Low Back Disorders Quizzes

True or False: A Registered Kinesiologist in Ontario has the authority to independently communicate a diagnosis identifying a disease or disorder as the cause of symptoms

False

True or False: Registered Kinesiologists (RKINs) have a broad scope of practice.

True

True or False: A Registered Kinesiologist in Ontario has authority to independently communicate a diagnosis identifying a disease or disorder as the cause of symptoms.

False

Applying a biomedically-oriented perspective on the causes and consequences of low back pain would focus on which of the following:

a. tissue damage

b. nociception

c. posture

d. biomechanical loading

e. all of the above

e. all of the above

True or False: Regression-to-the-mean suggests that risk factors for LBP cannot be established.

False

Which of the following factors contribute to LBP and disability?

a. comorbidities

b. genetic

c. social

d. psychological

e. biophysical

f. all of the above

f. all of the above

Which of the following is not a risk factor for LBP reporting?

a. drinking more than 1 unit/day of alcohol

b. history of LBP

c. heavy or frequent lifting at work

d. living with depression

a. drinking more than 1 unit/day of alcohol

Which of the following would be considered a psychological influence on LBP?

a. interpersonal relationships

b. religious beliefs

c. identity

d. thoughts

e. body mechanics

c. identity & d. thoughts

True or False: Eliminating a LBP risk factor will eliminate LBP.

False

Approximately what proportion of LBP cases are labelled as "non-specific" in clinical practice?

a. 15%

b. 60-90%

c. 50%

d. 85%

d. 85%

True or False: Low back pain is a common sign of tissue injury.

False

Expressed as a proportion of a population, the number of new cases of low back pain in a specified period is called:

a. point prevalence

b. lifetime prevalence

c. incidence

d. period prevalence

c. incidence

True or False: LBP is defined by the location (vs. source) of pain.

True

True or False: Statistics suggest that about 80% of adults in the world are currently experiencing low back pain. 

False

True or False: Odds Ratios cannot be calculated based on data collected in case-control studies.

False

True or False: Lumbar vertebrae are generally avascular. 

False

True or False: Myotomes are an area of skin supplied by a single spinal nerve. 

False

True or False: Intervertebral discs have a rich direct blood supply. 

False

Free nerve endings have been found in several spinal tissues, along with evidence for noxious stimulation of:

a. intervetebral discs (inner-third innervated)

b. ligaments

c. facet joints

d. muscles

b. ligaments, c. facet joints, d. muscles

True or False: The lumbosacral plexus is comprised of a network of mixed nerves. 

True

Which of the following is not considered as a "functional" subdivision of a lumbar vertebrae?

a. facet joints

b. posterior elements

c. pedicles

d. vetebral body

a. facet joints

Which of the following will be least likely to deform when an isolated lumbar interbody joint (i.e. posterior elements removed) is loaded in compression?

a. nucleus pulposus

b. posterior elements

c. posterior annulus fibrosus

d. vertebral body

a. nucleus pulposus

True or False: Ligamentum flavum is comprised of a very high proportion of collagen (vs. elastin).

False

The trabeculae in the cancellous bone of the vertebrae are arranged so that they:

a. are organized in a lattice-like arrangement

b. have a relatively stronger/larger vertical/axial members

c. have relatively weaker/small horizontal/transverse members

d. all of the above

d. all of the above

The orientation of the interspinous ligament (ISL) was misrepresented in early anatomical literature, which led to misinterpretations of its mechanical function. Current knowledge is that, in the anatomical position (i.e. lumbar curve approximately "neutral"), ISL prevents:

a. lateral translation of the superior vertebra on the inferior vertebra 

b. posterior translation of the superior vertebra on the inferior vertebra 

c. anterior translation of the superior vertebra on the inferior vertebra

b. posterior translation of the superior vertebra on the inferior vertebra 

The innermost muscle of the abdominal wall is:

a. transversus abdominis

b. external obliques

c. rectus abdominis

d. internal obliques

a. transversus abdominis

True or False: There is scientific consensus on the role(s) of the latissimus dorsi muscle on lumbar spinal mechanics.

False

The oblique abdominal muscles have lines-of-action that do not directly contribute to creating a flexor moment about the lumbar spine. Rather, they indirectly contribute because their forces are redirected through the:

a. lumbodorsal fascia

b. linea alba

c. cauda equina

d. latissimus dorsi

b. linea alba

True or False: When the lumbar spine curvature is lordotic, fibres of the interspinous ligament and lumbar erector spinae are oriented in opposite directions (relative to the compressive axis of the intervertebral joints).

True

Which of the following muscles have the greatest potential to extend the lumbar spine?

a. rotatores

b. multifidus

c. interspinales

d. intertransversarii

b. multifidus

Which of the following lumbar motions occur about a body-fixed anteroposterior axis?

a. axial twist

b. flexion

c. lateral bend

d. extension

c. lateral bend

True or False: Low back (intervertebral) compression forces are inherently harmful/dangerous. 

False

Which of the following would be represented as a relative (joint) angle.

a. pelvic tilt

b. trunk orientation

c. spinal alignment

c. spinal alignment

True or False: Lumbar motion reflects a change in lumbar position.

True

True or False: In comparison to carrying a load with one hand, carrying a load with two hands generally requires greater trunk muscle coactivation and imposes lumbar spinal load penalties.

False

True or False: The alignment of the lumbar spine does not change when a person adopts a relaxed standing posture for a period of 5 minutes.

False

True or False: The lumbar spine contributes to seated postural control when no backrest is present.

True

True or False: In multi-joint movements like manual lifting, averaging the low-back loads across performers can result in a "mythical average" response that may not be reflective of any single performer.

True

True or False: Two people of similar anthropometrics may execute a movement in very different ways, and thus impose more/less low-back loading as a consequence.

True

A person who is standing with a hyper-lordotic posture is instructed to posteriorly rotate the pelvis whilst maintaining overall head, arms, and trunk position. Which of the following functional muscle groups would need to actively shorten to "flatten" the lumbar spine:

a. hip extensors

b. lumbar extensors

c. hip flexors

d. lumbar flexors

a. hip extensors & d. lumbar flexors

True or False: Lower intervertebral (L3/L4, L4/L5) and lumbosacral (L5/S1) joints rotate more when assuming an upright seated posture than when assuming a slouched seated posture.

False

Lumbar joint rotational stiffness decreases with prolonged postural loading, which requires more muscle stiffness to maintain posture. This may result in:

a. greater low back loading

b. greater potential for motor control errors

c. more tissue creep (deformation)

d. all of the above

d. all of the above

Bones are strongest when loaded in:

a. shear

b. compression

c. tension

b. compression

Viscoelastic creep in a ligament is observed as a change in its [????] with application of a tensile load of constant magnitude.

a. length

b. force

c. stress

a. length

In human movement, when muscle-tendon complexes exhibit concentric action, they are effectively functioning (mechanically) as: 

a. motors

b. springs

c brakes

d. struts

a. motors

True or False: Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. 

True

True or False: Verified damage or disruption of intervertebral discs is more frequently observed in people who experience symptoms than those who do not. 

True

Which of the following fractures are commonly seen in osteoporotic vertebrae?

a. crush

b. wedge (anterior)

c. biconcave

d. all of the above

d. all of the above

Which of the following would be associated with non-specific low back pain?

a. vertebral fracture

b. malignancy

c. axial spondyloarthritis

d. none of the above

d. none of the above

A vertical herniation is most associated with:

a. intrusion

b. protrusion

c. sequestration

d. extrusion

e. bulging

a. intrusion

Compressive strength of the lumbar spine is influenced by which of the following?

a. age

b. sex

c. loading history

d. all of the above

d. all of the above

True or False: The fundamental notion underlying mechanical injury theory is that an injury occurs when the applied load exceeds tissue load tolerance. 

True

True or False: Dynamic, axial loading of the spine at slow-to-moderate movement speeds is more likely to result in positive intervertebral disc adaptations than is loading associated with high-speed movements. 

True

True or False: People who have a LBP history almost always have weaker trunk muscles than people without a LBP history.

False

A person who experiences episodes of LBP associates them with forward bending movements. Over time, the person develops a fear of bending forward, and avoids doing so in daily life. This is an example of:

a. maladaptation

b. kinesiopathology

c. pathokinesiology

d. adaptation

a. maladaptation

From a spine system controllability perspective, which of the following muscle capacities is proposed as being most important:

a. strength

b. endurance

c. power

c. power

At a group-level of analysis and in comparison to people without LBP, those who have LBP tend to:

a. exhibit sensorimotor deficits

b. use less lumbar spine motion when bending/twisting

c. coordinate trunk muscles differently

d. move more slowly

e. all of the above

e. all of the above

True or False: Movement impairments can be cause or consequence of low back disorders. 

True

From a "systems perspective", which of the following can lead to uncontrolled spine motions:

a. proprioception deficits

b. muscle-tendon unit creep

c. corrupted reflexes

d. intervertebral disc degeneration

e. muscle fatigue

f. all of the above

f. all of the above

True or False: It is common for a person with no current/history of LBP to exhibit altered flexion-relation phenomenon (e.g. no evidence of myo-electric silence).

False

Which of the following are emphasized in the movement-focused exercise approach to physical capacity development:

a. movement processes

b. coaching control of key movement features

c. coaching specific exercise technique (“form“)

d. movement outcomes

a. movement processes & b. coaching control of key movement features

True or False: Individual-level responses to the movement-focused exercise approach discussed in lecture were well-represented by the group-level responses (based on aggregated data).

False

A "Back Facts" infographic (for public education) was discussed in lecture. Which of the following statements were proposed by its authors to reflect a fact about LBP:

a. Low back pain often indicates a serious, life-threatening condition that requires immediate intervention.

b. Poor posture is a primary cause of low back pain and directly influences its persistence.

c. Core muscle weakness is the main cause of low back pain, and strengthening these muscles alone prevents recurrence.

d. Graduated movement (including exercise) are generally considered safe and beneficial.

d. Graduated movement (including exercise) are generally considered safe and beneficial.

True or False: Odds Ratios (OR) cannot be calculated in case-control studies.

False

Which of the following statements best reflects an evidence-based approach to using education for preventing LBP:

a. Education focused on the structural causes of LBP is most effective in reducing future episodes of pain.

b. Emphasizing the importance of "perfect posture" at all times is essential in LBP education for prevention.

c. Educating individuals that pain does not always indicate harm may help reduce fear and improve self-management of LBP.

d. Educational programs should emphasize avoiding all physical activity to prevent aggravating LBP.

c. Educating individuals that pain does not always indicate harm may help reduce fear and improve self-management of LBP.

The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach assesses the quality of evidence across which of the following domains:

a. risk of bias

b. inconsistency

c. imprecision

d. indirectness

e. publication bias

f. all of the above

f. all of the above

Which of the following best describe secondary prevention:

a. focuses on early detection and intervention to limit recurrence or persistence of LBD

b. aims to prevent LBD before they occur

c. seeks to reduce the impact and burden of existing LBD

a. focuses on early detection and intervention to limit recurrence or persistence of LBD

A study evaluating a workplace intervention to prevent LBD reports a risk ratio (RR) of 0.75 with a 95% confidence interval of 0.60 to 0.93. Based on this information, which statement is most accurate?

a. The intervention likely has no effect on the risk of LBD because the confidence interval includes values above 0.50.

b. The intervention likely lowers the risk of LBD, and the result is statistically significant.

c. The intervention may increase the risk of LBD, but the result is statistically significant.

d. The intervention likely has no effect on the risk of LBD, as the confidence interval includes 1.0.

b. The intervention likely lowers the risk of LBD, and the result is statistically significant.

McGill recommends a 4-stage approach to developing low back capacity. Arrange the stages in the order recommended.

Groove the fundamentals

Improve power

Improve endurance

Improve strength

Groove the fundamentals, Improve endurance, Improve strength, Improve power

True or False: Interventions to improve ankle, hip, or shoulder mobility will automatically reduce the biomechanical demands imposed on the lumbar spine during unrehearsed whole-body movements.

False

Lower extremity joint mobility and flexibility may (hypothetically) increase potential for low-back injury during lifting by:

a. forcing the lumbar spine to bend/twist awkwardly

b. increasing lumbar spinal load tolerance

c. reducing loads applied on lumbar spine

a. forcing the lumbar spine to bend/twist awkwardly

True or False: Research suggests that in people with a LBP history, there are associations between hip mobility/flexibility status and the passive lumbar flexion  moments imposed during everyday tasks.

True

Movement patterns are effectively constrained by which of the following:

a. individual performer

b. performance environment

c. task performed

d. all of the above

d. all of the above

True or False: Application of the "key features" concept implies that there is a universally correct way to coordinate and control movements to prevent LBD.

False

Low-back power is a product of:

a. low back compression force

b. low back moment

c. lumbar spine angular velocity

d. trunk segment motion

b. low back moment & c. lumbar spine angular velocity

Which of the following best describes "yellow flags" in the management of LBP:

a. Signs indicating the immediate need for surgical intervention

b. Physical symptoms suggesting a high likelihood of serious underlying pathology

c. Indicators requiring urgent imaging to identify structural abnormalities

d. Psycholosocial factors that may contribute to the development of chronic pain and disability

d. Psycholosocial factors that may contribute to the development of chronic pain and disability

True or False: The STaRT Back screening tool focuses on diagnosis of yellow flags.

False

What do people with low back pain (LBP) commonly want or expect from healthcare providers?

a. assessment

b. explanation

c. pain management

d. improved function

e. all of the above

e. all of the above

During an initial meeting with a person with LBP, which of the following is an important area to explore:

a. their daily routines, attitudes about pain, and activities that worsen or relieve symptoms

b. only the person's pain location and intensity

c. medication preferences as the primary focus of the session

d. detailed movement assessments before discussing patient goals

a. their daily routines, attitudes about pain, and activities that worsen or relieve symptoms

True or False: Pain intensity rating scales are a useful tool in the management of LBP, but they should not be the sole focus of assessment or treatment planning.

True

Which of the following is true about the Roland-Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI):

a. neither measures functional limitations

b. both measure disability related to LBP

c. RMDQ is used only for severe disability

d. ODI is unrelated to LBP assessment

b. both measure disability related to LBP

True or False: Exercise is recommended as a first-line management strategy for acute LBP.

False

Which of the following is NOT a consistent recommendation across musculoskeletal (MSK) pain conditions:

a. Progress should be evaluated using outcome measures

b. Radiological imaging should be performed routinely for all people with MSK pain

c. Care should be person-centered, with shared decision-making and effective communication

d. Provide individuals with education about their condition and management options

b. Radiological imaging should be performed routinely for all people with MSK pain

Which of the following is a key principle of person-centred care:

a. Establishing a therapeutic alliance and promoting shared decision-making for self-management

b. Adopting a strictly biomedical approach to understand the person's experience

c. Avoiding discussions about anticipated challenges, such as barriers to adherence or recurrence

d. Prioritizing clinician-led decisions without considering the patient's values and needs

a. Establishing a therapeutic alliance and promoting shared decision-making for self-management

True or False: The presence of red flags in LBP management always indicates a serious underlying pathology and warrants immediate imaging or invasive interventions.

False

True or False: Despite many clinical practice guidelines with similar recommendations for the management of LBP, there is still a pervasive gap between evidence and practice.

True

Which of the following statements about exercise and LBP is most accurate:

a. Exercise does not support primary or secondary prevention of LBP

b. Exercise is harmful for individuals with LBP

c. Exercise is not recommended for acute LBP but is helpful for subacute and chronic LBP

d. Exercise for subacute and chronic LBP does not improve pain or function

c. Exercise is not recommended for acute LBP but is helpful for subacute and chronic LBP

Which of the following statements best describes the purpose and nature of clinical practice guidelines (CPG):

a. CPG are strict protocols that healthcare providers must follow to ensure uniformity in treatment

b. CPG provide standardized global recommendations that do not vary between organizations or nations

c. CPG are developed exclusively by researchers to ensure scientific rigour in healthcare decision-making

d. CPG are tools developed collaboratively to assist in applying best available evidence while considering individual values, professional judgment, and available resources

d. CPG are tools developed collaboratively to assist in applying best available evidence while considering individual values, professional judgment, and available resources

What is the primary purpose of developing a tailored test battery for individuals with LBP?

a. to identify specific anatomical pain sources

b. to identify the most effective medication for pain relief

c. to identify activities to avoid during work or leisure

d. to identify symptom-modifying postures, motions, and/or loads

d. to identify symptom-modifying postures, motions, and/or loads

True or False: Identifying symptom-provoking or -relieving postures, motions, and/or loads during a physical assessment facilitates LBP diagnosis.

False