Mk case study
Sponsored Links
This presentation is the property of its rightful owner.
1 / 21

MK Case Study PowerPoint PPT Presentation


  • 63 Views
  • Uploaded on
  • Presentation posted in: General

MK Case Study. Patient Profile. 22 year old man: bartender/student LBP onset 2 weeks ago (15 days) Spread to R gluteal pain 10 days ago. History. Onset AM after flag football game Gradual onset with return to work (bartender) Denies pain during game Previous Hx of ruptured Left RF

Download Presentation

MK Case Study

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


MK Case Study


Patient Profile

  • 22 year old man: bartender/student

  • LBP onset 2 weeks ago (15 days)

  • Spread to R gluteal pain 10 days ago


History

  • Onset AM after flag football game

    • Gradual onset with return to work (bartender)

  • Denies pain during game

  • Previous Hx of ruptured Left RF

  • No Rx

  • No Meds

  • No radiography


immediate with standing

Standing > 1/2 hr spreads to gluteal pain

Running immediate increase in LBP stopped activity

Prolonged sitting (>30) increases LBP

Sitting relieves 5”, immediate return with return to stand

Sit 15” to relieve

Cannot run

Must lay down 30” to relieve

Able to sit if on L ischium only

Aggravating …………Easing


Observation

  • Stands WB primarily L LE

  • Slight L shift (contralateral)

  • Corrected SB R Upper Lumbar


Objective

  • Flexion:

    deviates L, poor unrolling of lordosis

    limit finger tips to mid tibia

    No change in LB SM

    Correction of deviation some increase in pain improves range


Objective

  • Extension:

    0-5 degrees

    deviates to L

    Increases his comparable LBP

    correction increases c/o pain more


Objective

  • SB R 0-5 degrees

    -increased his LB pain

    - flattened curve

  • SB L 0-15 degrees

    - painless


Palpation

  • Hypomobility into extension L4 & L5

  • *Stiff & painful with central PA @ L4> L5

  • **Stiff & painful with R unilateral @ L4

  • Slight decrease pain with R unilateral @L5


Objective

  • Neurological: clear DTR, Myotome, Sensation

  • Special Test -


Pain scale

  • Patient: @ rest “4/10”

  • Standing > 30”: 8/10

  • Sitting > 3”: 3/10

  • Running: 0/10 stopped activity

  • Lifting: 1/10


Hip MobilityR L

  • Flexion140140

  • Extension 15 20

  • XR 60 60

  • IR 40 45

  • ABD 45 50

  • ADD 20 20


PSFS

  • Standing: 2

  • Sitting: 4

  • Running: 0

  • Lifting: 2

  • TOTAL =8 8/4 activities = 2


ODI & FABQ

  • Oswestry Score: 20 = 40%

  • FABQW: 19

  • FABQPA: 39


CPR

  • No Sm distal to knee

  • < 16 days

  • FABQW = 19

  • Hypomobility 4/5, 5/1 extension

  • Hip IR >35


CPR

  • No Sm distal to knee

  • 15 days

  • FABQW < 19

  • Hypomobility 4/5, 5/1 extension

  • Hip IR >35 both sides

  • Woahh ! 5/5 Positive Likelihood Ratio: infinite


Trial Treatment

  • Supine LS V GPM in RSB

    Post

  • painless in standing

  • Extension: 10 degrees, decreased deviation, painfree


Treatment 2

  • Pain: 3/10 at rest in standing

  • Extension: 10 degrees, then pain dev L

  • SB R 10 degrees, P+

  • Repeat V


Treatment 3Pre-Rx

  • Painscale: 1/10 rest

  • Extension: 15 degrees no deviation, no pain

  • SBR 15-20 degrees P-

  • Rx

    -Active extension/active exercise


Initial Re-test

  • Pain Scale: 6 1

  • PSFS: 2 8

  • Oswestry:20 5

  • FABQ:19 6


  • Login