LBP Classifications
A pt presents with end-range pain in extension following an incident at work related to picking something up off the ground. Based on this information alone what ICF classification would you say applies best?
LBP w/ Mobility Defecits
Anterior longitudinal ligament (ALL) is stretched during what motion?
Extension
Demonstrate how you would assess joint mobility and explain reasoning.
CPAs or (B) UPAs for extension. UPAs for lateral flexion and rotation.
T or F: Directional preference can reliably determine which treatment will work best for a patient
False; can predict better outcomes but intervention results are mixed
Translated to “Out of many, one" what Latin phrase appears on the “tails” side of many US coins?
E Pluribus Unum
A pt presents with LE sensory deficits. What ICF classification would you expect?
LBP w/ Radiating pain
Describe arthrokinematics of the vertebral body and inferior facets during extension.
Vertebral body tilts and slides posterior and inferior facets slide inferior
This phenomenon refers to distal pain moving closer to the spine with repeated movements
Centralization
What ancient civilization was based on the myth of Romulus and Remus?
Ancient Rome
A truck driver comes into the clinic complaining of pain associated with prolonged sitting during long drives. From that information alone, what ICF classification do you suspect?
LBP w/ movement coord. deficits
Describe motion at the pelvis and hip during lumbar flexion.
Lumbar flexion --> initial posterior pelvic tilt
End-range anterior pelvic tilt and hip flexion
Pt presents with excessive lumbar extension. What are 2 treatment ideas to improve this movement coordination deficit?
- Improve/modify neutral spine positions at rest
- Improve hip flexor length/stiffness
- Improve paraspinal stiffness and inhibition
- Improve abdominal strength/stability, control
- Improve lumbar/hip coordination
- Train CNS on normal posture and movement control
- Teach the hips to extend more easily
What is directional preference?
Movement direction that reduces or centralizes a patient's pain.
Which country went to war with Emus (and lost)?
Australia: Emu War of 1932
Lumbar flexion more flexible than hip flexion is what MSI classification.
Lumbar flexion syndrome
What direction does the sacrum move during lumbar extension.
Counternutation. "As goes the spine, so goes the sacrum".
Demonstrate and explain ROM assessment for Lumbar flexion and extension
Double inclinometer (T12 and S2). Zero on patient. Difference indicates ROM measurement.
What is the most common directional preference?
Extension
Where is the largest herd of hippos outside of Africa located?
Columbia (Pablo Escobar)
If a pt is restricted in lumbar flexion at end range, what McKenzie Classification would they fall under?
Flexion dysfunction
Describe sacrum-on-innominate movement during nutation.
Sacrum glides inferior and posterior on innominate
Demonstrate and explain trunk extension MMT
5 = hands behind head
4 = hands folded behind back (mod. = in front of face)
3 = arms at side of body
2 = partial motion
What was the main takeaway of both these articles?
Centralization and Directional Preference are common and good prognostic signs (tend to have less pain, better function, and better short/medium term outcomes) but cannot reliably guide intervention.
What was the name of the 17-year-old gorilla that was shot to death at the Cincinnati Zoo in 2016 when a child fell into its enclosure?
Harambe