Maluf K S, Sahrmann S A, Van Dillen L R
Movement Science Program, Program in Physical Therapy, Washington University School of Medicine, St Louis, MO, USA.
Phys Ther. 2000 Nov;80(11):1097-111.
This case report describes the use of a classification system in the evaluation of a patient with chronic low back pain (LBP) and illustrates how this system was used to develop a management program in which the patient was instructed in symptom-reducing strategies for positioning and functional movement.
The patient was a 55-year-old woman with a medical diagnosis of lumbar degenerative disk and degenerative joint disease from L2 to S1. Rotation with extension of the lumbar spine was found to be consistently associated with an increase in symptoms during the examination. Instruction was provided to restrict lumbar rotation and extension during performance of daily activities.
The patient completed 8 physical therapy sessions over a 3-month period. Pretreatment, posttreatment, and 3-month follow-up modified Oswestry Disability Questionnaire scores were 43%, 16%, and 12%, respectively.
Daily repetition of similar movements and postures may result in preferential movement of the lumbar spine in a specific direction, which then may contribute to the development, persistence, or recurrence of LBP. Research is needed to determine whether patients with LBP would benefit from training in activity modifications that are specific to the symptom-provoking movements and postures of each individual as identified through examination.
本病例报告描述了一种分类系统在评估一名慢性下腰痛（LBP）患者中的应用，并说明了该系统如何用于制定一个管理计划，在该计划中指导患者采用减轻症状的姿势调整和功能活动策略。
患者为一名55岁女性，医学诊断为L2至S1节段腰椎间盘退变和关节退变疾病。在检查过程中发现，腰椎旋转伴伸展始终会导致症状加重。指导患者在日常活动中限制腰椎旋转和伸展。
患者在3个月内完成了8次物理治疗。治疗前、治疗后及3个月随访时改良Oswestry功能障碍问卷评分分别为43%、16%和12%。
日常重复类似的动作和姿势可能导致腰椎在特定方向上的优先运动，进而可能导致下腰痛的发生、持续或复发。需要开展研究以确定，通过检查确定了引发症状的特定动作和姿势后，下腰痛患者是否会从针对这些动作和姿势的活动调整训练中获益。
Zotero 插件