Flashcards in Review of year 1 material Deck (79)
Manipulation is a _______ velocity technique.
Mobilization is a _______ velocity technique
Distraction is a form of ?
- hands close to the joint line
- patient comfortable?
- therapist comfortable? (table height, joints in neutral)
- position joint (open packed, end range)
- keep arms in line with the direction of force
- stabilize (proximal bone usually)
- continually assess patient's tolerance/response
- if the patient isn't relaxing, ask yourself what you can do to make them relax more
- passive supine SLR
- crossed supine SLR
- slump (seated SLR)
- femoral nerve tension test
- spring test
- prone instability test
SIJ tests (4)
- SI distraction
- SI compression
- thigh thrust (posterior shear test)
- sacral thrust (spring test)
Screening: tests of function (4)
- chair stand
- single leg stance
- back bending
Screening: active motion testing (5)
- lateral flexion
- repeated movements
Things to watch for when testing active motion
- limitations of movement
- curve reversal
- compensatory movement
Contraction of what muscle facilitates pelvic floor contraction?
What two muscles might atrophy post lumbar surgery?
When would you perform dynamic lumbar stabilization with a patient?
- hypermobile people who are symptomatic
- people with a fracture to promote stabilization
What is lumbar spinal stenosis?
Narrowing of the skeletal canal
Symptoms of lumbar spinal stenosis
- loss of sensation
- reflex changes
- balance deficit from decreased nerve function
- pain with extension like reaching overhead
*- relief with flexion, sitting, recumbence*
Clinical picture of spinal stenosis patient
- 30's 40's: long history of low back pain
- 50's: generally asymptomatic
- 60's: slow onset, feels like leg pain but is actually compression. can't walk or stand long due to upright posture. numbness, paresthesia, weakness. LE symptoms predominate back pain, if any.
Symptoms of neurogenic claudication
- absent peripheral pulse (nerve compression affects blood circulation)
- ischemic signs in calves (pain, paresthesia, cramping)
- cauda equina symptoms (incontinence, saddle paresthesia, gait imbalance due to inability to coordinate muscle activity)
Interventions for stenosis
- flexion: knees to chest, drape over a swiss ball
- Neurontin: decreases nerve excitability
- laminectomy: cutting away bone and cleaning out
defect or fracture of vertebrae (typically pars, located between facets)
vertebrae shifted out of normal position
Grades: fraction of body slipped
I: up to 1/4
II: 1/4 to 1/2
III: 1/2 to 3/4
IV: 3/4 to full
Symptoms of spondylolisthesis
pain with palpation
flexion (midrange) feels good
Symptoms of clinical lumbar instability
- "catch in the back"
- Gower's sign
- reversal of LP rhythm
- pain moving into flexion
- pain returning from flexion
- clunking feeling or giving way
Treatment for clinical lumbar instability
core exercise in neutral spine
- lumbar fusion
Lateral shift is named for...
the direction the shoulders move
The upper body shifts _______ from pain in lateral shift.
away from the pain
Correction of lateral shift _______ intensity and causes _________.
centralization of symptoms
After correction of lateral shift, one should avoid...
Classifications of instability (5)
specific exercise (flexion or extension biased)