LBP clusters

Question 1

LBP with Mobility def.

During the Movemen and Provocation Exam, what is done before doing the Laslett Provocation Cluster to rule in/out SI issues?

Answer 1

Lumbar Screen:
- AROM => AROM with overpressure
- Combined motions (quadrant)
- Repeaded motions/sustained positions
- PAIM test
- Neurodynamic Testing

This lumbar screen has test that attempt to alleviate or provoke Sx from the thoracolumbar and lumbosacral segments from T10 to L5-S1. Once the lumbar spine is clear, greater confidence in the laslett cluster is achieved. When Sx do not centralize, moving from a small shift to moderate shift that the source of pain is in the sacroiliac joint

Question 2

LBP with mob.

Whats the Clinical Prediction Rule to do a Lumbosacral Manipulation?

Answer 2

• Sx duration < 16 days
• No Sx distal to knee
• FABQw < 19
• Hip IR >35°
• Hypomobility with PA accessory testing

need 4/5

Question 3

With LBP with Movement Coordination Impairments, what is the Diagnostic Test-Item Cluster?

Answer 3

• =/> 53° of lumbar AROM
  –Measured with Dual Inclinometer
• Lack of hypomobility with central PA accessory motion testing

Question 4

What is the Clinical Prediction Rule for Lumbar Stabilization Exercise Program?

Answer 4

• (+) Prone Instability Test
• Aberrant motions present
• Age < 41 (Most Significant)
• SLR > 91°

Question 5

What is the Clinical Prediction Rule of Failure for Lumbar Stabilization Exercise Program?

Answer 5

• (-) Prone Instability Test
• Hypomobility with PAIVM testing
• Aberrant motions absent
• FABQpa score </=9

Question 6

What was the Diagnostic Cluster developed to determine which patients have Lumbar Spinal Stenosis?

Answer 6

Cooks Cluster (Lumbar Spinal Stenosis)
- Bilateral Sx
- Leg pain > Back pain
- Pain during standing and walking
- Pain relief upon sitting
- Age >48 years old

Question 7

What is the Cluster for Lumbar Traction or Positional Distraction, in the Prone position?

Answer 7

• Radicular LE pain
• Signs of nerve compression (DTR, Myotomes, Dermatomes)
• Peripheralization of Sx with extension
• (+) Crossed SLR (45°)