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Utilizing Clinical Practice Guidelines for Treatment of Low Back Pain: Summary
THE FOUR INTERVENTION CATEGORIES FOR LBP CPGS: Exercise :
• Generally beneficial to reduce pain and disability • Not possible to recommend any exact exercise • Progressive exercise training recommended in older adults Manual therapy and other directed therapies : • Thrust and nonthrust joint mobilizations recommended for acute and chronic LBP • No evidence to support “other directed therapies” such as dry needling and traction for acute LBP • Traction not recommended for chronic LBP with leg pain due to lack of efficacy Classification systems : • No evidence directly comparing effectiveness of different classification systems • No evidence to support one classification system as more effective than another Client education : • Active strategies are recommended instead of passive in all LBP scenarios • Education should not be used as a stand-alone treatment • For postoperative cases, education is encouraged, though most of the research regarding CPGs has focused only on lumbar decompression and discectomy
CASE STUDY
J.P. has had LBP for many years. She has given up on some activities due to fear that her symptoms will get worse. J.P. wants to be able to cook in her kitchen for her family. She has had to take some time off work due to her LBP and does not want to continue to order out and spend more money while she is out of work.
J.P. is explaining to her occupational therapist that her main priority is cooking. Her OT collaborates with J.P. on organizing her kitchen to reduce the intensity and frequency of bending and twisting needed to retrieve commonly used items. Her OT teaches her ways to position herself while reaching to avoid any overstretching or poor compensatory movements. Her OT devises a treatment plan that encompasses environmental modifications as well as exercises to target the muscles that are contributing to her LBP. The therapist focuses on an exercise program that J.P. found meaningful to improve carry over Results: Patient showed significant improvement in functional mobility, occupational performance, pain levels, and quality of life
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