Texas Physical Therapy and PTA 27-Hour Summary Book

45

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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