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This Concept Map, created with IHMC CmapTools, has information related to: Case 10 - Sara Nugent - Spondylolisthesis Part II, Sara special tests compress SI joint posteriorly positive for pain/provocation of sx Sara is negative, Sara special tests prone instability test, spondylolsthesis grades I - 0-25% slippage II - 26-50% III - 51-75% IV - 76-100% *surgery for Grade III/IV, Sara Intervention core stabilization abdominal bracing for lordosis deep abdominal exercises Eval of Specific Stabiliing Exercise in the Tx of Chronic LBP with Radiologic Dx of Spondylolysis or Spondylolisthesis (O'Sullivan, Phyty et. al, 1997), spondylolsthesis s/sx Sx: radiating pain inceased painin lumbar extension pain c STS decreased pain c flexion decreasd pain stand --> sit Signs: step deformity hypermobility c involved segment c PROM testing, Sara dx instablity, Part II - Sara PT diagnosis 16 yo gymnast 8 months s/p lumbar decompression c spinal fusion L45 return to high school abnormal arthrokinematics limit her ability in ADL's and IADL's, Part II - Sara exam assess for: ms spasm posture ms length impairments hypo/hypermobility - arthrokinematics, Prozac effects SSRI indicated for depression, OCD, eating disorders increased risk of suicide in adolecents nervousness, nausea, dry mouth, weight loss, excessive happiness severe SE - rash, fever, swelling, hallucinations be aware of suicidal thoughts, panic attacks, change in sleeping behavior, Intervention duration 4-6 weeks minimum for PT, Intervention hypermobility PA start Grade I and progress to higher grades hot pack TENS, Sara special tests straight leg raise assessent for neural tension Sara is positive for hypermobility, Sara s/sx * signs pain with prolonged sitting 8/10 hypermobility flexibiliy - hamstring, hip abductors & limited iliopsoas & ITB increased tone in lumbar parspinals L345, Sara special tests Gower test forward flexion @ hips & pt asked to recover position positive is if pt needs to use their hands to move back up Sara is positive, Part II - Sara Oswestry 44% "severe disability", spondylolsthesis L45 most common dx by x-ray - oblique view "Scottie dogs" deformity or hypermobility MRI & CT Scan, Part II - Sara exam UQS/LQS see lab notes, spinal fusion welding process option for source of pain spinal decompression mvmt precautions: 4-6 months avoid twisting, reach, bend forward avoid lifting ɱ lbs cautious with sneezing, coughing, etc avoid prolonged sitting - hips above knees if do sit, Sara special tests pelvic mobility palpate PSIS positive for lack of stabiliy pt lifts leg as marching & PT assess mobility, Sara special tests slump test neural test positive for pain & provocation of sx Sara is negatve