Physical Therapy Management of the Patient with Low Back Pain – a Case-Based Motor Control Approach

Course Description

This webinar is designed to meet the continuing education needs of physical therapists and physical therapist assistants, as established by your accreditation body. Focused on the latest evidence-based practices in evaluation and rehabilitation of low back pain and injuries, the program will equip participants with the knowledge and skills necessary to effectively manage patient care throughout the rehabilitation journey.

The program starts with a review of lumbar spine anatomy, includes differential diagnosis, and outlines the different phases of a rehabilitation program based on pattern recognition for the different sub-types of low back pain. Participants will gain a thorough understanding of choosing and applying appropriate evaluation tests and measures, as well as sort through the appropriate application of specific therapeutic interventions based on the details of patient presentation. Pain management strategies, patient education, neurological and motor control re-education, therapeutic exercise, functional training and appropriate mobility and strengthening exercises will be covered.

Furthermore, the program emphasizes the critical role of motor control in the evaluation and rehabilitation of low back pain, and its impact on movement patterns. This ensures participants can design rehabilitation programs that not only address physical limitations but also promote optimal neuromuscular control and core stability for building improved functional mobility, as is recommended by current research on rehabilitation of patients with LBP.

Lastly, the course will include significant time spent on a case-based approach to patient care to allow participants to practice the knowledge they have learned. The patient case portion of the course will include diverse patient cases that will help the learner to process evaluation data and synthesize an appropriate treatment plan using real-world examples of actual patient presentation. Participants will leave this course with actionable skills that they can take with them to the clinic and begin using immediately.

By participating in this course, physical therapists and physical therapist assistants will be empowered to:

• Perform a thorough patient history that is specific to the needs of a patient with low back pain.
• Perform an organized quick scanning examination for the patient complaining of low back pain that is focused on efficiently compiling objective information for the purpose of pattern recognition.
• Differentially diagnose and recognize categories of low back pain and dysfunction based on patient demographics, history, pain presentation and objective findings using the Treatment Based Classification System.
• Develop holistic, individualized rehabilitation programs for the patient with low back pain that aligns with the Integrated Systems Model and is based on the evaluation findings, pattern diagnosis, specific patient needs and functional limitations.
• Explain how to optimize the addition of manual therapy techniques for the patient with low back pain, with a focus on removing barriers to optimal recovery and utilizing a test-retest model.
• Progress patients with low back pain through a rehabilitation program, incorporating core muscle activation, neuromuscular re-education and motor control exercises for improved function.
• Foster a collaborative approach to care for the patient with low back pain, working effectively with the referring provider and patients to achieve the best possible outcomes.

Course Objectives

At the end of this course, the participant will be able to:

Core Competencies:

• Implement evidence-based evaluation and rehabilitation techniques for patients presenting with low back pain.
• Subjectively and objectively scan patients with low back pain using evidence-based methods.
• Differentiate and diagnose the potential underlying pathoanatomical and pathomechanical causes of low back pain and dysfunction.
• Develop individualized rehabilitation programs tailored to patient presentation and needs.
• Explain the theory behind different manual therapy techniques for the removal of barriers and facilitation of patient movement.
• Explain how to progress patients through rehabilitation stages, emphasizing the assessment and promotion of motor control at each stage.
• Develop advanced patient education skills specific to the low back pain population that focus on patients taking ownership and control of their condition.
• Collaborate with patients and referring providers for optimal outcomes.

Module One Objectives: Anatomy, Biomechanics and Natural History as it Relates to Physical Therapy Examination, Differential Diagnosis and Categorization of the Patient with Low Back Pain.

• Define the anatomical boundaries of low back pain (LBP), including appropriate applied terminology.
• Recall the components of the lumbar motion segment.
• Summarize essential components of a subjective examination for the patient who complains of LBP as a method to begin the process of pattern recognition.
• Recognize red flags and non-mechanical sources of pain during the lumbar exam that may necessitate medical referral.
• Differentiate mechanisms of injury that lead to LBP for the purpose of pattern recognition in Physical Therapy.
• Describe an efficient sequence of easily reproducible objective measures for forming pattern recognition from a Physical Therapy lumbar scanning examination.
• Detail the performance of special tests, including neurological and neural mobility assessment, to aid in the classification of a patient’s LBP.
• Identify the three outcome categories following a Physical Therapy lumbar scanning exam with regards to patient disposition.
• Summarize clinical prediction rules and patient prognosticators that can be applied to Physical Therapy treatment planning for the patient with LBP.
• Review the categories of the Treatment Based Classification System (TBCS) for top-tier patient assessment and patient management.

Module Two Objectives: Reviewing Lumbar Scanning Exam and Applying Specific Treatment to Pattern Recognition in the Physical Therapy Treatment Planning for the Patient with LBP:

• Summarize additional Physical Therapy special tests, including muscle length and stability assessment as they relate to the patient with LBP.
• Review a brief focused sequence of Physical Therapy evaluation to clear the lumbo pelvic-hip complex as it relates to treatment of LBP.
• State key areas of observation and palpation for the lumbar spine and pelvis.
• Define the different categories of barriers and how they apply to sequencing treatment planning utilizing a “test-retest” approach.
• Review the current state of the literature regarding the efficacy of manual therapy interventions for patients with LBP.
• Identify and differentiate interventions targeted at removing soft tissue barriers, including but not limited to percussion massagers, cupping, IASTM, and manual massage.
• Explain the Integrated Model and describe its application to the holistic management of the patient with LBP.
• Differentiate methods for assessing and coaching the activation of key muscles.
• Sequence and perform core stabilization exercises of progressive difficulty based on motor control principles that are targeted at addressing the needs of the patient with LBP throughout the stages of their recovery.
• Propose and apply a well-balanced therapeutic exercise program (the pyramid principle) aimed at stratification of goals and proper treatment progressions.

• Prerequisites

  None

• Educational Level

  Intermediate

• Other

  Satisfactory completion of this course will require the participant to respond to polling questions asked throughout the webinar.