ADRIAN - TWO ways you could improve confidence or ability to lumbar flex by Roma Forbes

ADRIAN - TWO ways you could improve confidence or ability to lumbar flex by Roma Forbes https://padlet.com/romaforbes/adrian en-us 2018-10-22 00:04:12 UTC 2025-11-12 18:41:37 UTC hello@padlet.com 1. Advice + Education - Reassure Adrian that back is safe to move, exercise may reduce pain & pain doesn't = tissue damage https://padlet.com/romaforbes/adrian/wish/295299134 2. Regress exercise to sitting or 4-pt kneel (unloaded) to show he can flex his back without bracing and breath holding]]> 2018-10-22 05:40:24 UTC https://padlet.com/romaforbes/adrian/wish/295299134 https://padlet.com/romaforbes/adrian/wish/295299159 MWM
-4 point kneel
-heel to bum
-therapist applies a glide
-progress by increasing range ]]> 2018-10-22 05:40:38 UTC https://padlet.com/romaforbes/adrian/wish/295299159 https://padlet.com/romaforbes/adrian/wish/295299160 Move his back passively --> as show him that it is not creating pain/injury
The back is very strong, resilient
Exercise is important
Pain does not equal damage ]]> 2018-10-22 05:40:39 UTC https://padlet.com/romaforbes/adrian/wish/295299160 https://padlet.com/romaforbes/adrian/wish/295299164 1. advice and education, reassuring the patient that the spine is a robust structure, designed to move, and that in fact moving the back will help rehabilitate it and reduce pain. explain how the NS system works and that the pain is not corresponding to damage
2. move his back passively to demonstrate that movement can be pain free]]> 2018-10-22 05:40:41 UTC https://padlet.com/romaforbes/adrian/wish/295299164 https://padlet.com/romaforbes/adrian/wish/295299176 Advice and Education - mri/imaging findings and % of asymptotic patients. Spine stable and well supported structure safe to move. Return to work sooner have better prognosis
Manual therapy - ]]> 2018-10-22 05:40:45 UTC https://padlet.com/romaforbes/adrian/wish/295299176 1. Advice and education about strength of spine, nervous system sensitivity and pain, reassure that is safe to move https://padlet.com/romaforbes/adrian/wish/295299192 2. Gentle movements of flexion to improve confidence and demonstrate the ability and safety to move the back into flexion ]]> 2018-10-22 05:40:51 UTC https://padlet.com/romaforbes/adrian/wish/295299192 https://padlet.com/romaforbes/adrian/wish/295299201 1. reassurance that he is not doing any harm to his back
2. forward lean in sitting to show him that it is safe to move]]> 2018-10-22 05:40:53 UTC https://padlet.com/romaforbes/adrian/wish/295299201 https://padlet.com/romaforbes/adrian/wish/295299213 1) Thumb on xiphoid process, pinky on belly button. Ask patient to bend and have the two come closer together

2) Patient education - Assurance that the spine is strong and stable. Bending it will not hurt the back]]> 2018-10-22 05:40:56 UTC https://padlet.com/romaforbes/adrian/wish/295299213 https://padlet.com/romaforbes/adrian/wish/295299220 1.Reduce it back to sitting or even 4 point kneeling to show him that he is able to move his back especially NWB

2. Lumbopelvic dissociation in sitting

]]> 2018-10-22 05:41:00 UTC https://padlet.com/romaforbes/adrian/wish/295299220 https://padlet.com/romaforbes/adrian/wish/295299227 1. education regarding movements - his back is strong and is safe to move
2. controlled flexion (progressing in range) with relaxed breathing that is not painful to reassure him that it is safe]]> 2018-10-22 05:41:04 UTC https://padlet.com/romaforbes/adrian/wish/295299227 Neuromatrix Management https://padlet.com/romaforbes/adrian/wish/295299240 1. reduce cognitive threat: reconceptualise beliefs about pain levels and that it is important to keep back moving
2. enhance self-efficacy: you need to keep your back moving, we understand that youre having pain but we will start at a point where you are pain-free and progress from there.
3. Graded exposure]]> 2018-10-22 05:41:08 UTC https://padlet.com/romaforbes/adrian/wish/295299240 https://padlet.com/romaforbes/adrian/wish/295299318
MWM 4 point kneeling with breathing control
Get patient doing this reg at home
pelvic tilt in sitting as tolerated

]]> 2018-10-22 05:41:30 UTC https://padlet.com/romaforbes/adrian/wish/295299318 1. regress the movement into a flexion in 4-point kneel https://padlet.com/romaforbes/adrian/wish/295299323 2. reassure him on the resilient nature of the spine and that it was designed to move. avoiding movement by bracing all the time might actually by contributing to symptoms ]]> 2018-10-22 05:41:31 UTC https://padlet.com/romaforbes/adrian/wish/295299323 Patient advice and education – address any catastrophizing beliefs using the FABQ questionnaire. Build confidence by getting the patient to do exercises they were able to complete instead of something way too challenging https://padlet.com/romaforbes/adrian/wish/295299375 2018-10-22 05:41:54 UTC https://padlet.com/romaforbes/adrian/wish/295299375 Make patient aware of breath holding - breathing exercises before doing test https://padlet.com/romaforbes/adrian/wish/295299386 2018-10-22 05:41:57 UTC https://padlet.com/romaforbes/adrian/wish/295299386 https://padlet.com/romaforbes/adrian/wish/295299542 --> can get them to do what they can manage with already, and while doing that encourage

them to perform while being relaxed and not using maladaptive things

--> can get them to do directional perference, if you get centralization it shows that mvmt can be helpful

]]> 2018-10-22 05:43:21 UTC https://padlet.com/romaforbes/adrian/wish/295299542 romaforbes https://padlet.com/romaforbes/adrian/wish/303078878 Address findings on FABQ
Choose position that would be tolerated to start flexion
Breathing control on flexion in 4 point kneel
progress to sitting and standing ]]> 2018-11-12 01:23:30 UTC https://padlet.com/romaforbes/adrian/wish/303078878 romaforbes https://padlet.com/romaforbes/adrian/wish/303079283 1. Debunking myths, consider what they want to find out, who have they seen about it in the past
2. Ask if work is supportive, have they had time off? Show them statistics about people who don't return ASAP
3. Work together and listen to find easing strategies, breathing, exercises etc. ]]> 2018-11-12 01:25:53 UTC https://padlet.com/romaforbes/adrian/wish/303079283 romaforbes https://padlet.com/romaforbes/adrian/wish/303079324 1- A&E = initial injury healed. Explain chronic pain

2- Teach patient 4pt kneel motor control and possible progression

3- SLider with progression to possible tensioner. ]]> 2018-11-12 01:26:08 UTC https://padlet.com/romaforbes/adrian/wish/303079324 romaforbes https://padlet.com/romaforbes/adrian/wish/303079367 1- A&E = initial injury healed. Explain chronic pain

2- Teach patient 4pt kneel motor control and possible progression

3- SLider with progression to possible tensioner. ]]> 2018-11-12 01:26:28 UTC https://padlet.com/romaforbes/adrian/wish/303079367 romaforbes https://padlet.com/romaforbes/adrian/wish/303079465 1. address beleifs and expectations that flexion is harmful

2. sliders to reduce mechanosensitivity

3. encourage her to start exercising and moving again, asking her what sort of activities she enjoys doing/graded exercise

4. deep breathing to help decrease bracing?]]> 2018-11-12 01:26:51 UTC https://padlet.com/romaforbes/adrian/wish/303079465 priorities romaforbes https://padlet.com/romaforbes/adrian/wish/303079664 1. advice and education: explain how the nervous system works, disc bulge is very common and doesn't always correlate to symptoms; good prognosis for her condition
2. pain management exercises: cat cow and knee side to side exercises
3. graded re-exposure to functional tasks. Flare ups are normal and ok]]> 2018-11-12 01:27:54 UTC https://padlet.com/romaforbes/adrian/wish/303079664 romaforbes https://padlet.com/romaforbes/adrian/wish/303079767 1. Address any catastrophizing thoughts or misunderstanding
2. Pain management - heat, icing, soft tissue techniques
3. motor control exercises - lumbopelvic dissociation, finding neutral spine, ]]> 2018-11-12 01:28:09 UTC https://padlet.com/romaforbes/adrian/wish/303079767 Priorities romaforbes https://padlet.com/romaforbes/adrian/wish/303079779 1. Education
2. Reassurance
3. Short term goals (reduce fear of movement)]]> 2018-11-12 01:28:14 UTC https://padlet.com/romaforbes/adrian/wish/303079779 management romaforbes https://padlet.com/romaforbes/adrian/wish/303079819 1. correct unhelpful beliefs and explain the complexity of nervous system and pain
2. encourage exercise, start with what patient is confident and gradually progress
3. give reassurance that our lumbar is stable and adaptable ]]> 2018-11-12 01:28:26 UTC https://padlet.com/romaforbes/adrian/wish/303079819 romaforbes https://padlet.com/romaforbes/adrian/wish/303079832 1. Advice and education- the spine is a really stable structure!
2. Passive ROM- reduce fear avoidance
3. Motor Control- 4pt kneel sit to heels

]]> 2018-11-12 01:28:31 UTC https://padlet.com/romaforbes/adrian/wish/303079832 Priorities * romaforbes https://padlet.com/romaforbes/adrian/wish/303079883 - get them to move back
- LP dissociation
- graded exercise program ]]> 2018-11-12 01:28:52 UTC https://padlet.com/romaforbes/adrian/wish/303079883 romaforbes https://padlet.com/romaforbes/adrian/wish/303080171 reduce cognitive threat
plan for graduated return to meaningful actvities
Mobilisation with movement
start small exercises/movements that are seen as safe]]> 2018-11-12 01:30:15 UTC https://padlet.com/romaforbes/adrian/wish/303080171 Specific MT technique where patient Adrian actively moves - MWM to flex in 4 pt kneel romaforbes https://padlet.com/romaforbes/adrian/wish/312593961 2018-12-09 07:10:43 UTC https://padlet.com/romaforbes/adrian/wish/312593961 address beleifs and expectations re pain and injury - relay role of movement and restoring ROM through frequent ROM exercises with relaxed breathing romaforbes https://padlet.com/romaforbes/adrian/wish/312593997 2018-12-09 07:11:25 UTC https://padlet.com/romaforbes/adrian/wish/312593997