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Clinical prediction rules (CPR) for predicting success with spinal hypermobility treatment Age < 41 (most important factor) Positive prone instability test SLR > 91 Aberrant(shaking) movement patterns
Hypermobility Clinical Features RE: Pain pain increased with extension, worse at the end of the day, hypertonicity of lumbar PVM, poor strength & coordination
Clinical prediction rules (CPR) for predicting failure with spinal hypermobility treatment Lack of hypomobility with PIVM, negative prone instability test, lack of aberrant movements, FABQ <9
Demographics of Spondylolithesis Males > Females (although female slippage is 4 x as likely to continue to progress)
Signs of Spondylolsis Muscle banding w/ standing, "Step" prescence in standing (both disappear in prone position), bilateral sciatica, increased lordosis, hamstring tightness
Grades of Spondylolithesis 1-25% slip (anterior) 2-50% slip 3-75% slip 4- 100% slip
Symptoms of spondylolsis Unable to sit extended period of time, relief w/flexion & rest, radiation into leg, episodic or recurrent LBP
7 clinical signs of instability 1- Inability to sit for a prolonged period 2- increased muscle tone with standing 3- "step" (spondylolithesis) on standing 4- decreased muscle tone in prone 5- shaking while bending forward 6- Grade 5-6 on PIVM (unstable) 7- Radiological findings
CPR for acute LBP manipulation <16 days sxs, >35 degrees hip IR, PAIVM reveals hypomobility, FABQ <19, No sxs distal to the knee
Lumbar Spine Coupled movement with flexion Sidebending & Rotation to SAME side
Lumbar spine Coupled movement with extension Sidebending & rotation OPPOSITE side
Non-coupled movement of Lumbar spine with flexion Sidebend to right with active rotation to the left (OPPOSITE)
Non-coupled movement of Lumbar spine with extension Sidebend to right with active rotation to right (SAME)
3 models for treating back pain Pathanatomical, Biopsychosocial, and Segmental Dysfunction
2 categories of Segmental dysfunction model 1- Altered segment stiffness 2- Altered Motor control
CPR for cervical HVT 1-NDI < 23%, 2-Bilateral involvement, 3- Don't perform sedentary work > 5 hrs/day, 4- Feel better w/neck movement, 5- Don't feel worse with cervical extension, 6- Dx of spondylosis without radiculopathy
5 contraindications for upper cervical manipulation downs syndrome, MVA, RA, Long term steroid use, hypermobility
6 special test for cervical radiculopathy Vertebral artery, spurling's test, neck distraction, ULNT1 (median), Cervical ROM, Bakody's sign (shoulder abduction test)C4-C5
CranioCervical vertebral ligaments of the spine: Cruciate ligament , alar ligament, posterior longitudinal ligament, ligamentum flava, ligamentum nuchae, anterior longitudinal ligament limit extension of vertebral column
Purpose of the alar ligament limit rotation
What type of joint is the Atlantoaxial (AA) joint? Uniaxial synovial (diarthodial)
What level of the Lumbar spine is at the same height as the Iliac Crest? L4-L5 interspace
What sacral level is the PSIS of the pelvis used to locate? S2 level
How do you locate the SI Joint? Inferior and medial to the PSIS
What area can be located once the SI Joints are located bilaterally? Coccyx
Location of the Ala on the Sacrum? Lateral superior portion ("wings")
Created by: sgerding01