Event Title

Application of clinical practice guidelines to the management of a patient with chronic low back pain: a case report

Location

Hall of Governors

Start Date

7-4-2017 4:00 PM

End Date

7-4-2017 6:00 PM

Description

Background: LBP has a lifetime prevalence of 65-80% of the population. Physical therapy is a common treatment for patients who are experiencing low back pain. Clinical practice guidelines assist physical therapist with accurate treatment of these conditions. Purpose: To describe the outcome after poor response to directional preference determined by clinical practice guidelines should be changed based on patient response to physical therapy.Case Description: A 59 year-old Caucasian female patient with complaints of low back pain with radicular symptoms for six months demonstrated a directional preference (extension bias) at the time of evaluation. Her office job required her to work at a computer for long hours. Prior to her injury she was independent with all activities without use of an assistive device. She had no pertinent medical history related to low back pain and was cleared of all red flags.

Outcomes: After two weeks of her extension bias directional preference based interventions, the patient no longer demonstrated a decrease in reported symptoms with extension but only improved when in supported position like lying supine or with sustained motions. Physical therapy interventions moved away from directional preference protocols to a progressive spinal stabilization with emphasis in deep spinal stabilizers and global trunk musculature. This patient responded favorably as demonstrated by the Oswestry Disability Index with a spinal stabilization program. After a total of 5 weeks of physical therapy which consisted predominantly of a progressive stabilization program, the patient was able to return to her independent prior level of function.

Discussion: Clinical practice guidelines assist in the plan of care process. There are many ways that low back pain can be treated but patient response should dictate patient interventions

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Apr 7th, 4:00 PM Apr 7th, 6:00 PM

Application of clinical practice guidelines to the management of a patient with chronic low back pain: a case report

Hall of Governors

Background: LBP has a lifetime prevalence of 65-80% of the population. Physical therapy is a common treatment for patients who are experiencing low back pain. Clinical practice guidelines assist physical therapist with accurate treatment of these conditions. Purpose: To describe the outcome after poor response to directional preference determined by clinical practice guidelines should be changed based on patient response to physical therapy.Case Description: A 59 year-old Caucasian female patient with complaints of low back pain with radicular symptoms for six months demonstrated a directional preference (extension bias) at the time of evaluation. Her office job required her to work at a computer for long hours. Prior to her injury she was independent with all activities without use of an assistive device. She had no pertinent medical history related to low back pain and was cleared of all red flags.

Outcomes: After two weeks of her extension bias directional preference based interventions, the patient no longer demonstrated a decrease in reported symptoms with extension but only improved when in supported position like lying supine or with sustained motions. Physical therapy interventions moved away from directional preference protocols to a progressive spinal stabilization with emphasis in deep spinal stabilizers and global trunk musculature. This patient responded favorably as demonstrated by the Oswestry Disability Index with a spinal stabilization program. After a total of 5 weeks of physical therapy which consisted predominantly of a progressive stabilization program, the patient was able to return to her independent prior level of function.

Discussion: Clinical practice guidelines assist in the plan of care process. There are many ways that low back pain can be treated but patient response should dictate patient interventions