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Utilizing Clinical Practice Guidelines for Treatment of Low Back Pain: Summary
• Postoperative LBP : ○ Most research on general education in the postoperative LBP category is with lumbar decompression and discectomy surgery ○ No specific recommendation is provided
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
for other surgical procedures such as spinal fusion due to lack of evidence HEALTHCARE CONSIDERATIONS
Occupational Interventions for the Prevention of Low Back Pain: • LBP can affect one's participation in ADL and IADL such as rest, sleep, toileting, dressing, functional mobility, personal hygiene and sexual activity, caregiving tasks, care of pets, driving/community mobility, home management, meal preparation, work, and shopping. The nature of these activities may limit an individual from participating or exacerbate their symptoms (AOTA, 2014) • By encouraging clients to identify a supportive exercise activity that they find meaningful (e.g., Pilates, yoga, strength training), there is a higher chance of accountability. By evaluating which functional activities are most difficult and which exercise activities are most enjoyable, the interventionist can provide the client with an individualized plan that will address their goals and improve their participation in daily living CONCLUSION The ICF model assists clinicians in classifying clients on a more individualized and personal level. CPGs have been created based on high- quality and up-to-date research. CPGs assist clinicians in providing the best quality of care by recommending interventions for different classifications of a disease or disorder.
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