|
Outcome measures and treatment strategies during chiropractic care. |
|||
| Tx#/Wk# |
Functional Outcomes |
Pain Control |
Flight/USMC Fitness Training |
|
|
|||
| 1/1 |
• VAS = 1.5 current, 7.1 upon waking, 9.5 worst •Medication needed for pain control • RMDQ = 5/24 • Significant pain with flight • Unable to run/do sit-ups |
• HVLAM [11] (T11-L2 & SI joint) • AMRT [12,13] & PIR or PCS [14] of (g. medius, g. max, QL and PVTs) • Home TrP Tx (g. medius) • Moist heat pack • See flight surgeon if pain increased |
• G. medius stretch (2 @ 30 sec) • Double knee-chest stretches (10 reps @ 10 sec each) • Continue stretches recommended by PT and DO • Walking, elliptical and bicycle to tolerance |
|
|
|||
| 5/5 |
• No sharp pain • No medication needed to control pain • Mild ache after flying high G several times per week • Minimal pain with activities of daily living |
Same as above |
As above + • Supine leg raises (Dead Bugs 50 reps) • Static crunch to tolerance (90 sec) • Prone isometric core endurance (plank) for 90 sec |
|
|
|||
| 11/15 |
• Verbal pain scale = 0 • Mild tightness associated with prolonged sitting • Full activities • Able to perform plank exercise > 2 minutes • No pain with running |
Periodic HVLAM, PCS and AMRT as necessary |
As above + • Oblique crunches (50/side) • Isometric side bridge (60 sec) • Static lunge psoas stretch • Oblique crunches on gym ball • Latissimus pull downs • Seated rows • Gradual return to running |
|
|
|||
| 16/30 |
• VAS = 0 • RMDQ = 0/24 • Able to perform plank exercise > 120 sec, side-bridges > 60 sec, 100 crunches in < 120 sec, 50 oblique crunches per side • Able to fly multiple times/wk including long and high G flight with only mild tightness afterward • Passed required physical fitness test with no pain |
No treatment required |
• Maintain core stability and coordination exercises as part of routine exercise • 3 mi run 3x/wk, elliptical or stationary bike on other days |
|
Tx = treatment; Wk = week; VAS = visual analog scale; RMDQ = Roland Morris disability questionnaire; HVLAM = high velocity low amplitude manipulation; T = thoracic; L = lumbar; AMRT = active myofascial release technique; PIR = post-isometric relaxation; PCS = post-contraction stretch; QL = quadratus lumborum; PVT = paravertebral muscles; TrP Tx = trigger point therapy | |||
Green et al. Chiropractic & Osteopathy 2006 14:11 doi:10.1186/1746-1340-14-11 |
|||