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Low Back Standing Exam

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1. Exam Series: Guide to the Back Exam

of the cervical spine. Assess for flexion, extension, and lateral flexion (fingers should touch the fibula) of the back, ensuring that the patient keeps their leg straight and recognizing that tight hamstrings may limit range of motion. Rotation is best assessed with the patient seated in order to isolate movement of the back from the hips. A power examination of the back is not necessary. GI/GU exam : A digital rectal exam is required to assess tone if there are any concerns for cauda equina. A post void (...) . Wikipedia. . Accessed 2018. 2. Corwell B. Back Pain. In: Rosen’s Emergency Medicine . 9th ed. Elsevier; 2018:275-284. 3. Sudhir A, Perina D. Musculoskeletal Back Pain. In: Rosen’s Emergency Medicine . 9th ed. Elsevier; 2018:569-576. 4. Moore D. Lower Extremity Spine and Neuro Exam. Orthobullets. . . Accessed 2018. [ ] 5. Chou R, Fu R, Carrino J, Deyo R. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet . 2009;373(9662):463-472. [ ] 6. Jarvik J, Gold L, Comstock B, et al

2018 CandiEM

2. Low Back Standing Exam

Walk on heels (L5 root) Walk on toes (S1 root) Tandem Walk may suggest cerebellar disorder(e.g. ) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Low Back Standing Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Examination About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency (...) Low Back Standing Exam Low Back Standing Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Low Back Standing Exam Low Back Standing

2018 FP Notebook

3. Is standing balance altered in individuals with chronic low back pain? A systematic review. (Abstract)

Is standing balance altered in individuals with chronic low back pain? A systematic review. To examine the static standing balance of individuals with chronic low back pain when compared to a healthy control group.A search of available literature was done using PubMed, SPORTDiscus, CINAHL, and Scopus databases. Studies were included if they contained the following: (1) individuals with chronic low back pain 3 months or longer; (2) healthy control group; (3) quantified pain measurement; and (4 (...) back pain had poorer performance overall compared to healthy controls. Despite inconsistencies in statistical significance, effect sizes were frequently large, indicating a lack of sufficient power in the included studies. Data were insufficiently reported among certain studies, limiting the ability of direct study comparison.Results suggest that balance is impaired in individuals with chronic low back pain when compared to healthy individuals. Implications for rehabilitation Static balance

2018 Disability and rehabilitation

4. Diagnosis and Treatment of Low Back Pain

Diagnosis and Treatment of Low Back Pain Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis & Treatment of Low Back Pain 7075 Veterans Blvd Burr Ridge, IL 60527 630-230-3600 www.spine.org © 2020 North American Spine Society 978-1-929988-65-5Diagnosis & Treatment of Low Back Pain | Preface Recommendations were developed based on a specific definition, inclusion/exclusion criteria, and the resulting literature which excluded conditions such as presence (...) of a neurological deficit or leg pain experienced below the knee, among others. Given the exclusion criteria, these guideline rec- ommendations address a subset of low back pain care as opposed to low back pain in its entirety. This clinical guideline is not intended to be a fixed treatment protocol; it is anticipated that there will be patients who require more or less treatment than what is outlined. This clinical guideline should not be construed as including all proper methods of care or excluding other

2020 North American Spine Society

5. Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Low Back Pain

Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Low Back Pain Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis & Treatment of Low Back Pain 7075 Veterans Blvd Burr Ridge, IL 60527 630-230-3600 www.spine.org © 2020 North American Spine Society 978-1-929988-65-5Diagnosis & Treatment of Low Back Pain | Preface Recommendations were developed based on a specific definition, inclusion/exclusion criteria, and the resulting (...) literature which excluded conditions such as presence of a neurological deficit or leg pain experienced below the knee, among others. Given the exclusion criteria, these guideline rec- ommendations address a subset of low back pain care as opposed to low back pain in its entirety. This clinical guideline is not intended to be a fixed treatment protocol; it is anticipated that there will be patients who require more or less treatment than what is outlined. This clinical guideline should not be construed

2020 American Society of Regional Anesthesia and Pain Medicine

6. Examining Racial and SocioEconomic Disparities (ERASED) in Chronic Low Back Pain Study

Examining Racial and SocioEconomic Disparities (ERASED) in Chronic Low Back Pain Study Examining Racial and SocioEconomic Disparities (ERASED) in Chronic Low Back Pain Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Examining Racial and SocioEconomic Disparities (ERASED) in Chronic Low Back Pain Study (ERASED) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03338192 Recruitment Status : Recruiting First Posted

2017 Clinical Trials

7. Examining the Role of Coaching in Health-system Transformations

Examining the Role of Coaching in Health-system Transformations 8 JUNE 2017 Rapid Synthesis Examining the Role of Coaching in Health-system Transformations 8 January 2020 HEALTH FORUMMcMaster Health Forum 1 Evidence >> Insight >> Action Rapid Synthesis: Examining the Role of Coaching in Health-system Transformations 90-day response 08 January 2020 Examining the Role of Coaching in Health-system Transformations 2 Evidence >> Insight >> Action Rapid-Improvement Support and Exchange RISE’s mission (...) Waddell K, Evans C, Sharma K, Bullock H, Grimshaw JM, Lavis JN. Rapid synthesis: Examining the role of coaching in health-system transformations. Hamilton: McMaster Health Forum, 8 January 2020. Product registration numbers ISSN 2292-7999 (online)McMaster Health Forum 3 Evidence >> Insight >> Action KEY MESSAGES Questions • What is the role of coaching in implementing health-system reforms at different levels (i.e., interorganizational, organizional and practice)? • What does coaching look like

2020 McMaster Health Forum

8. Are opioids effective in the treatment of chronic low back pain? Full Text available with Trip Pro

for these figures comes from the National Health and Nutritional Examination Survey, in which 14.5% of . 5 Previously, the best evidence to support the use of opioids for chronic low back pain–and the evidence on which the three organizations based their recommendations–came from a few dozen short-term randomized controlled trials comparing the use of opioids against placebo for the treatment of back pain. A meta-analysis published in 2016 in JAMA Internal Medicine analyzed the results from 13 of these trials (...) Are opioids effective in the treatment of chronic low back pain? Are Opioids Effective in the Treatment of Chronic Low Back Pain? – Clinical Correlations Search Are Opioids Effective in the Treatment of Chronic Low Back Pain? April 17, 2019 4 min read By Anna Hirsch Peer Reviewed The use of opioid medications for chronic low back pain, or for any chronic non-cancer pain complaint, is still a source of controversy in the medical community, with a large divide between the recommendations

2019 Clinical Correlations

9. Low Back Pain, Adult Acute and Subacute

of hip range of motion • Single leg balance and ability to maintain level pelvis for 30 seconds (lateral hip pain within 30 seconds may suggest gluteal tendinopathy) (Grimaldi, 2017) • Other examination of joints as indicated by history and initial exam • Additional examination including respiratory, gastrointestinal or genital urinary examination recom- mended, as indicated by history Poor lumbar segmental motion without neurologic findings could represent nonspecific or mechanical low back pain (...) Low Back Pain, Adult Acute and Subacute Health Care Guideline: Adult Acute and Subacute Low Back Pain www.icsi.org Copyright © 2017 by Institute for Clinical Systems Improvement 1 Diagnosis Algorithm Text in blue in this algorithm indicates a linked corresponding annotation. Adult patient present with acute or subacute low back pain History and exam: • Pain characteristics • Sensory and strength changes • Prior treatment and response yes Complete assessment tools for pain and function

2018 Institute for Clinical Systems Improvement

10. Exam Series: Guide to the Knee Exam

, Move” Throughout the physical examination compare the asymptomatic to the symptomatic knee. The knee exam should be conducted with the patient supine, examining a knee in a chair or wheelchair can significantly compromise your exam! Every patient will have a different laxity to their joints at baseline, use the asymptomatic knee to get a sense of the patients baseline laxity. Pain with provocative movements without associated laxity suggests a ligament strain rather than a tear. Remember to assess (...) meniscus. To test for a lateral meniscus injury internally rotate the foot while applying a varus force and try to trap the meniscus throughout movement. : Flex the patient’s knee to 90° and apply pressure on the patient’s foot towards the distal femur. Pain with pressure suggests a meniscal injury. : Support the patient while they stand on the injured leg flexed to 20°. Ask them to rotate on the tibia back and forth, assessing for joint line pain or mechanical symptoms. Test Sensitivity Specificity

2018 CandiEM

11. Low back pain and radicular pain: development of a clinical pathway

-medicalisation and medical over-consumption 4 . Moreover, a lot of caregivers are involved in the management of low back and radicular pain, from the first line to second or third line and a large practice variation is noticed, also in a small country as Belgium. 5 A lack of integration is also suspected between the modes of care and settings (e.g. inpatient, outpatient, emergency department, pain clinics) with a risk of duplicate exams and improper treatments. KCE Report 295 Low back pain and radicular pain (...) do not have back pain at all. Radicular pain should be differentiated from other causes of leg pain, such as coxarthrosis, gonarthrosis or gluteal tendinopathies. Typical for radicular pain is that the pain: • Usually follows one (or several) dermatome patterns; • Usually can be provoked: in disc herniation patients by flexion (Valsalva-manoeuvers, straight leg raising test, bending or sitting); in stenosis patients by extension (standing, walking) 14 Low back pain and radicular pain: development

2017 Belgian Health Care Knowledge Centre

12. Low back pain and radicular pain: evaluation and management

NICE METHODOLOGY 19 2.5.1 Searching for evidence 19 2 Low back pain and radicular pain KCE Report 287 2.5.2 Grading evidence 20 2.6 ANALYSIS OF NICE REVIEW 22 2.7 FORMULATION OF RECOMMENDATIONS 23 2.8 EXTERNAL REVIEW 26 2.8.1 Healthcare professionals (stakeholders) 26 2.9 FINAL VALIDATION 26 3 CLINICAL RECOMMENDATIONS 26 3.1 ASSESSMENT OF LOW BACK PAIN AND RADICULAR PAIN 26 3.1.1 History taking and clinical examination 26 3.1.2 Risk assessment and stratification 29 3.1.3 Imaging 35 3.2 NON-INVASIVE (...) highlighted however the potential utility of a combination of clinical tests and confirmed that a history taking and a clinical examination (including testing motor) is needed to exclude the presence of symptoms or signs suggestive of possible serious underlying pathology (red flags). This is linked with another NICE recommendation based on consensus and included in the NICE chapter on imaging: “Think about alternative diagnoses when examining or reviewing people with low back pain, particularly

2017 Belgian Health Care Knowledge Centre

13. Biomechanical features of sit-to-stand and stand-to-sit in patients with low back pain: a systematic review

Biomechanical features of sit-to-stand and stand-to-sit in patients with low back pain: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation (...) different true effects are likely to exist. The random-effects model takes into account both the within-study (sampling error) and between-study (differences in the true effect size) variance. Should the excessive between-study variance be very low or zero, the random-effects model will yield the same results as the fixed-effect model. For further details, see the and to pre-clinical meta-analysis. Example: Because of the exploratory nature of animal studies, a random effects model will be used

2017 PROSPERO

14. AIUM/IUGA Practice Parameter for the Performance of Urogynecological Ultrasound Examinations

on the perineum. Obtain a midsagittal image containing the inferoposterior AIUM Practice Parameter for the Performance of Urogynecologic Ultrasound Examinations 852 J Ultrasound Med 2019; 38:851–864symphyseal margin and urethra in the front and the anal canal in the back (Figure 1). Measure the bladder length and the perpen- dicular anteroposterior diameter to determine residual urine. Measure the detrusor wall thickness (Figure 2). 2. Perform a dynamic assessment of the pelvic?oor. a. Compare split-screen (...) of at least 6 seconds’ dura- tion, document organ descent against a horizontal line placed through the inferior symphyseal margin (Figure 4). 5 Note: Care should be taken to avoid levator coactiva- tion. 6 While most examinations for pelvic organ descent can be carried out supine, persistent levator coactivation sometimes requires imag- ing in the standing position. However, ultra- sound threshold values for “normal” organ descent are varied in the literature and have not beenwellestablished. 7–9

2019 American Institute of Ultrasound in Medicine

15. Diagnosis and Treatment of Low Back Pain

. Recommendations # Recommendation Strength* Category† A. Diagnostic Approach 1. For patients with low back pain, we recommend that clinicians conduct a history and physical examination, that should include identifying and evaluating neurologic deficits (e.g., radiculopathy, neurogenic claudication), red flag symptoms associated with serious underlying pathology (e.g., malignancy, fracture, infection), and psychosocial factors. Strong for Reviewed, Amended 2. For patients with low back pain, we suggest (...) in the future. Identifying areas where evidence was lacking for the 2017 CPG can help identify priority areas for future research. Future studies examining the results of LBP CPG implementation may lead to the development of new evidence particularly relevant to clinical practice. VA/DoD Clinical Practice Guideline for Diagnosis and Treatment of Low Back Pain September 2017 Page 20 of 110 V. Guideline Work Group Guideline Work Group* Department of Veterans Affairs Department of Defense Sanjog Pangarkar, MD

2017 VA/DoD Clinical Practice Guidelines

16. Can standing back extension exercise improve or prevent low back pain in Japanese care workers? Full Text available with Trip Pro

Can standing back extension exercise improve or prevent low back pain in Japanese care workers? We suggested a standing back extension exercise 'One Stretch' based on the McKenzie method, to examine the ability to improve or prevent low back pain (LBP) in Japanese care workers.We conducted a single-center, non-randomized, controlled study in Japan. Care workers in an intervention group received an exercise manual and a 30-minute seminar on LBP and were encouraged with a group approach, while

2016 The Journal of manual & manipulative therapy Controlled trial quality: uncertain

17. Reducing Sedentary Behavior to Decrease Low Back Pain: Stand Back Study

Reducing Sedentary Behavior to Decrease Low Back Pain: Stand Back Study Reducing Sedentary Behavior to Decrease Low Back Pain: Stand Back Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Reducing (...) Sedentary Behavior to Decrease Low Back Pain: Stand Back Study (StandBack) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02624687 Recruitment Status : Completed First Posted : December 8, 2015 Results First Posted : February 19, 2019 Last Update Posted : March 13, 2019 Sponsor: University of Pittsburgh

2015 Clinical Trials

18. Imaging in Patients with Low Back Pain

. – Moderately Recommended Standing or weight-bearing MRI for any back or radicular pain syndrome or condition – Not Recommended Routine CT for acute, subacute, or chronic non-specific LBP, or for radicular pain syndromes – Not Recommended CT for patients with acute or subacute radicular pain syndrome that has failed to improve within 4 to 6 weeks and there is consideration for an epidural glucocorticoid injection or surgical discectomy – Recommended SPECT for the evaluation of patients with low back pain (...) Imaging in Patients with Low Back Pain Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

19. "Examination of the Impact of a Dynamic Flexion Orthosis (Dynaflex®Ottobock) or of a Back Bandage (Lumbo Sensa®Ottobock) on the Voluntary Activation of the Back Muscles in Patients With Specific Back Pain"

conditions to examine, if the particular technical aid has a positive impact on pain-related activation of the back muscles. Condition or disease Intervention/treatment Phase Back Pain Device: Lumbo Sensa® bandage Device: Dynaflex® flexion orthosis Not Applicable Detailed Description: Usually low back pain is accompanied by male and prolonged activation of the back muscles through the Central Nervous System. It has been proved that this male innervation pattern are often related to a to the spine (...) Flexion Orthosis (Dynaflex®Ottobock) on the Voluntary Activation of the Back Muscles in Patients With Specific Low Back Pain" and "Examination of the Impact of a Back Bandage (Lumbo Sensa®Ottobock) on the Voluntary Activation of the Back Muscles in Patients With Specific Low Back Pain" Study Start Date : September 2015 Estimated Primary Completion Date : December 2016 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment

2015 Clinical Trials

20. Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing Full Text available with Trip Pro

Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain (LBP) during prolonged standing. We examined asymmetry of lumbopelvic movement timing during a clinical test of active hip abduction in back-healthy people who developed LBP symptoms during standing (Pain Developers; PDs) compared to back-healthy (...) people who did not develop LBP symptoms during standing (Non Pain Developers, NPDs). Participants completed the hip abduction test while movement was recorded with a motion capture system. Difference in time between start of hip and lumbopelvic movement was calculated (startdiff). PDs moved the lumbopelvic region earlier during left hip abduction than right hip abduction. There was no difference between sides in NPDs. In PDs, the amount of asymmetry was related to average symptom intensity during

2016 Human movement science

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