CPR for Lumbar Stabilisation
Be the first to edit this page and have your name permanently included as the original editor, see the editing pages tutorial for help.
|
Original Editor - Your name will be added here if you created the original content for this page. Lead Editors - Your name will be added here if you are a lead editor on this page. Read more. |
Indication
[edit | edit source]
Because patients presenting with low back pain are a heterogeneous population, and because in 85% of cases no specific diagnosis can be made for low back pain, a treatment based classification system is useful for physical therapists in developing rehabilitation programs for patients unspecified with low back pain. In this type of system, patients are categorized according to general presentation, findings from a physical examination, impairments, and functional limitations, and are grouped into one of several treatment classifications. In order to assist with this classification, clinical prediction rules are a set of criteria that a patient should meet in order to be placed into a specific treatment group.
Clinical Prediction Rule[edit | edit source]
- Younger Age (<40 years old)
- Increased Flexibility (Average SLR > 91o)
- Aberrant Motions or Instability Catch during Lumbar Flexion/Extension ROM
- Hypermobility of the Lumbar Spine
- (+) Prone Instability Test
Description[edit | edit source]
Optimal spinal stabilzation can be achieved by strengthening the deep back and abdominal muscles. These include the transverse abdominus, quadratus lumborum, oblique abdominals, multifidus, and erector spinae. Exercises targeting these specific muscles should be done in a progression, usually beginning with the transverse abdominus to provide the patient with initial stabilization that can be used during subsequent exercises and daily activities.
|-
|
|
|-
These exercises are only one example of the stabilization progressions that can be used for patients requiring this technique. They can and should be modified according to specific patient needs, preferences, or functional demands.
Key Evidence[edit | edit source]
A 2003 study done by Fritz et al compared the treatment based classification (TBC) approach and current clinical practice guidelines (CPG) for treatment of patients with low back pain. The TBC system involved classifying patients into categories and matching the treatment to the category. The clinical practice guidelines included low stress aerobic exercise, general muscle re-conditioning, and advice to remain active. The change was evaluated using the initial and four week Oswestry score. Although both groups showed some improvement, the study found a 22% greater improvement for patients whose treatment was matched on the TBC as compared to those who were provided treatment based on the CPG.
Fritz JM, Delitto A, Erhard DC. (2003) Comparison of Classification-Based Physical Therapy with Therapy Based on Clinical Practice Guidelines for Patients with Acute Low Back Pain. SPINE. 28 (13) 1363-1372.
Ultrasound- Strong Internal Oblique if Transverse Abdominus not working very much or weak.
Resources[edit | edit source]
add appropriate resources here, including text links or content demonstrating the intervention or technique
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
References[edit | edit source]
Fritz JM, Cleland JA, Childs JD. (2007) Subgrouping Patients with Low Back Pain: Evolution of a Classification Approach to Physical Therapy. Journal of Orthopaedic & Sports Physical Therapy, 37 (6), 290-302.
Hicks GE, Fritz JM, Delitto A, McGill SM. (2005) Preliminary Development of a Clinical Prediction Rule for Determining Which Patients with Low Back Pain Will Respond to a Stabilization Exercise Program. Archives of Physical Medicine and Rehabilitation, 86 (9), 1753-1762.
