Regional Interdependence in Low Back Pain: Interventions
Regional Interdependence[edit | edit source]
- Regional interdependence is the concept that a musculoskeletal treatment targeting a specific area of the body could have effects in another, seemingly unrelated, part of the body[1].
- Examples of Regional Interdependence:
- Elbow
- Shoulder
Examination[edit | edit source]
Screen patient for red flags[2]
Condition | Red Flags |
Back-related tumor |
|
Cauda equina syndrome |
|
Back-related infection |
|
Spinal compression fracture |
|
Abdominal aneurysm |
|
Physical Impairment Measures[2]
- Evaluate Thoraco-Lumbar Active and Passive ROM
- Segmental Mobility
- Pain Provocation with Segmental Mobility Testing
- Judgments of Centralization during Movement Testing]
- Patient flex forward multiple times asking about any changes in pain.
- Repeat this with extension and lateral flexion.
- Look for a centralization of pain with repeated motion in a specific direction.
- Prone Instability Test
- Judgments of the presence of aberrant movement
- Measured by painful arc with flexion or return from flexion. If patient complains of pain when returning to standing from flexion or feels a catch, this is a positive test.
- Straight Leg Raise
- Slump Test
- Trunk Muscle Power and Endurance
- Check Trunk Flexors, Extensors, Lateral Abdominals, Transversus Abdominis, Hip Abductors, and Hip Extensors for strength looking for any muscle imbalances.
- Passive Hip Internal Rotation, External Rotation, Flexion, and Extension
- Mental Impairment Measures
- Fear Avoidance Beliefs Questionnaire
References[edit | edit source]
- ↑ Wainner RS, Whitman JM, Cleland JA, Flynn TW. Regional Interdependence: A Musculoskeletal Examination Model Whose Time Has Come. J Orthop Sports Phys Ther 2007;37(11):658-660. Pub Med Link: http://www.ncbi.nlm.nih.gov/pubmed/18057674 (accessed 26 Oct 2013).
- ↑ 2.0 2.1 Delitto A, George S.Z. et al. Low Back Pain Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. J Orhtop Sports Phys Ther. 2012;42(4):A1-A57 Pub Med Link: http://www.ncbi.nlm.nih.gov/pubmed/22466247 (accessed 26 October 2013).