

drawing abdomin in prone pos (10 sec holds)

Question 17

What can a tight iliopsoas lead to

Answer 17

tonicity may lead to lumbar lordosis

-release of iliopsoas enhances TA activation, altered lumbar lordosis and decreased LBP

Question 18

what is lower crossed syndrom (whats tight and weak)

Answer 18

tight- thoracolumar extensors, hip flexors)

weak- abdominals, glute max