Lumbopelvic Examination Quiz
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Questions and Answers

What is the primary purpose of utilizing outcome measures in a lumbopelvic examination?

  • To quantify the patient's subjective experience and functional limitations. (correct)
  • To identify the specific anatomical source of the patient's pain.
  • To establish a definitive medical diagnosis for the patient's condition.
  • To determine the patient's pain tolerance threshold.

    • A patient's Oswestry Disability Index (ODI) score improves from 40% to 25% following intervention. According to the Minimum Clinically Important Difference (MCID), what is the clinical significance of this change?

  • The change indicates a minimal improvement, barely meeting the MCID threshold.
  • The change represents a successful treatment outcome as it exceeds a 20% reduction. (correct)
  • The change is not clinically significant as it is less than the MCID of 12-20%.
  • The change is only relevant if the patient also reports a 50% reduction in pain on the NPRS.

    • When using the Patient Specific Functional Scale (PSFS), what does a score of '0' indicate for a chosen activity?

  • The patient is unable to perform the activity. (correct)
  • The patient can perform the activity with slight difficulty.
  • The patient can perform the activity at the same level as before injury.
  • The activity is not relevant to the patient's functional limitations.

    • What aspect of a patient's condition is primarily assessed by the Fear Avoidance Beliefs Questionnaire (FABQ)?

    <p>The patient's beliefs about how physical activity and work influence their low back pain. (C)</p> Signup and view all the answers

    What is the Minimum Detectable Change (MDC) for the Patient Specific Functional Scale (PSFS)?

    <p>2.5 points (C)</p> Signup and view all the answers

    During the subjective examination, what is the significance of reproducing a patient's familiar symptoms during the physical exam?

    <p>It indicates that the symptoms are generally reducible with physical therapy interventions. (B)</p> Signup and view all the answers

    What is the primary purpose of conducting a physical examination after a thorough subjective examination in lumbopelvic assessment?

    <p>To confirm or refute the working hypothesis developed during the subjective examination. (C)</p> Signup and view all the answers

    What is the range of scores for each question within the Oswestry Disability Index (ODI)?

    <p>1-5 (C)</p> Signup and view all the answers

    What is the primary purpose of performing FABER and FADIR tests?

    <p>To assess for reproduction of symptoms and/or deficits related to hip pathology. (B)</p> Signup and view all the answers

    Which of the following is an example of a Passive Accessory Intervertebral Joint Movement (PAIVM)?

    <p>Central Posterior-Anterior glide (C)</p> Signup and view all the answers

    What is the main distinction between Passive Physiological Intervertebral Movements (PPIVM) and Passive Accessory Intervertebral Joint Movements (PAIVM)?

    <p>PPIVMs are passively performed movements that could be actively performed, while PAIVMs cannot be actively performed. (B)</p> Signup and view all the answers

    When performing Central Posterior-Anterior (PA) glides, which of the following techniques is emphasized?

    <p>Maintaining a broad contact and slowly sinking into the tissue with the lower body. (A)</p> Signup and view all the answers

    During both PAIVM and PPIVM assessments, what two primary factors are evaluated?

    <p>Reproduction of symptoms and quality of movement. (B)</p> Signup and view all the answers

    During lumbar flexion ROM assessment, which instruction is most appropriate to give to the patient?

    <p>Tuck chin to chest, slide hands down your legs as far as you can. (A)</p> Signup and view all the answers

    In repeated motions assessment, what clinical phenomenon guides the direction of motion?

    <p>Centralization vs Peripheralization (B)</p> Signup and view all the answers

    Testing light touch sensation in the lower extremity dermatomes is primarily indicative of:

    <p>Nerve root pathology (A)</p> Signup and view all the answers

    Which dermatome level corresponds to the medial malleolus?

    <p>L4 (A)</p> Signup and view all the answers

    When assessing myotomes, the primary objective is to identify:

    <p>Muscle weakness (D)</p> Signup and view all the answers

    Ankle plantarflexion strength is primarily testing which myotome level?

    <p>S1 (A)</p> Signup and view all the answers

    In addition to range of motion, what other components are included in a hip screen as part of a lumbar spine assessment?

    <p>Internal Rotation (IR) and External Rotation (ER) (D)</p> Signup and view all the answers

    Which of the following best describes the application of overpressure during lumbar ROM assessment?

    <p>Applying a sustained force at end range (A)</p> Signup and view all the answers

    Study Notes

    Lumbopelvic Examination

    • The lumbopelvic examination is a detailed process used by physical therapists, particularly those specializing in orthopedic physical therapy.
    • The objectives of the examination focus on assessing lumbopelvic mobility, strength, and joint assessment.
    • A subjective examination involves gathering patient information, including pain location, initial hypothesis, factors that worsen or improve the pain, and associated history (e.g., mechanism of injury, timeframe).
    • The subjective exam also incorporates collecting information on how many times a patient experiences pain, and how much is required to reduce experience of pain.

    Subjective Exam Outcome Measures

    • The subjective exam collects data on pain location documented via body charts.
    • The exam also covers a patient's initial hypothesis or assumptions about the cause of injury, and factors that make the pain worse and better.
    • History includes the mechanism of injury, timeframe, and any relevant medical history.
    • It also includes a working hypothesis, which is a preliminary idea or assumption about the potential cause of the patient's condition.

    Outcome Measures

    • Oswestry Disability Index (ODI)
    • Patient Specific Functional Scale (PSFS)
    • Fear Avoidance Beliefs Questionnaire (FABQ)
    • Numeric Pain Rating Scale (NPRS)

    Oswestry Disability Index (ODI)

    • The ODI is a self-report questionnaire used to assess disability related to low back pain.
    • It consists of 10 questions, each scored on a scale of 1 to 5, related to activities limited by back pain.
    • The total score out of 50 is then multiplied by 2 to determine the percentage of disability.
    • A minimum clinically important difference (MCID) of 6-10 points (or 12-20% change) is often considered clinically meaningful improvement.
    • A 50% reduction in the ODI score is often considered a successful treatment outcome in research.

    Patient Specific Functional Scale (PSFS)

    • Patients choose 3-5 activities where they have difficulty due to pain/injury.
    • The activities are rated on a scale from 0 to 10.
    • A score of 0 indicates the inability to perform the activity, while a score of 10 suggests the ability to perform the activity at the same level as before the injury.
    • The average of the ratings for the chosen activities provides a measure of functional limitations.
    • The minimum detectable change is 2.5 points and the minimum clinically important difference is 1.5 points.

    Fear Avoidance Beliefs Questionnaire (FABQ)

    • The FABQ is used to assess the beliefs about activity and work that contribute to low back pain and incorporates 16 questions.
    • The answers are on a scale from "completely disagree" to "completely agree".
    • Higher scores indicate increased fear avoidance behavior.
    • The FABQ includes two subscales—physical activity and work subscales.
    • The minimum clinically important difference is 25%.

    Numeric Pain Rating Scale (NPRS)

    • The Numeric Pain Rating Scale (NPRS) is a simple, self-report tool used to assess pain intensity.
    • Patients rate their pain on a scale of 0 to 10.
      • 0 = no pain
      • 10 = worst pain imaginable
    • A minimum clinically important difference (MCID) and minimum detectable change (MDC) are both considered to be 2 points.

    Physical Exam

    • The primary purpose of the physical exam is to confirm or refute the working hypothesis, allowing for hypothetical deductive reasoning that leads to diagnosis/prognosis.
    • The physical exam aims to reproduce the patient's familiar symptoms to determine whether they are reproducible.
    • Reproducible symptoms are usually indicative of a manageable condition
    • Non-reproducible symptoms may necessitate further evaluation or referral.
    • The physical exam focuses on identifying impairments and functional limitations, providing specific targets for effective intervention.

    Lumbopelvic Examination Subcomponents

    • Lumbar ROM (Range of Motion) is evaluated for flexion, extension, lateral flexion, and rotation, with specific instructions provided on how to perform each of the motions to help with reproduction of symptoms.
    • Repeated Motions: Repeating motions can assess centralization and peripheralization of symptoms.
    • Dermatomes: This involves testing light touch sensation from L2 to S2, and comparing bilaterally.
      • Dermatome locations on the body are provided.
    • Myotomes: This tests strength of muscles associated with various spinal levels.
      • Instructions are provided to test the different muscles, and the assessment involves determining weakness if any.
    • Hip Screen: Tests hip range of motion (ROM) including flexion, internal and external rotation, and extension, along with FABER and FADIR tests to assess for reproduction of symptoms.
      • Diagrams of the hip screen are provided for visual representation.
    • Joint Assessments: Passive Accessory Inter-Vertebral Joint Movement (PAIVM) and Passive Physiological Inter-Vertebral Movements (PPIVM) are evaluated to assess for limitations in movement and pain reproduction from various motions. Instructions for performing joint assessment maneuvers are provided.

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    Lumbopelvic Exam PDF

    Description

    Test your knowledge on outcome measures used in lumbopelvic examinations, including the significance of the Oswestry Disability Index and the Fear Avoidance Beliefs Questionnaire. This quiz covers essential assessments and clinical significance related to patient outcomes in physical therapy. Enhance your understanding of clinical assessment tools and their implications.

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