Regional Interdependence in Low Back Pain: Interventions
Original Editors - Brandan Lym, Mitchell Blythe, Cory Horstman, Nathan Domino, and Dana Schmidt part of the Des Moines University Student Project
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
- Look for a centralization of pain with repeated motion in a specific direction.
- Prone Instability Test
- Judgments of the presence of aberrant movement
- Straight Leg Raise
- Slump Test
- Trunk Muscle Power and Endurance
- Passive Hip Internal Rotation, External Rotation, Flexion, and Extension
- Mental Impairment Measures
- Fear Avoidance Beliefs Questionnaire
Also consider Hip Examination
- Active and Passive ROM
- Joint Mobility
- Strength
Outcome Measures Used[edit | edit source]
- Oswestry Disability Index
- Roland-Morris Disability Questionnaire
- Modified Spinal Stenosis Scale
- Numeric Pain Rating Scale
- Global Rating of Change Scale
- Patient Report of Function
Interventions[edit | edit source]
Thoracic Spine[edit | edit source]
Manipulation
- Supine Thoracic Posterior to Anterior HVLA Manipulation
Hip[edit | edit source]
Manipulation
- Supine Long Axis Distraction HVLA Manipulation
Mobilizations
- Supine Hip Caudal Glide Mobilization
- Prone Hip Posterior to Anterior Mobilization
Therapeutic Exercise
- Strengthening
- Hip Abduction with slight extension and internal rotation
- Flexibility
- Supine Iliopsoas Stretch
- Prone Rectus Femoris Stretch
-
Outcomes[edit | edit source]
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).