Treatment-based Classification System for Patients With Low Back Pain: The Movement Control Approach
Abstract We present the movement control approach as part of the treatment-based classification system. This approach proposes a movement control schema that clarifies that movement control is a product of the interplay among multiple biopsychosocial components. The schema illustrates that for movem...
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Veröffentlicht in: | Physical therapy 2017-12, Vol.97 (12), p.1147-1157 |
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creator | Alrwaily, Muhammad Timko, Michael Schneider, Michael Kawchuk, Greg Bise, Christopher Hariharan, Karthik Stevans, Joel Delitto, Anthony |
description | Abstract
We present the movement control approach as part of the treatment-based classification system. This approach proposes a movement control schema that clarifies that movement control is a product of the interplay among multiple biopsychosocial components. The schema illustrates that for movement to occur in a dynamically controlled fashion, the lumbar spine requires both local mobility and global stability. Local mobility means that the lumbar spine and its adjacent regions possess adequate nerve and joint(s) mobility and soft tissue compliance (ie, the malleability of tissue to undergo elastic deformation). Global stability means that the muscles of the lumbar spine and its adjacent regions can generate activation that is coordinated with various joint movements and incorporated into activities of daily living. Local mobility and global stability are housed within the bio-behavioral and socio-occupational factors that should be addressed during movement rehabilitation. This schema is converted into a practical physical examination to help the rehabilitation provider to construct a clinical rationale as to why the movement impairment(s) exist. The examination findings are used to guide treatment. We suggest a treatment prioritization that aims to consecutively address neural sensitivity, joint(s) and soft tissue mobility, motor control, and endurance. This prioritization enables rehabilitation providers to better plan the intervention according to each patient's needs. We emphasize that treatment for patients with low back pain is not a static process. Rather, the treatment is a fluid process that changes as the clinical status of the patient changes. This movement control approach is based on clinical experience and indirect evidence; further research is needed to support its clinical utility. |
doi_str_mv | 10.1093/ptj/pzx087 |
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We present the movement control approach as part of the treatment-based classification system. This approach proposes a movement control schema that clarifies that movement control is a product of the interplay among multiple biopsychosocial components. The schema illustrates that for movement to occur in a dynamically controlled fashion, the lumbar spine requires both local mobility and global stability. Local mobility means that the lumbar spine and its adjacent regions possess adequate nerve and joint(s) mobility and soft tissue compliance (ie, the malleability of tissue to undergo elastic deformation). Global stability means that the muscles of the lumbar spine and its adjacent regions can generate activation that is coordinated with various joint movements and incorporated into activities of daily living. Local mobility and global stability are housed within the bio-behavioral and socio-occupational factors that should be addressed during movement rehabilitation. This schema is converted into a practical physical examination to help the rehabilitation provider to construct a clinical rationale as to why the movement impairment(s) exist. The examination findings are used to guide treatment. We suggest a treatment prioritization that aims to consecutively address neural sensitivity, joint(s) and soft tissue mobility, motor control, and endurance. This prioritization enables rehabilitation providers to better plan the intervention according to each patient's needs. We emphasize that treatment for patients with low back pain is not a static process. Rather, the treatment is a fluid process that changes as the clinical status of the patient changes. This movement control approach is based on clinical experience and indirect evidence; further research is needed to support its clinical utility.</description><identifier>ISSN: 0031-9023</identifier><identifier>EISSN: 1538-6724</identifier><identifier>DOI: 10.1093/ptj/pzx087</identifier><identifier>PMID: 30010971</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Back pain ; Care and treatment ; Classification ; Compensation ; Diagnosis ; Humans ; Low back pain ; Low Back Pain - diagnosis ; Low Back Pain - rehabilitation ; Lumbar Vertebrae - physiopathology ; Medical treatment ; Methods ; Models, Theoretical ; Movement ; Pain ; Pain management ; Patients ; Physical therapy ; Physical Therapy Modalities - classification ; Rehabilitation ; Triage - methods ; Viscoelasticity</subject><ispartof>Physical therapy, 2017-12, Vol.97 (12), p.1147-1157</ispartof><rights>2017 American Physical Therapy Association 2017</rights><rights>COPYRIGHT 2017 Oxford University Press</rights><rights>COPYRIGHT 2017 Oxford University Press</rights><rights>Copyright © 2017 American Physical Therapy Association</rights><rights>Copyright Oxford University Press, UK Dec 2017</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c654t-31c43c52ead9ab5dce426a66bd9e3729eaf5ca2a8b5e32315268b44fe7c2e5a33</citedby><cites>FETCH-LOGICAL-c654t-31c43c52ead9ab5dce426a66bd9e3729eaf5ca2a8b5e32315268b44fe7c2e5a33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1579,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30010971$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alrwaily, Muhammad</creatorcontrib><creatorcontrib>Timko, Michael</creatorcontrib><creatorcontrib>Schneider, Michael</creatorcontrib><creatorcontrib>Kawchuk, Greg</creatorcontrib><creatorcontrib>Bise, Christopher</creatorcontrib><creatorcontrib>Hariharan, Karthik</creatorcontrib><creatorcontrib>Stevans, Joel</creatorcontrib><creatorcontrib>Delitto, Anthony</creatorcontrib><title>Treatment-based Classification System for Patients With Low Back Pain: The Movement Control Approach</title><title>Physical therapy</title><addtitle>Phys Ther</addtitle><description>Abstract
We present the movement control approach as part of the treatment-based classification system. This approach proposes a movement control schema that clarifies that movement control is a product of the interplay among multiple biopsychosocial components. The schema illustrates that for movement to occur in a dynamically controlled fashion, the lumbar spine requires both local mobility and global stability. Local mobility means that the lumbar spine and its adjacent regions possess adequate nerve and joint(s) mobility and soft tissue compliance (ie, the malleability of tissue to undergo elastic deformation). Global stability means that the muscles of the lumbar spine and its adjacent regions can generate activation that is coordinated with various joint movements and incorporated into activities of daily living. Local mobility and global stability are housed within the bio-behavioral and socio-occupational factors that should be addressed during movement rehabilitation. This schema is converted into a practical physical examination to help the rehabilitation provider to construct a clinical rationale as to why the movement impairment(s) exist. The examination findings are used to guide treatment. We suggest a treatment prioritization that aims to consecutively address neural sensitivity, joint(s) and soft tissue mobility, motor control, and endurance. This prioritization enables rehabilitation providers to better plan the intervention according to each patient's needs. We emphasize that treatment for patients with low back pain is not a static process. Rather, the treatment is a fluid process that changes as the clinical status of the patient changes. This movement control approach is based on clinical experience and indirect evidence; further research is needed to support its clinical utility.</description><subject>Back pain</subject><subject>Care and treatment</subject><subject>Classification</subject><subject>Compensation</subject><subject>Diagnosis</subject><subject>Humans</subject><subject>Low back pain</subject><subject>Low Back Pain - diagnosis</subject><subject>Low Back Pain - rehabilitation</subject><subject>Lumbar Vertebrae - physiopathology</subject><subject>Medical treatment</subject><subject>Methods</subject><subject>Models, Theoretical</subject><subject>Movement</subject><subject>Pain</subject><subject>Pain management</subject><subject>Patients</subject><subject>Physical therapy</subject><subject>Physical Therapy Modalities - classification</subject><subject>Rehabilitation</subject><subject>Triage - methods</subject><subject>Viscoelasticity</subject><issn>0031-9023</issn><issn>1538-6724</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqV0l-L1DAQAPAiineevvgBJCCCCr3LnyZt7m1d9DxYPfFWfAxpOt3t2jY1SfXOT2-WXZWVZVHykDD8MpMwkySPCT4lWLKzIazOhh83uMjvJMeEsyIVOc3uJscYM5JKTNlR8sD7FcaY5Jm8nxyxeMIyJ8dJNXegQwd9SEvtoULTVnvf1I3RobE9ur71ATpUW4c-xEh0Hn1uwhLN7Hf0SpsvMdz052i-BPTOfoN1JjS1fXC2RZNhcFab5cPkXq1bD4-2-0ny6c3r-fRtOru6uJxOZqkRPAspIyZjhlPQldQlrwxkVGghykoCy6kEXXOjqS5KDowywqkoyiyrITcUuGbsJHm-yRvLfh3BB9U13kDb6h7s6BXFOc6lpIJE-vQvurKj6-ProiKUFFhk_JAisuBScCHwH7XQLaimr21w2qxLqwmnJBPrslGle9QCenC6tT3UTQzv-NM9Pq4KusbsvfBi50I0AW7CQo_eq8vrj_9h3_-zLS5mhz65tca2LSxAxW5Pr3b9y403znrvoFaDazrtbhXBaj3cKg632gx3xE-23RjLDqrf9Nc0R_BsA-w4HEr0Ewji-3I</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Alrwaily, Muhammad</creator><creator>Timko, Michael</creator><creator>Schneider, Michael</creator><creator>Kawchuk, Greg</creator><creator>Bise, Christopher</creator><creator>Hariharan, Karthik</creator><creator>Stevans, Joel</creator><creator>Delitto, Anthony</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88I</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20171201</creationdate><title>Treatment-based Classification System for Patients With Low Back Pain: The Movement Control Approach</title><author>Alrwaily, Muhammad ; Timko, Michael ; Schneider, Michael ; Kawchuk, Greg ; Bise, Christopher ; Hariharan, Karthik ; Stevans, Joel ; Delitto, Anthony</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c654t-31c43c52ead9ab5dce426a66bd9e3729eaf5ca2a8b5e32315268b44fe7c2e5a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Back pain</topic><topic>Care and treatment</topic><topic>Classification</topic><topic>Compensation</topic><topic>Diagnosis</topic><topic>Humans</topic><topic>Low back pain</topic><topic>Low Back Pain - diagnosis</topic><topic>Low Back Pain - rehabilitation</topic><topic>Lumbar Vertebrae - physiopathology</topic><topic>Medical treatment</topic><topic>Methods</topic><topic>Models, Theoretical</topic><topic>Movement</topic><topic>Pain</topic><topic>Pain management</topic><topic>Patients</topic><topic>Physical therapy</topic><topic>Physical Therapy Modalities - classification</topic><topic>Rehabilitation</topic><topic>Triage - methods</topic><topic>Viscoelasticity</topic><toplevel>online_resources</toplevel><creatorcontrib>Alrwaily, Muhammad</creatorcontrib><creatorcontrib>Timko, Michael</creatorcontrib><creatorcontrib>Schneider, Michael</creatorcontrib><creatorcontrib>Kawchuk, Greg</creatorcontrib><creatorcontrib>Bise, Christopher</creatorcontrib><creatorcontrib>Hariharan, Karthik</creatorcontrib><creatorcontrib>Stevans, Joel</creatorcontrib><creatorcontrib>Delitto, Anthony</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Career & Technical Education Database</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Physical therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alrwaily, Muhammad</au><au>Timko, Michael</au><au>Schneider, Michael</au><au>Kawchuk, Greg</au><au>Bise, Christopher</au><au>Hariharan, Karthik</au><au>Stevans, Joel</au><au>Delitto, Anthony</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment-based Classification System for Patients With Low Back Pain: The Movement Control Approach</atitle><jtitle>Physical therapy</jtitle><addtitle>Phys Ther</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>97</volume><issue>12</issue><spage>1147</spage><epage>1157</epage><pages>1147-1157</pages><issn>0031-9023</issn><eissn>1538-6724</eissn><abstract>Abstract
We present the movement control approach as part of the treatment-based classification system. This approach proposes a movement control schema that clarifies that movement control is a product of the interplay among multiple biopsychosocial components. The schema illustrates that for movement to occur in a dynamically controlled fashion, the lumbar spine requires both local mobility and global stability. Local mobility means that the lumbar spine and its adjacent regions possess adequate nerve and joint(s) mobility and soft tissue compliance (ie, the malleability of tissue to undergo elastic deformation). Global stability means that the muscles of the lumbar spine and its adjacent regions can generate activation that is coordinated with various joint movements and incorporated into activities of daily living. Local mobility and global stability are housed within the bio-behavioral and socio-occupational factors that should be addressed during movement rehabilitation. This schema is converted into a practical physical examination to help the rehabilitation provider to construct a clinical rationale as to why the movement impairment(s) exist. The examination findings are used to guide treatment. We suggest a treatment prioritization that aims to consecutively address neural sensitivity, joint(s) and soft tissue mobility, motor control, and endurance. This prioritization enables rehabilitation providers to better plan the intervention according to each patient's needs. We emphasize that treatment for patients with low back pain is not a static process. Rather, the treatment is a fluid process that changes as the clinical status of the patient changes. This movement control approach is based on clinical experience and indirect evidence; further research is needed to support its clinical utility.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>30010971</pmid><doi>10.1093/ptj/pzx087</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Back pain Care and treatment Classification Compensation Diagnosis Humans Low back pain Low Back Pain - diagnosis Low Back Pain - rehabilitation Lumbar Vertebrae - physiopathology Medical treatment Methods Models, Theoretical Movement Pain Pain management Patients Physical therapy Physical Therapy Modalities - classification Rehabilitation Triage - methods Viscoelasticity |
title | Treatment-based Classification System for Patients With Low Back Pain: The Movement Control Approach |
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