Spinal Manipulative Therapy: The Evidence

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Author:
dmshaw9
ID:
261997
Filename:
Spinal Manipulative Therapy: The Evidence
Updated:
2014-02-14 10:43:12
Tags:
Spinal Manipulative Therapy Evidence
Folders:
MS2
Description:
MS2
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  1. Gold Standards of Diagnosis
    • Disc involvement = MRI
    • Spondylosis = None
    • Spondylolysis = Combination (bone scan, SPECT, & CT)
    • Spondylolisthesis = Lateral view radiograph
    • Radiculopathy = None
    • Facet irritation = Facet joint injection/facet block
  2. SI Joint Dysfunction
    • (+) Standing Flexion Test
    • (+) Supine to Longsitting Test
    • (+) Seated PSIS Palpation
    • (+) Prone Knee Flex Test
  3. SI Joint Pain
    (diagnostic of SIJ pain if 3+ present)

    • (+) Sacral Compression Test
    • (+) Sacral Distraction Test
    • (+) Sacral Thrust Test
    • (+) Thigh Trust Test
    • (+) Gaenslen's Test
  4. Lumbar Manipulation for Acute LBP: Success
    (Lumbar manipulation indicated if 4 or more present)

    • No pain distal to the knee
    • Duration of symptoms < 16 days
    • Lumbar hypomobility on Spring testing
    • Either hip has >35 degrees of IR
    • FABQ-W < 19
  5. Lumbar Manipulation for Acute LBP: Failure
    • Decreased average total hip rotation ROM
    • Longer duration of symptoms
    • Not having LBP only
    • (-) Gaeslen's Test
    • (-) Lumbar hypomobility (Spring test)
    • Decreased hip IR ROM discrepancy between sides
  6. Lumbar Stabilization for LBP: Success
    (Success likely if 3 or more present)

    • SLR > 91 degrees
    • (+) Prone Instability Test
    • (+) Aberrant movements¬†
    • Age < 40 years
  7. Lumbar Stabilization for LBP: Failure
    (Failure likely if 3 or more present)

    • FABQ-PA < 8
    • (-) Prone instability test
    • (-) Aberrant movements
    • (-) Hypermobility during P-A spring testing
  8. Lumbar Manipulation if PFPS
    (Indicated if 3 or more present)

    • Side-to-side hip IR difference of >14 degrees
    • Ankle DF w/ knee flexed > 16 degrees
    • Navicular drop > 3mm
    • No self-report stiffness w/ sitting > 20 min
    • Squatting reported as most painful activity

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