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Evidence-Based Examination of the Lumbar Spine: An Update

presented by Chad Cook, PT, PhD, MBA, FAPTA, FAAOMPT

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Disclosure Statement:

Financial: Chad Cook receives compensation from MedBridge for this course. He also is a research consultant for Hawkins Foundation of the Carolinas. Chad Cook receives royalties from Pearson education, Maitland Australian Physiotherapy Association, AgenceEBP, and is a paid associate editor for JOSPT.

Non-Financial: Chad Cook is a senior associate editor for BJSM and is an editorial board member for J Physiotherapy and JMMT.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 74 Minutes; Learning Assessment Time: 62 Minutes

In this course, users will evaluate the impact and prevalence of lumbar dysfunction, understand the imperative patient history elements of a low back examination, and identify which patient history components are affiliated with lumbar pathology. The most common forms of self-reported outcome measures for the lumbar spine are presented and discussed. Viewers will also identify the most prevalent red flags germane to the lumbar spine examination and differentiate the purposes of each diagnostic test for sinister problems. An objective is to synthesize the importance of specific, meaningful clinical findings during the examination process and evaluate the benefit of palpation and manual muscle testing as part of a dedicated clinical examination. Lastly, viewers will identify the most diagnostic lumbar-spine-oriented special tests and apply the tests to the appropriate diagnoses. Current research is presented throughout the course to provide learners with the proper tools for evidence-based management of these patients. This course is part of a comprehensive clinical series covering examination and intervention for the cervical, thoracic, and lumbar spine, as well as the upper (shoulder, elbow, wrist, and hand) and lower (hip, pelvis, knee, foot, and ankle) quarters.

Meet Your Instructor

Chad Cook, PT, PhD, MBA, FAPTA, FAAOMPT

Chad Cook, PT, PhD, MBA, FAPTA, FAAOMPT, is a professor at Duke University and the program director of the Doctor of Physical Therapy division with a Category A appointment in the Duke Clinical Research Institute. He is a clinical researcher, physical therapist, and profession advocate with a long-term history of clinical care excellence and service…

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Chapters & Learning Objectives

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1. Lumbar Spine Dysfunction: Prevalence and Economic Impact

In this chapter, learners will evaluate the economic impact of lumbar dysfunction and consider the prevalence/incidence of lumbar pain and how it influences clinical practice. The overall burden of lumbar pain is discussed in comparison to other musculoskeletal and nonmusculoskeletal conditions worldwide.

2. Patient History and Outcomes Measures

In this chapter, learners will discuss the imperative patient history elements of a low back examination and define which patient history components are affiliated with lumbar pathology. Learners will also discuss the most common forms of self-reported patient outcome measures, as well as their validity.

3. Observation

In this chapter, learners will identify the link between observation of posture and lumbar pain or dysfunction. Learners will also identify the benefits of general observation of a patient’s expression of fear, anxiety, or distress.

4. Triage and Screening

In this chapter, learners will identify the most prevalent red flags germane to the lumbar spine examination. The chapter will compare and contrast the purposes of each diagnostic test for sinister problems. Learners will also analyze the triggers that would prompt the use of a test for ruling out a condition, and evaluate the benefit of performing these “ruling out” actions first within the examination. Lastly, learners will understand structural differentiation.

5. The Movement Examination of the Lumbar Spine

This chapter will synthesize the importance of the movement assessment and will contrast the goals of the three primary phases of the initial examination.

6. Palpation, Muscle Endurance, and Physical Performance Measures

This chapter will evaluate the benefit of palpation as part of a dedicated clinical examination. Learners will also evaluate the benefit and types of manual muscle testing for the lumbar spine.

7. Confirmation-Based Special Tests

In this chapter, learners will understand the language of diagnostic accuracy and will identify the most diagnostic lumbar-oriented special tests. The purpose of the chapter is to apply the tests to the appropriate diagnoses for better patient management.

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