Lumbar Assessment: Difference between revisions
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=== Palpation === | === Palpation === | ||
It is crucial for a reliable diagnosis and intervention of treatment to adequately palpate the lumbar processi. <br>Within the scientific world there has been a debate about the palpation of the processi spinosi because scientists assumed that often different persons indicated the processi on a different place (Mckenzie et al). However, Snider et al (2011) has shown that the indicated points of the different therapists lie that the distance between the indicated points of the different therapists is much smaller than it had always been claimed. Obviously there were differences because some therapists have more experience and others have more anatomical knowledge. Also the difference in personality between the therapists led to differences in locating the processi. <br>Furthermore, this investigation has proven that it is more useful to indicate different points instead of just 1 point. Also it’s proven that a manual examination to detecte the lumbar segmental level is highly accurate when accompanied by a verbal subject response<br>There are of course elements that hinder the palpation. For example, a BMI (body mass index) of 30kg/m2 considerably diminishes the accuracy (Ferre et al). Anatomical abnormalities might also cause problems. The abnormality of the 12th rib leads, for example, to a negative palpal accuracy in the region L1-L4 for all therapists (Snider et al). <br><br> | |||
=== Neurologic Assessment <br> === | === Neurologic Assessment <br> === |
Revision as of 23:14, 23 May 2011
Original Editors - Ben Vandoorne
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Subjective[edit | edit source]
Patient Intake[edit | edit source]
- Self‐report
- Performance‐based outcome measures
- Region‐specific historical examination
Special Questions
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- Red Flags:
During the investigationyou must pay attention to any ‘red flag’ that might be present. Koes et al (2006) mentioned the following ‘red flags’:
• Onset age < 20 or > 55 years
• Non-mechanical pain (unrelated to time or activity)
• Thoracic pain
• Previous history of carcinoma, steroids, HIV
• Feeling unwell
• Weight loss
• Widespread neurological symptoms
• Structural spinal deformity
- Yellow Flags
Investigations
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- Radiological Considerations
Objective[edit | edit source]
Observation[edit | edit source]
- Posture
- Movement Patterns
Functional Tests
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Palpation[edit | edit source]
It is crucial for a reliable diagnosis and intervention of treatment to adequately palpate the lumbar processi.
Within the scientific world there has been a debate about the palpation of the processi spinosi because scientists assumed that often different persons indicated the processi on a different place (Mckenzie et al). However, Snider et al (2011) has shown that the indicated points of the different therapists lie that the distance between the indicated points of the different therapists is much smaller than it had always been claimed. Obviously there were differences because some therapists have more experience and others have more anatomical knowledge. Also the difference in personality between the therapists led to differences in locating the processi.
Furthermore, this investigation has proven that it is more useful to indicate different points instead of just 1 point. Also it’s proven that a manual examination to detecte the lumbar segmental level is highly accurate when accompanied by a verbal subject response
There are of course elements that hinder the palpation. For example, a BMI (body mass index) of 30kg/m2 considerably diminishes the accuracy (Ferre et al). Anatomical abnormalities might also cause problems. The abnormality of the 12th rib leads, for example, to a negative palpal accuracy in the region L1-L4 for all therapists (Snider et al).
Neurologic Assessment
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Movement Testing[edit | edit source]
- AROM, PROM, and Overpressure
- Passive Intervertebral Motion
- Muscle Strength