Clinical Orthopaedic Rehabilitation Spinal Disorders

Transcription

1 COURSE DESCRIPTION Clinical Orthpaedic Rehabilitatin Spinal Disrders This prgram is a practical, clinical guide that prvides guidance n the evaluatin, differential diagnsis, treatment and rehabilitatin f patients with rthpaedic prblems. The fcus f this vlume is n Spinal Disrders. In an easy t use frmat, it cvers all rthpaedic cnditins and prcedures frm initial examinatin thrugh the pstperative r pst-injury perid, including arthrplasty, fractures, and sprts injuries. Each chapter is written jintly by an rthpaedic surgen and a physical therapist. LEARNING OBJECTIVES Spinal Disrders Mdule 1 Whiplash Injury: Treatment and Rehabilitatin Define the term whiplash assciated disrder,(wad), and why it is cmmnly regarded as a challenging cnditin t treat Explain why patients with WAD can be cnfused as malingerers Discuss the current clinical best practice mdel fr evaluating an individual fr a neck injury when WAD is suspected Discuss the current clinical best practice mdel fr rehabilitatin frm a whiplash injury based n current literature, alng with cntrversies Keep in mind that current research must be examined Analyze the treatment recmmendatins as detailed by the Quebec Task Frce Build a rehabilitatin prgram fr WAD Include specific gals fr each stage f rehabilitatin Include a prgressive exercise plan Discuss manual therapy techniques based n current best-available evidence Summarize the cmmn clinical signs f chrnic whiplash Summarize the key pints in the treatment f chrnic spinal pain Therapeutic Exercise fr the Cervical Spine Describe hw neck pain can affect cervical muscle strength, including specific muscles that are prne t impairment Build a functinal prgressive strengthening prgram fr the cervical muscles Include exercises, and prgressins, fr the fllwing: Muscular crdinatin Muscular endurance Muscular strength Repsitining acuity Oculmtr cntrl Pstural stability Mbility Prvide a list f exercises with a high level f trapezius electrmygraphic activity Page 1 f 5 Accelerated Online Learning Clinical Orthpaedic Rehabilitatin

2 Spinal Disrders Mdule 2 Treatment-Based Classificatin f Lw Back Pain Prvide examples f lw back pain etilgies Describe the treatment-based classificatins f lw back pain, including imprtant clinical findings matched interventins fr each Demnstrate specific manual therapy techniques that be used t treat lw back pain Cre Stabilizatin Training Explain hw a strng cre cntributes t stability during dynamic functinal mvements in ccupatinal tasks and sprt activities Prvide specific examples in sprting activities with respect t demands and the utcmes f a prperly functining cre unit Understand the anatmy f the cre unit, including bth lcal and glbal musculature, and the functin f each structure with relatin t mvement and stability Describe the varius mechanisms f injury that can lead t cre dysfunctin and instability Cnduct a thrugh examinatin f the cre including the applicatin f mdalities and special tests t determine specific dysfunctins Discuss the imprtance f a sustained, cntrlled cntractin f the transverse abdminis in reducing the incidence f lw back pain Describe the tw gals f an advanced therapeutic exercise prgram fr the cre Lead an individual thrugh a sessin n hw t perfrm an abdminal hllwing exercise, a plank, and multifidi activatin exercises, cmplete with instructins n hw t perfrm each mvement Discuss hw t use the hllwing exercise t guide treatment and rehabilitatin f cre dysfunctin Build a functinal, prgressive rehabilitatin cre activatin and stabilizatin prgram Develp beginner, intermediate and advanced prgrams Include perturbatin exercises in later stages Include functinal exercises that incrprate abdminal hllwing Build t functinal mvements and exercises Spinal Disrders Mdule 3 McKenzie Apprach t Lw Back Pain Identify the fur types f pain, and describe each with respect t activatin Discuss the gals f the McKenzie apprach with respect t the stage f healing Analyze the anatmy f the intervertebral disc and hw specific mechanical frces can cause migratin f the nucleus pulpsus Discuss the varius McKenzie syndrmes f lw back pain including the fllwing: Definitin Etilgy Factrs cntributing t pain and the specific type f pain reprted by the individual Characteristics and descriptrs Cnduct a thrugh histry and physical examinatin using the McKenzie apprach Discuss hw patient respnses t mvements will help guide the clinical evaluatin and the structure f the rehabilitatin prgram Review the strengthening and stretching techniques that can be incrprated int a functinal rehabilitatin plan fr each f the syndrmes classified by McKenzie Page 2 f 5 Accelerated Online Learning Clinical Orthpaedic Rehabilitatin

3 Rehabilitatin Fllwing Lumbar Disc Surgery State the prevalence f lw back pain in the general ppulatin State the prevalence f spinal surgery in the United States with respect t the rest f the wrld ppulatin, and the success rate fr lumbar disc surgery with respect t patient-reprted utcme Summarize the current best evidence fr pstdiscectmy rehabilitatin as reprted by the 2008 Cchrane Review Discuss the imprtance f designing a pstdiscectmy rehabilitatin prgram based n each individual patient Prvide a list f cmmn utcme measures Describe the benefits f cnducting a thrugh physical examinatin Evaluate the imprtance f the fllwing when designing a pstdiscectmy rehabilitatin prgram Patient educatin, including the fur categries f discussin Exercise Describe hw lw back pain affects the functin f the cre musculature Describe the gals f an exercise prgram Build a functinal, prgressive rehabilitative exercise prgram that culd ptentially be used fr a pstdiscectmy patient Walking prgram Manual therapy Neural tissue mbilizatin Mdalities Spinal Disrders Mdule 4 Chrnic Back Pain and Pain Science Identify the cmpnents f the bi-psych-scial apprach t managing back pain Discuss the imprtance f each cmpnent Describe each f the three key issues in understanding pain with respect t the fllwing: Anatmy Physilgical prcesses Discuss hw clinical assessment and rehabilitatin techniques are guided by bth anatmical structures and physilgical prcesses invlved with pain Summarize the clinical best evidence fr the management f chrnic back pain Spinal Manipulatin Define spinal manipulatin Differentiate between manipulatin and mbilizatin f the spine Discuss the six characteristics f spinal manipulative techniques State the cmmn cnsensus pints regarding lw back pain Critique the rle f thracic manipulatin n utcme measures fr individuals with neck pain Critique the rle f spinal manipulatin n utcme measures fr individuals with lw back pain Describe the mdes f actin a high velcity, lw amplitude thrust (HVLAT) has n the zygapphyseal jint Discuss hw an audible pp during spinal manipulatin affects treatment utcme State the purpse f spinal lcking Describe the cupling behavirs f the cervical spine Describe the cupling behavirs f the thracic and lumbar spine Page 3 f 5 Accelerated Online Learning Clinical Orthpaedic Rehabilitatin

4 State the cupled mtins f specific spinal segments and hw t achieve facet appsitin lcking at each segment Analyze the research n safety f spinal manipulatin at the cervical and lumbar levels Review the cntraindicatins fr spinal manipulatin Review key pints t remember when selecting a patient fr spinal manipulatin, alng with prper technique Identify the cntraindicatins fr spinal manipulatin, and pssible causes fr each Understand the general techniques fr spinal manipulatin Understand the technique fr targeting a specific spinal segment fr manipulatin Spinal Disrders Mdule 5 Neurdynamics Define the fllwing terms: Neurdynamics Adverse neural tensin Neurdynamic test Neurgenic pain Sensitizing mvements Differentiating mvements Sliders Tensiners Define dysesthetic pain and hw it typically manifests Describe the physilgy f in channels and mechanisms under which the cncentratin and functin f each can be mdified Define central sensitivity Describe the key cncepts f neurbimechanics with respect t relevant anatmical and physilgical factrs Explain hw mvement affects functin f the nervus system Describe the base tests as prpsed by Butler, and the key pints t remember when perfrming the tests Identify and define the primary mechanism fr nerve pain with mvement Prvide a list f relevant clinical questins when assessing neurdynamics within a patient Identify the fcus f neurdynamic treatments Demnstrate the base tests in neurdynamics including hw t guide a patient frm the starting psitin thrugh the test Specific Lumbpelvic Stabilizatin Define lumbpelvic instability Identify and discuss the three interdependent levels f lumbpelvic stability List the three interdependent subsystems f spinal stability and describe hw deficits in ne subsystem can affect the ther tw Define the passive, active, and neural subsystems f spinal stability with respect t relevant anatmy, and hw they cntribute t stability Dichtmize the trunk muscles int lcal and glbal muscle stability systems Define bth feedfrward and feedback cntrl f lumbpelvic stability and discuss hw each are achieved Prvide a list f clues upn clinical examinatin that indicate spinal instability in an individual List the parameters fr spinal stability Page 4 f 5 Accelerated Online Learning Clinical Orthpaedic Rehabilitatin

5 Describe the tw appraches fr imprving spinal prtectin Discuss the rle f bth the lumbar multifidus and the transverse abdminis in intersegmental stability Describe hw transverse abdminis dysfunctin cntributes t spinal instability Cnstruct a functinal, prgressive exercise rehabilitatin prgram t prmte spinal segmental stability Spinal Disrders Mdule 6 Spndyllisthesis Define the five types f spndyllisthesis Prvide the diagnstic criteria fr spndyllisthesis including the fllwing: Reprted symptms Palpatin Radigraphic evidence Cnstruct a treatment prtcl fr an individual with spndyllisthesis, and prvide the primary reasn fr each cmpnent f the prtcl Build a functinal, prgressive exercise rehabilitatin prgram fr an individual with spndyllisthesis List the surgical indicatins fr a child/adlescent with spndyllisthesis List the surgical indicatins fr an adult with spndyllisthesis Prvide the mst cmmn indicatin fr surgical interventin Describe the surgical interventins fr spndyllisthesis based n degree f spinal segment slippage, and the utcmes fr each Lumbar Spine Micrdiscectmy Surgical Rehabilitatin Analyze the clinical research examining rehabilitative techniques fllwing micrdiscectmy Identify the main fcus f rehabilitative prgrams fllwing lumbar micrdiscectmy Page 5 f 5 Accelerated Online Learning Clinical Orthpaedic Rehabilitatin