Implementing Physiotherapy Practices for Lower Back Pain

FT PRACTICE FOR BACK PAIN LOWER/LOW BACK PAIN(LBP) 5.2. Implementation 5.2.1. Tools preparation  Mechanical lower back pain case scenario  Examination bed  Blank clinical management  Tensimeter and stethoscope  Vital sign measurement  Convey the purpose/purpose of measuring blood pressure, pulse frequency and respiratory frequency to the patient status report to record all physiotherapy 5.2.6.1. Tension measurement  Free the patient's upper arm from clothing  Place the cuff on the patient's upper arm with the lower border  2 cm above the cubital fossa  Feel the presence of a.brachial pulse on the medial side of the cubital fossa. Place the stethoscope in the ear, and the stethoscope membrane in the area where the a.brachial pulse can be felt.  Tighten the fastener then pump the pump quickly to 180 to 200 mmHg  Loosen the fastener slowly (lowering speed does not exceed  3 mmHg/second) while listening to the systole and diastole  Convey the measurement results to the patient.  Record the measurement results 5.2.6.2. Pulse measurement  Prepare a watch/stopwatch  Feel with three fingers for a radial pulse on the radial side of the ventral wrist  Count the number of beats in one minute.  Convey the measurement results to the patient.  Record the measurement results 5.2.6.3. Measurement of respiratory frequency  Prepare a watch/stopwatch  Hold the patient's hand as if to measure the pulse to distract the patient  While observing chest/abdominal movements, count the number of breaths in one minute  Convey the measurement results to the patient.  Record the measurement results 5.2.7. Inspection 5.2.7.1. Static inspection  Observe vertebral compensatory curves (scoliosis, hyperlordosis & kyposis)  Observe the symmetrical/normal position of the right and left legs.  Observe the symmetrical/normal position of the right and left shoulders.  Observe facial expressions, whether they are experiencing pain. Record the results of the examination 5.2.7.2. Dynamic inspection  The patient is asked to walk then observe the normality of the patient's walking  The patient is asked to squat to stand and bend to determine the mobility of the Lumbar Vertebrae, hip, knee and ankle.  Record the results of the examination. 5.2.8. Palpation  Press the right and left areas of the lumbar vertebrae determine the tension of the paravertebral muscles.  Press the complaint area with three fingers (pressure using the palmar tip of the finger) to determine the presence of tenderness.  Record the results of the examination 5.2.9. Motion check 5.2.9.1 Position the patient supine to a. Passive movements carried out by Hip practitioners: flexion, abduction, adduction, Trunk: right-left lateral flexion movement b. Active movements carried out by the patient Hip: flexion, abduction, adduction movements Trunk: lateral movements flexion right-left c. Isometric movements: Hip: movement against resistance towards flexion, abduction, adduction. Trunk: movement against flexion. resistance towards left and right lateral 5.2.9.2 Position the patient face down a. Passive movements carried out by the practitioner: Hip: extension movement Trunk: extension movement b. Active movements carried out by Hip patients: extension movements Trunk: extension movement c. Isometric movements: Hip: extension movement Trunk: extension movement 5.2.9.1. Active movement check  The practitioner instructs the patient to stand up, then the patient moves the lumbar vertebrae in the direction of flexion, extension, right lateral flexion, left lateral flexion, rotation.  Observe LGS, rhythm of movement, speed of movement, and pain.  The patient is asked to move the hip in the direction of flexion and extension then observe the LGS, rhythm of movement, speed of movement, and pain.  Record the measurement results whether there is limited movement or not and whether there is movement pain or not. 5.2.9.2. Passive movement examination a. Examination of movement in the supine position.... b. Prone position movement examination.... c. The patient is asked to sleep on his back, practice beside the patient and then do passive movements of the hip in the direction of flexion, extension, endorotation and exorotation. These movements are carried out to determine the limitations of movement. d. Record the measurement results to see if there are limitations in movement, changes in endfeel and movement pain.