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Utilizing Clinical Practice Guidelines for Treatment of Low Back Pain: Summary
ICF Model of LBP Examples
Acute LBP with Radiating Pain
Play in soccer league, Pick up 2 y/o son from floor or crib
Sitting for desk job, Don/doff pants
Spinal mobility, hamstring flexibility, core strength
Bedroom on 2nd floor of home, avid soccer player
30 y/o male, HTN
Acute LBP with Radiating Pain
Spinal mobility, hip mobility, LE and core strength
Feed his dog, Meal prep for family
Driving to work, Sitting for a meal
Single level home, rural, cold climate,
30 y/o male, DM2
Interventions for acute LPB with leg pain: • Trunk muscle strengthening • Specific trunk muscle activation • Note: Moderate evidence (B) Interventions for chronic LBP: • Trunk muscle strengthening • Trunk muscle endurance • Specific trunk muscle activation exercise
INTERVENTIONS
1. EXERCISE The McKenzie Method of Mechanical Diagnosis and Therapy (MDT): • Evidence-based protocol that can be applied to spine and extremities—acute, subacute and chronic • Individualized program of exercises based on clinical clues observed during assessment • Often mistaken as an “extension-based program” Williams Exercises: • Promote lumbar flexion and strengthening of abdominals and gluteals • Series of exercises: Pelvic tilt, single knee to chest motion, double knee to chest motion, partial sit up, hamstring stretch, hip flexor stretch, and squat Interventions for acute LPB without leg pain: • Specific trunk muscle activation • Note: Weak evidence (C)
• Aerobic exercise • Aquatic exercise • General exercise Note: Strong evidence (A) Movement Control Exercise: • Note: Strong evidence (A)
Exercise Guidelines for Older Adults (65+ years): • WHO´s Global Recommendations on Physical Activity for Health • Older adults: 150 min of moderate or 75 min vigorous intensity aerobic activity weekly • Also include 2+ days of muscle strengthening exercise
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