A Coggle Diagram about RED FLAGS + cause by recent changes in diet/lifestyle/medication?, Examination (MVT testing: AROM (flexion 40-60, extension 20-35, side flexion 15-20 - looking for willingness to move, quality of movement, where movement occurs, range, pain, painful arc, deviation)
Overpressure (at the end of all AROM if they are pain free, normal end feel should be tissue stretch)
Muscle Strength (resisted isometrics in flex, ext, side flex, rotation; core stability, functional strength tests), finger-floor distance (forward flexion), hyperextension, Slump test: ddx tight hamstrings / dural tension, pedal pulse, Two-stage treadmill test: if walks further with incline, lumbar stenosis, FABER test (SI pathology), neurological: muscle tone, sensory/motor loss (dermatomes, myotomes), reflex (Hoffmann's sign, Babinski, deep tendon reflexes). myotomal muscle testing, ankle DF for L4 hip ABD, ankle DF, ankle EV, big toe EXT for L5 *hip EXT, knee FLEX, ankle PF, ankle EV for S1. Laseque, Crossed laseque, Femoral Nerve Stretch Test., observation: walking pattern, posture standing, posture sitting, stand-sit-stand pattern, pelvic tilt, leg length, spinal deformities (kyphosis, hypo/hyperlordosis, scoliosis), body type, , Functional tests: pain provoking demonstration, squat test (excludes lower limb MSK pathology), More pain on coughing, sneezing or straining, palpation: Passive Intervertebral Motion = reproducing pain (finding the source segment), vajutad järjest proc.spinosuse peale, siis fassettliigeste peale (1 pöidla kaugusel laterally) (PPIVMs, PAIVMs),
Muscle Tone, deformities, signs of inflammation (swelling, redness, incr.temperature), spinal ROM: inclinometer (vt clinical guidelines APTA), adjacent joints: SI, hip, knee, ankle, Judgments of Centralization During Movement Testing. Centralization occurs when the location of the patient’s symptoms, such
as pain or paresthesias, is perceived by the patient to be in a more proximal location in response to single and repeated movements or
sustained positions. Peripheralization occurs when the location of the patient’s symptoms is perceived in a more distal location, such
as the calf or foot, in response to single and repeated movements or sustained positions., subgrouping, stratification: Treatment of patients based on subgrouping results in better outcomes than treatment based on clinical guidelines. 1) triage based on patient prognosis / responsiveness to treatment / underlying mechanisms. 2) treatment based on triage group, Pain Provocation With Segmental Mobility Testing (present/absent) (vajutad proc.spinosuste /fassettide peale igas segmendis), Segmental Mobility Assessment (hyper-hypo), prone instability test, Judgments of the Presence of Aberrant Movement: painful arc with flexion or return from flexion, instability catch, Gower sign, reversal of lumbopelvic rhythm and Trunk Muscle Power and Endurance (lat abdominals, trunk flex-ext, transversus abdominis, hip abductors, hip extensors)), yellow flags (unhelpful beliefs about recovery (pain reflects damage), When relevant psychological
factors are identified, the rehabilitation approach should be
modified to emphasize active rehabilitation, graded exercise
programs, positive reinforcement of functional accomplishments,
and/or graduated exposure to specific activities that
a patient fears as potentially painful or difcult to perform. , fear, avoidance of movement, low mood, isolation, reliance on passive treatments, LBP is dangerous, potentially disabling, distressed affect, ORANGE FLAG. clearly “abnormal” psychological or psychiatric factors or disorders (eg, posttraumatic stress disorder, major depression) suggestive of diagnosable psychopathology, Catastrophic thoughts, passive coping strategies, incl resting and poor problem solving), history (outcome measures, type, location and duration of symptoms, presence of subjective weakness and dysesthesia,, dermatomal radiation, current therapy + Has the patient had any other investigations such as radiology (Xray, MRI, CT, ultrasound) or blood tests?, absence of work, exacerbating/alleviating factors, Self‐report (present complaint (PC), history of present compaint (HPC), past medical history (PMH), drug history (DH), social history (SH))
What is the patient’s age?
What is the patient’s occupation?
What was the mechanism of injury?
How long has the problem bothered the patient?
Where are the sites and boundaries of pain?
Is there any radiation of pain? Is the pain centralizing or peripheralizing
Is the pain deep? Superficial? Shooting? Burning? Aching?
Is the pain improving? Worsening? Staying the same?
Is there any increase in pain with coughing? Sneezing? Deep breathing? Laughing?
Are there any postures or actions that specifically increase or decrease the pain or cause difficulty?Is the pain worse in the morning or evening? Does the pain get better or worse as the day progresses? Does the pain wake you up at night?Which movements hurt? Which movements are stiff?
Is paresthesia (a “pins and needles” feeling) or anesthesia present?
Has the patient noticed any weakness or decrease in strength? Has the patient noticed that his/her legs have become weak while walking or climbing stairs?
What is the patient’s usual activity or pastime? Before the injury, did the patient modify or perform any unusual repetitive or high-stress activity?
Which activities aggravate the pain? Is there anything in the patient’s lifestyle that increases the pain?
Which activities ease the pain?
What is the patient’s sleeping position? Does the patient have any problems sleeping?
Does the patient have any difficulty with micturition?
Are there any red flags that the examiner should be aware of, such as a history of cancer, sudden weight loss for no apparent reason, immunosuppressive disorder, infection, fever, or bilateral leg weakness?
Is the patient receiving any medication?
Is the patient able to cope during daily activities?, continence and breathing disorders?), spinal masqueraders (aortic aneurysm. ant chest pain, severe tearing back pain, not relieved by rest, not aggravated by spinal palpation., MI. mid-thoracic, radiating to arm, chest pain., ectopic pregnancy. vaginal bleeding, missed period., acute pancreatitis. thoracolumbar, presenting with gallstones, after binge drinking., Duodenal ulcer. pain worsens with hunger, high acid levels., UTI. dysuria, fever., prostatitis. fever, lbp radiating to rectum., gallstones. after-fatty-meal-pain. pain colicky, sharp intermitting periods of pain., kidney problems and visceral cancer. pain cannot be relieved, severe at night, pain progressive.), modalities (passive, active and education), blue flags (low return-to-work expectancies and lack of confidence in performing work-related activities), stratification/triage (acute/subacute and chronic/non-responsive to other treatment options), predictors of LBP () and