What RUSI answars in LBA cases

-
According to Knudson HA (a doctor of physical therapy) real time ultrasound imaging can provide answer all of the following questions or identify the following problems associated with LBA.

1. Test voluntary activation through conscious effort. Identify change in motor control in individuals with low back pain. If muscle wasting is identified, what is the % difference between sides of the specific segment? Identify unilateral muscle wasting within a specific segment of lumbar multifidus. Is the patient able to consciously contract lumbar multifidus while in an unloaded position without trunk movement or limb loading? Can the patient emphasize activation of deep fibers of multifidus while limiting activation of superficial fibers? (Poor quality of lumbar multifidus contraction?) Does the muscle composition of multifidus look healthy, without fatty infiltrate, fluid from injury, fibrosis, soft tissue adhesions, or calcium deposits?

2. Does the patient display one of 5 clinical patterns of transversus abdominis dysfunction during testing for the automatic recruitment strategy used by the nervous system to control the trunk? Observe the automatic recruitment strategy to identify normal or abnormal control of transverse abdominis during load transfer involving movement of limbs. Is the patient able to maintain a tonic hold of transverse abdominis without movement of the spine during testing for conscious activation?

3. How long can a patient sustain a transverse abdominis or lumbar multifidus contraction before fatiguing? Can the patient co-contract transverse abdominis and lumbar multifidus, independent of the global superficial muscles of the back/abdomen?

4. When the patient draws in the lower abdomen, how much of a linear change in lateral pull of the fascia attachment occurs from rest to active without significant internal obliques thickness increase and with minimal transverse abdominis thickness increase? Does the patient have automatic tonic contraction occurring with movement?

Reference:

www.back-exercises.com

Comments

Post a Comment

Popular posts from this blog

Entrapment of medial calcaneal nerve (MCN)

-
Image
Peripheral nerve entrapment is a rare, but important, cause of foot and ankle pain that often is underdiagnosed and mistreated. A peripheral nerve may become entrapped anywhere along its course, but certain anatomic locations are characteristic (2). The medial calcaneal nerve (MCN) The Tibial nerve is called the planter nerve in the sole. The tibial nerve passes to the sole of the foot takes a turn on the medial side of the calcaneum is called MCN. The medial calcaneal nerve arises from tibial nerve of the inner side of the ankle, perforates the laciniate ligament, travels downwards passing below the bony projection on the inner side of the ankle, and supplies the skin over the medial aspect of the heel. Hence it is the most important nerve for heel sensations. MCN have 2 branches. The anterior branch dominate the cutaneous sensation of the anterior part of the medial calcaneal and heel weight loading field, while the posterior branch dominate the sensation of the posterior an...
Read more

Differential diagnosis of Anatomic (Radial) snuffbox pain: It is not always DeQuervain’s tenosynovitis.

-
Image
Tendon, Bone & Ligament causes: 1. DeQuervain’s tenosynovitis: Swelling of tendon of APL (Abductor pollicis longus) & extensor pollicis brevis at lateral wrist near anatomic snuff box.  The primary complaint is radial sided wrist pain that radiates up the forearm with grasping or extension of the thumb. The pain has been described as a “constant aching, burning, pulling sensation." Pain is often aggravated by repetitive lifting, gripping, or twisting motions of the hand. Swelling in the anatomical snuff box, tenderness at the radial styloid process, decreased CMC abduction ROM of the 1st digit, palpable thickening of the extensor sheaths of the 1st dorsal compartment and crepitus of the tendons moving from the extensor sheath may be found upon examination. Other possible findings include weakness and paresthesia in the hand. Finkelstein’s diagnostic test will present positive provoking the patient’s symptoms. If left untreated, the inflammation and progressive narro...
Read more

Chronic fatigue syndrome

-
Introduction: Severe fatigue is a common complaint among patients. Often, the fatigue is transient or can be attributed to a definable organic illness. Some patients present with persistent and disabling fatigue, but show no abnormalities on physical examination or screening laboratory tests. In these cases, the diagnosis of chronic fatigue syndrome (CFS) should be considered. According to Centers for Disease Control and Prevention (CDC, USA) Chronic fatigue syndrome (CFS) currently is defined as: (1) fatigue of at least 6 months' duration, seriously interfering with the patient's life; and (2) without evidence of various organic or psychiatric illnesses that can produce chronic fatigue. The World Health Organization classifies myalgic encephalomyelitis/chronic fatigue syndrome (ME/cfs) as a nervous system disease. Together with other diseases under the G93 heading, ME/cfs shares a triad of abnormalities involving elevated oxidative and nitrosative stress (O&NS), activat...
Read more