Evidence- Based Examination of the Lumbar Spine Presented by Chad Cook, PT, PhD, MBA, FAAOMPT Practice Sessions/Skill Check- offs

Transcription

1 Evidence- Based Examination of the Lumbar Spine Presented by Chad Cook, PT, PhD, MBA, FAAOMPT Practice Sessions/Skill Check- offs Chapter Five: Movement Examination of the Lumbar Spine Time) (45 minutes CEU Skilled Process Review in Chapter Address the Shift Slide 7 5:01 Photo Description Check Off Attempt to correct the shift by pulling the pelvis (using a shear force) toward the displaced thoracic region. Block with your shoulder and consider moving the trunk into flexion and extension. Flexion Slide 8 8:14 12:09 The patient bends forward while in a standing position and attempts to touch their fingers to the floor. Repeat the motion several times to determine how it influences their symptoms. 1

2 Flexion with Slide 8 8:14 12:58 While the patient maintains the flexed position the clinician provides an to the lower thoracic region and the sacrum. The movement is analogous to stringing a bow. Extension Slide 9 9:10 13:07 The patient bends backward while in a standing position while stabilizing their hands on their hips. Repeat the motion several times to determine how it influences their symptoms. 2

3 Extension with Slide 9 9:10 13:36 While the patient maintains the extended position the clinician provides an into further extension. Perform repeated movements Slide 11 10:09 Perform repeated movements in extension, supine, and in standing sidelying, consider loaded and unloaded techniques Side Flexion (R and L) 10:42 13:50 While in standing the subject side bends toward the left and the right side. Repeat the motion several times to determine how it influences their symptoms. 3

4 Side Flexion (R and L) with 10:42 14:18 The clinician applies an by pulling the patient further into side flexion and blocking the side toward the movement. Rotation (R and L) 11:20 14:38 The patient is suggested to sit up tall and rotate. They are then instructed to rotate to one side then the other. Rotation (R and L) with 11:20 14:56 The clinician applies an by pulling the patient further into rotation. Blocking the knee and maintaining tall sitting posture will keep the rotation focused to the lumbar region. 4

5 Flexion Slide 16 16:23 17:54 into passive physiological flexion with a focus toward flexion. Compare different levels to determine mobility symmetry. Extension Side Flexion Slide 17 16:58 17:54 Slide 17 16:58 19:10 into passive physiological extension with a focus toward extension. Compare different levels to determine mobility symmetry. into passive physiological side flexion with a focus toward side flexion. Compare different levels to determine mobility symmetry. Rotation Central Posterior Anterior Accessory Slide 18 17:22 19:23 Slide 21 21:43 23:57 into passive physiological rotation with a focus toward rotation. Compare different levels to determine mobility symmetry. The clinician should perform at posterior to anterior movement at the spinous processes of the 5 lumbar segments. 5

6 Unilateral Posterior Anterior Accessory to the Facet Transverse glide to the lumbar spine Notes: Slide 22 22:21 25:09 Slide 23 22:56 26:10 The clinician should perform a posterior to anterior movement at the facets of the left and right aspect of the five lumbar segments. The clinician should perform a transverse glide to the side of the spinous processes if the other methods were not robust at generating the concordant sign. Photos derived from Cook C. Orthopedic Manual Therapy: An Evidence Based Approach. 2 nd edition. Upper Saddle River NJ. Prentice Hall;