History

CPR for vertebral fracture

Long term corticosteroid use, age>70, female, severe trauma

List out the spondys

Spondylosis: degenerative oa

Spondylolysis: pars fx

Spondylolisthesis: fracture and slippage

What are modic changes?

Changes (bad) to vertebral end plates

Joint changes in the spine are nearly a -, hard to pick - - sources

Given, specific nociceptive

Always do the 2! list ‘em

Full name, DOB

AIDET+?

Acknowledge pt, Introduce, Duration, Expectations

Irritability level and characteristics and how they guide interventions

• High irritability, acute (<6w), Pain 7+ (and at rest)

• Moderate irritability, pain 4-6 (intermittent rest)

• Low irritability, pain less than 3

• Minimize physical stress, activity modification, monitor impairments

• Mild to moderate physical stress, address impairments, basic functional activities

• Moderate to high physical stress, address impairments, high-level functional activities

First line tx for..

• Acute LBP

• Chronic LBP

• Education, advice to remain active

• Education, advice to remain active, exercise therapy, CBT

Pain where in ROM?

• LBP mobility

• LBP coordination

• Restricted range, pain with end

• Pain in initial to mid range

Patterns for radicular vs referred

Radicular follows dermatomal pattern, referred no

Radicular pain can still have - -

Positive SLR

CLASSIFICATIONS

Centralization present or C+P → -

No centralization, Yes to recent onset of symptoms (16d) and no sx distal to knee → -

3 of: SLR >91, + prone instability, + aberrant movements, age <40 → -

Specific exercise

Manipulation

Stabilzation

Manipulation CPR (+LR of 24.. 45→85%)

• recent sx (<16 d)

• segmental hypomobility

• Sx not distal to knee

• FABQW<19

• One hip IR>35 degrees

Pain and disability driver management model.. what is it?

Drivers of pain and disability, inner ring is more modifiable

STarT tool lets us know how “risky” someone’s recovery/prognosis from LBP is. What is the important number and what do you do at each risk level?

• 3 is the critical #

Low- education

Medium- conservative tx

High- psychological tx (+team)

FABQ is for what? What sections exist?

Fear/avoidance

• Full (0-96, 13 MCID), PA, (0-24, >14 elevated fear, MCID 4), Work (0-42, >34 no work 4wks, MCID 7)

NPRS MCID?

2

VAS out of - mm. MCID is _-_

100, 13-20 (1.3-2 pts)

PSFS MCID?

2-3

ODI has - sections scored out of -. MCID is _-_%

10, 5, 10-13%

ODI ranges

• Minimal disability

• Moderate disability

• Severe disability

• Crippling back pain

• Bed-bound/exaggerated

• 0-20%

• 21-40

• 41-60

• 61-80

• 81-100

What is RMDQ? Scored out of what? MCID?

Roland Morris disability questionnaire (for back), 0-24, MCID 4-5