Abstract:
: Background: In Mechanical Diagnosis and Therapy (MDT), patients with low back pain (LBP) are classified into subgroups to guide a management strategy. A common subgroup where symptoms improve with lumbar extension is labeled posterior derangement syndrome. A less common subgroup where symptoms improve with lumbar flexion is labeled anterior derangement syndrome. Case Presentation: The patient was a 23-year-old woman with intermittent LBP and discomfort over the left lower extremity was initially diagnosis with posterior derangement syndrome. At the initial and second consultations, postural correction and home exercises with lumbar extension were prescribed. However, at the third consultation, sustained lumbar extension revealed worsening of symptoms and function, which resulted in a revised diagnosis of anterior derangement syndrome. Complete recovery was achieved using exercises with lumbar flexion over 6 weeks. Outcomes: The patient wore the LUMOback in daily life, which is a wearable device measuring pelvic angle and acceleration, for 1 week before the initial MDT consultation and for 6 weeks until discharge. The posture scores (%) is the proportion of time in a week with neutral pelvic tilt. In this patient, the posture score decreased greater than a minimum detectable change of 11.7% when MDT classification changed to anterior derangement. Conclusions : This case report indicates the importance of sustained loading to identify the correct derangement syndrome, and follow-up sessions to confirm or reject the initial diagnosis by monitoring symptom and functional changes carefully. Habitual posture may be associated with reduction and aggravation of symptoms.
journal_name
Physiother Theory Practjournal_title
Physiotherapy theory and practiceauthors
Takasaki H PT, PhD,May S PT, PhDdoi
10.1080/09593985.2018.1488906subject
Has Abstractpub_date
2020-04-01 00:00:00pages
533-541issue
4eissn
0959-3985issn
1532-5040journal_volume
36pub_type
杂志文章abstract::The effectiveness of exercise programs for chronic low back pain (CLBP) is dependent upon patient adherence which is problematic to measure accurately. This cross-sectional observational study aimed to compare patient-reported levels of adherence with physiotherapists' perceptions of patient adherence; and to explore ...
journal_title:Physiotherapy theory and practice
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journal_title:Physiotherapy theory and practice
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journal_title:Physiotherapy theory and practice
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journal_title:Physiotherapy theory and practice
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journal_title:Physiotherapy theory and practice
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journal_title:Physiotherapy theory and practice
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journal_title:Physiotherapy theory and practice
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pub_type: 杂志文章,随机对照试验
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journal_title:Physiotherapy theory and practice
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