Term
|
Definition
centralized symptoms
attempts to improve ext |
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Term
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Definition
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Term
|
Definition
| mob toward symptomatic side |
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Term
| Lumbar rotation mob: which side? |
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Definition
| painful side up (unless disc) |
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Term
| Lumbar soft tissue/jt mob: Lateral |
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Definition
pt sidelying, hip/knee flex
PT FA on lower rib cage, top of iliac crest
PT grasps top lumbar tissue c fingertips
lifts tissue as FAs separate ribs/iliac crest |
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Term
|
Definition
pt prone
PT hand on TL jxn, sacrum
>> longitudinal shear |
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Term
| Lumbar segmental traction (L5-S1) |
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Definition
pt sidelying
PT elbow on sacrum, palpates targeted segment
traction on sacrum |
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Term
| Types of manual lumbar traction |
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Definition
supine, straight leg
supine, belt + 90º hip flex
pelvic c belt |
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Term
| Manual lumbar Tx: question to ask pt |
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Definition
| do you feel it in the front of your legs (2º to belt) or in your back (goooood)? |
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Term
| Method of manual lumbar tx that >> ant pelvic tilt (so be careful!) |
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Definition
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Term
| Supine manual lumbar Tx c belt: pt position |
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Definition
| supine, hip/knee flex to 90º; feet on PT's shldrs |
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Term
|
Definition
separation of vertebral bodies
distraction of facets
incr tension of spinal segment ligts
incr size of IVF
decr/straightening of spinal curves
stretch spinal mm |
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Term
| Theories behind traction's benefits |
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Definition
disc sucked back in
flattening of annulus ('pushes' disc back in)
decr of secondary mm spasm (>>decr disc pressure)
stimulation of Type II jt mechanoreceptors
fluid mobilization |
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Term
| Amt of force req'd for traction: force needed to move body horizontally on non-split table |
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Definition
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Term
| 50% BW is at level _____ and below |
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Definition
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Term
| Amt of force req'd for traction: force needed to move lower half of body on non-split table |
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Definition
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Term
| Amt of force req'd for traction: incr angle of pull (30º) >> |
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Definition
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Term
| Amt of force req'd for traction: use of a split table >> |
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Definition
| decr friction fores >> small poundages used c therapeutic effect |
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Term
| Amt of force req'd for traction: incr angle AND split table |
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Definition
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Term
| Amt of force req'd for traction: incr angle AND non-split table |
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Definition
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Term
| 1st step of Application of tx |
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Definition
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Term
| Tx: caution c mm spasm...why? |
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Definition
| may be masking instability |
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Term
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Definition
| instability may be present |
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Term
| Aim for ___% ∆ in pain during Tx Rx |
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Definition
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Term
| Duration: longer for static or intermittent? |
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Definition
| longer for intermittent (static >> creep) |
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Term
| Beginning Rx: ____ min of Tx for disc pts |
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Definition
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Term
| Tx works well for pts with... |
|
Definition
degenerative ∆s
bilat symptoms |
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Term
|
Definition
| unlikely to feel tx over area of injury |
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Term
| Cyriax: disc herniation tx - continuous or intermittent tx? |
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Definition
disc herniation: continuous
(tx must overcome mm spasm) |
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Term
| Cyriax: intermittent tx >> |
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Definition
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Term
| Saunders: degenerative ∆s & hypomobility - continuous or intermittent tx? |
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Definition
| degenerative ∆s & hypomob: intermittent tx |
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Term
| Summary of McKenzie Rx sequence |
|
Definition
correct lat shift
restore normal lordosis/lumbar ext
centralize symptoms c AROM
flex ex to optimize scar formation
HEP |
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Term
| Premise of McKenzie program |
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Definition
| IV disc is source of most LBP |
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Term
| Goals of McKenzie program |
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Definition
centralization of symptoms by helping pts find directional preference
teach pt to manage LBP c posture/mvmt ex |
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Term
| McKenzie: adverse rxn to ext ex 2º to... |
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Definition
| failure to detect/correct lat shift |
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Term
| Lat shift correction in prone |
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Definition
| sideglide pelvis/hips to painful side first (contralat lat shift), check ext |
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Term
| Lat shift correction in standing: PT watch-fors |
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Definition
ø peripheralization
may need to perform in slight flex/ext |
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Term
| Sustained posture (>5 min) of lying prone in ext may >> |
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Definition
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Term
|
Definition
lying prone
lying prone in ext
ext in lying
ext in standing
ext in lying c belt fixation
ext mob |
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Term
| Ext in lying v. Ext in standing - ROM gained |
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Definition
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Term
| If McKenzie ext ex are not successful... |
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Definition
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Term
| If McKenzie ext ex & unilat mob are not successful... |
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Definition
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|
Term
| McKenzie: goal of flex ex |
|
Definition
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Term
| McKenzie: criteria for progression to flex ex |
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Definition
centralization of symptoms
pt in fibroblastic healing phase (injury >8d, decr pain, decr mm spasm)
Repeated flex (5-6x) s peripheralization |
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Term
| McKenzie: initial buttock pain that resolves c repeated flex = |
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Definition
| adaptive shortening of annulus |
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Term
| McKenzie: buttock/leg symptoms c repeated flex in standing, but not lying = |
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Definition
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Term
| McKenzie: Flex Ex progression |
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Definition
flex in lying
flex in standing
flex in step standing |
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Term
| McKenzie: Rx of dural adhesions |
|
Definition
treat jt signs first
don't stress spine during dural mob |
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Term
| McKenzie: Rx progression of dural mobility |
|
Definition
90/90 stretch, ankle PF stretch
90/90 AND ankle PF stretch
... + cervical flex
slump stretching |
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Term
|
Definition
avoid sitting
use lumbar roll (sitting & lying)
avoid cough/sneeze in flexion
Ø flex in AM
ext ex p flex ex |
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Term
| McKenzie approach: limitations |
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Definition
disc = main pain source (BUT 80% of LBP is undx)
inert structures = target of ex (BUT neuromuscular system is also part)
works best c younger pt (may exacerbate older pts/facet degeneration) |
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Term
| Lumbar stabilization: basic components of trunk rehab program (6) |
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Definition
1. inner unit retraining
2. proprioceptive/perturbative training
3. outer unit strengthening
4. flexibility
5. cardiovascular training
6. functional training |
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Term
|
Definition
TrA
multifidus
diaphragm
pelvic floor
quadratus L |
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Term
| Mm of inner unit: tonic or phasic? |
|
Definition
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Term
| Emphasis of retraining inner unit for lumbar stabilization |
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Definition
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Term
| TrA eval in prone c pressure biofeedback: feedback pad pressure & change in pressure c correct test perf |
|
Definition
70 mmHg;
drop in 6-10 mmHg if performed correctly |
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Term
| Inner unit training: mm contraction duration & reps |
|
Definition
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Term
| Proprioceptive/perturbative training introduced when... |
|
Definition
pt maintains co-contraction of inner unit,
and pain is minimal |
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