Low Back Pain

A mother with LBP came into the OT clinic. She has a 1.5 year old who she is having a difficult time taking care of because her back pain would worsen. What do you, as the OT clinician, should recommend she do? a)Perform bathing in a portable tub on an elevated surface. b)To left a child from the ground, the mother should bend at the waist and lift the child by the armpits. c)Hire a nanny d)Tell the child to jump and the mother will catch the child in mid air

a)Perform bathing in a portable tub on an elevated surface.

What is true about sitting for a client with LBP? a)a firm armed chair that is supportive and not too low is recommended over a soft couch. b)To reduce stiffness, the client should not sit longer than 3 minutes. c)While working at a desk, the chair should allow the client with LBP to have their feet dangling from the edge of the chair. d)It is recommended to sit in the tub while bathing.

a)a firm armed chair that is supportive and not too low is recommended over a soft couch.

Which is the key to lower back pain client success and the foundation to build the rest of the intervention upon? a)An ADL obstacle course b)Client education of basic spinal anatomy and physiology c)energy conservation d)PAMs

b)Client education of basic spinal anatomy and physiology (helps the client understand what is occurring with movement while engaging in an occupation that results in pain.

If you are instructing a LBP client to use the logroll technique to lie back down in bed, what would you tell him/her to do? a)Plop down on the edge of bed, lie down, and then scoot your LE and trunk into alignment b)Sit down on the edge of bed, lower body to lie down on one side by raising legs and lowering head at the same time. Use arms to assist in moving without twisting. c)b)Sit down on the edge of bed, lower body to lie down on one side by raising legs and lowering head at the same time. Use arms to assist in moving while twisting d)any of the above is recommended

b)Sit down on the edge of bed, lower body to lie down on one side by raising legs and lowering head at the same time. Use arms to assist in moving without twisting.

All of the following are part of energy conservation principles a person with LBP can use EXCEPT: a)planning ahead b)pacing oneself c)setting priorities d)eliminating unnecessary tasks e)balancing activity with rest f)learning one's activity tolerance g)do everything in one session

g)do everything in one session

Body mechanics for back stabilization

1. maintaining a straight back 2. bending from the hip 3. avoiding twisting 4. maintaining good psoture 5. carrying objects close to the body 6. lifting with the legs 7. using a wide base of support 8. reduce back stress while standing 9. Avoid any twisting of the back during activities

Common adaptive equipment for persons with lower back problems (LBP)

1. Long handled sponges or brushes 2. reachers 3. long handled shoehorns 4. sock aids 5. elevated commodes or toilet seats 6 hand held shower sprayers 7. foot stools

Chair ergonomics for person with LBP

1. Provide back support 2. Maintain the hips and knees at 90 degree 3. with feet flat on the floor or on a foot rest

Squat

A movement in which a client keeps the back straight while maintaining neutral spine and squats.

T/F The client's ability to perform a squat is irrelevant to any knee or hip pathology.

FALSE (REQUIRES AN ABSENCE OF KNEE/HIP PATHOLOGY

T/F For a person with LBP, a bath is usually better than a shower.

FALSE (SHOWER IS BETTER THAN A BATH)

T/F A simple plastic lawn chair placed in the shower stall with bare feet can be used for a person with significant LBP

FALSE (the feet of the chair must be outfitted with nonskid safety feet)

T/F It is also recommended that a client with LBP grab onto towel bars, countertop, tub, or tissue holder when lowering themselvesv onto a toilet.

FALSE (this jeopardizes their safety, which may cause further injury. They will also be using lateral flexion or twist their backs)

Golfer's lift

Lifting movement in which the individual bends at the hips while raising one leg behind.

Diagonal lift

Movement where the lift is performed with one foot in front of the other and the legs shoulder length apart.

Read up on Spine Anatomy

Page 1093 Pedretti, 2013

T/F During an acute episode of back pain, a client can use the toilet by straddling the seat and facing the back of the toilet.

TRUE

T/F Keeping all items within easy reach in the shower makes showering easier.

TRUE

T/F Long handled scrub brushes or sponges allow washing of the back, legs, and feet without bending and twisting

TRUE

T/F When sitting in the tub, the LBP client should always use a bath mat to reduce the chance of slipping and drain the water before attempting to get out

TRUE

If you are instructing a LBP client to logroll out of bed from supine, what would you tell him/her to do: a)bend the knees while supine, cross your arms, roll onto side of body, push up with arms while coming up to sitting position. b)roll as a unit off the bed onto a soft surface c)cross your arms, roll onto side of body, and swing your body up into a sitting position d)any of the above is recommended

a)bend the knees while supine, cross your arms, roll onto side of body, push up with arms while coming up to sitting position.

Methods to promote stress reduction and coping in a person with LBP

a)relaxation techniques b)deep breathing c)meditation d)prayer e)guided imagery

Which would you recommend a client with LBP to do when sleeping? a)Purchase a feather or water bed. b)Stack 4 pillows to lay your head on c)Place a pillow under the knees while sleeping on the back. d)While lying on the side, client should sleep with top leg crossed over bottom leg. e)If sleeping on stomach, put a small pillow under the stomach, which will take stress off the lower back region.

c)Place a pillow under the knees while sleeping on the back.

After a client with LBP uses the toilet, how should the client turn to flush the toilet? a)Stand where the client is at and twist UB to reach lever. b)Have someone else do it for them c)Turn all the way around to face the toilet and flush d)After perihygiene, remain seated, and twist to flush

c)Turn all the way around to face the toilet and flush

On the basis of a lower back pain client's evaluation, the OT may include all of the following EXCEPT: a)Education regarding normal back anatomy and the physiology of back movement as they relate to performance of occupations b)Use of neutral spine back stabilization in occupational performance to reduce pain c)Education in basic body mechanics d)Educate client to sit down in a chair while not bending hips past 90 degrees e)Training in the use of energy conservation f)Education in strategies for pain management, stress reduction, and coping.

d)Educate client to sit down in a chair while not bending hips past 90 degrees

How would you, as an OT, recommend a client with LBP complete activities at bathroom sink? a)Bend forward to complete sink activities b)Stay up right with one foot on the ledge of the cabinet under the sink or bend forward and bear weight through one knee while abducting the other leg in the air. c)Stay up right with one foot on the ledge of the cabinet under the sink or bend forward and bear weight through one knee while abducting the other leg in the air. d)Stay up right with one foot on the ledge of the cabinet under the sink or bend forward and bear weight through one knee while extending a straight leg back for balance and support and maintaining a neutral spine position.

d)Stay up right with one foot on the ledge of the cabinet under the sink or bend forward and bear weight through one knee while extending a straight leg back for balance and support and maintaining a neutral spine position.

Typically, back pain is a result of all EXCEPT: a)poor physical fitness b)obesity c)reduced muscle strength and endurance d)anterolateral hip precautions e)poor body mechanics

d)anterolateral hip precautions

_____ ______ is probably the strongest personal predictor of incurring back trouble. a)emotional intelligence b)sensory profile c)tactile defensiveness d)social class

d)social class

You, as an OT, are making recommendations for a client with LBP regarding dressing. The following recommendations should be made EXCEPT: a)sit while dressing and keep the back straight b)lie flat on the bed while pulling clothing up c)Bend forward when getting dressed d)Bring foot to rest on the knees to don and doff socks and shoes e)Slip on shoes are easier than lace up shoes f)Thread a belt through the belt loops before donning pants g)eat different textured food h)c and g

h)c and g