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1. Clinicians should place high priority on interventions that prevent recurrences and the transition to chronic low back pain.
A. True
B. False
2. All of the following are primary ICF activities and participation codes associated with low back pain, EXCEPT:
A. d4108 Bending
B. d4158 Maintaining a body position
C. e1419 Proper lifting
D. d5701 Managing diet and fitness
3. Which ICD-10 code and condition is associated with acute, subacute, and chronic low back pain with movement coordination impairments?
A. M53.2 Spinal instabilities
B. M40.3 Flatback syndrome
C. M54.4 Lumbago with sciatica
D. M54.5 Low back pain
4. Low back pain is second to cardiovascular disease as the leading cause of activity limitation and work absence throughout much of the world and is associated with an enormous economic burden.
A. True
B. False
5. The most common stratum of people to experience low back pain are?
A. Females
B. Increases in age
C. Lower educational status
D. All of the above
6. All of the following statements regarding the overall risk of low back pain in adolescents are true, EXCEPT?
A. Similar to adults, girls appear to have a higher prevalence
B. Anthropometrics do not appear to be strongly associated with low back pain in adolescents
C. The risk of low back pain is much lower than adults, with prevalence rates near 40% to 50% by 20 years of age
D. Lumbar mobility or trunk muscle weakness do not appear to be strongly associated with low back pain in adolescents
7. When abnormalities are present on imaging studies, establishing a direct cause and effect between the pathological finding and the patient condition has proven elusive and most often does not assist greatly in patient management.
A. True
B. False
8. Prognostic factors for development of recurrent pain include all of the following, EXCEPT?
A. History of previous episodes
B. Excessive spine mobility
C. Excessive mobility in other joints
D. Familial history of low back pain
9. Using a treatment-based classification system incorporating ICF impairments of body functions is more effective than duration based clinical guidelines (acute, subacute, and chronic in nature).
A. True
B. False
10. What ICF impairment of body functions terminology and characteristics are used when a patient demonstrates restricted spinal range of motion and segmental mobility, and the patient's low back and low back-related lower extremity symptoms are reproduced with provocation of the involved segments?
A. Acute low back pain with mobility deficits
B. Acute low back pain with movement coordination impairment and radiating pain
C. Subacute low back pain with mobility deficits
D. Chronic low back pain with movement coordination impairments
11. Which term used by rehabilitation practitioners is used to reflect the tissue's ability to handle physical stress?
A. Resistance
B. Pliability
C. Irritability
D. None of the above
12. The ICD diagnosis of lumbosacral segmental/somatic dysfunction and the associated ICF diagnosis of subacute low back pain with mobility deficits are made with a reasonable level of certainty when the patient presents with the following clinical findings:
A. Symptoms reproduced with end-range spinal motions and provocation of the involved lower thoracic, lumbar, or sacroiliac segments
B. Movement coordination impairments of the lumbopelvic region with low back flexion and extension movements
C. Movement coordination impairments while performing self-care/home management activities
D. Movement coordination impairments while performing community/work-related recreational or occupational activities
13. A neurological status examination should be included for patients with low back pain. This includes assessment of:
A. Sensation
B. Reflexes
C. Muscle power
D. Motor control and movement coordination
E. All of the above
14. Which of the following conditions are NOT considered a red flag for the low back region?
A. Cauda equine syndrome
B. Spinal compression fracture
C. Intestinal cancer
D. Abdominal aneurysm
15. Current recommendations from the American College of Physicians are that imaging should never be indicated for severe progressive neurological deficits or when red flags are suspected.
A. True
B. False
16. In which low back pain scenario is a prompt workup with MRI or CT recommended, because delayed treatment in patients with progressive neurologic involvement is associated with poorer outcomes? Low back pain with:
A. Mobility deficits
B. Movement coordination impairments
C. Related (referred) lower extremity pain
D. Radiating pain
E. Related generalized pain
17. Which outcome measure does the following describe: 10 index items, 8 related to activities of daily living and 2 related to pain. Each item is scored from 0 to 5 and the total score is expressed as a percentage, with higher scores corresponding to greater disability.
A. Oswestry Disability Index
B. Medical Outcomes Survey Shor-Form-36
C. IRT/CAT functional status outcome tools
D. Roland-Morris Disability Questionnaire
18. The Segmental Mobility Assessment measures:
A. The amount of active lumbar flexion, extension, and side-bending motion measured using an inclinometer
B. With the patient prone, lower thoracic and lumbar segmental movement and pain responses
C. Aberrant movements
D. Dural and lower-limb nerve mobility
19. The Trunk Muscle Power and Endurance Test measures:
A. Pain in back; pain in lower limb; control of complex voluntary movements
B. Movement functions specified as mobility of the meninges, peripheral nerves and adjacent tissues
C. Radiating pain in a dermatome
D. Mobility of a single joint
20. Depressive symptoms are associated with all of the following in patients with low back pain, EXCEPT:
A. Disability
B. Medication use
C. Unemployment
D. Decreased pain intensity
21. Exaggerated negative orientation toward actual or anticipated pain experiences broadly defines:
A. Fear-avoidance beliefs
B. Pain catastrophizing
C. Psychosocial distress
D. None of the above
22. It has been suggested that altered movements of which joint may contribute to the development of low back pain, as they may alter the loads placed on the lumbar facets and posterior spinal ligaments:
A. Ankles
B. Shoulders
C. Hips
D. Wrists
23. Which exercises are commonly prescribed for patients who have received the diagnosis of spinal instability?
A. Motor control exercises
B. Transversus abdominis training
C. Dynamic lumbar stabilization exercises
D. All of the above
24. A randomized trial conducted by Yilmaz and colleagues indicated that lumbar spinal stabilization exercises, under the direction of a physical therapist, were superior to performing a general exercise program independently at home for patients with a recent lumbar microdiscectomy.
A. True
B. False
25. All of the following statements regarding flexion exercises are true, EXCEPT?
A. Improve spinal flexibility and hemodynamics
B. Flexion-based exercises increase compression of the lumbar nerve roots
C. Have long been considered a standard treatment for patients with lumbar spinal stenosis
D. Current guidelines detailing conservative intervention for stenosis recommend repeated flexion exercises in the supine, seated, and standing positions
26. There is conflicting evidence for the efficacy of intermittent lumbar traction for patients with low back pain.
A. True
B. False
27. Activity pacing, graded exposure, and maintenance strategies are all examples of?
A. The Psychological model
B. Behavioral education
C. Energy psychology
D. None of the above
28. Patient education and counseling strategies for patients with low back pain should emphasize in-depth, pathoanatomical explanations for the specific cause of the patient's pain, and promote extended bed-rest.
A. True
B. False
29. Patients with low back pain are believed to have increased neural sensitivity to afferent stimuli, including proprioception and movement. This process has been termed:
A. Central sensitization
B. Afferent sensitivity
C. Neurofeedback loop
D. None of the above
30. All of the following are primary intervention strategies for acute low back pain with mobility deficits, EXCEPT?
A. Manual therapy procedures to diminish pain and improve segmental spinal or lumbopelvic motion
B. Therapeutic exercises to improve or maintain spinal mobility
C. Patient education that encourages the patient to return to or pursue an active lifestyle
D. Consider the use of temporary external devices to provide passive restraint to maintain the involved lumbosacral structures in less symptomatic, mid-range positions.
31. Acute low back pain with associated radiating pain in the involved lower extremity, and lower extremity parethesias, numbness, and weakness are symptoms of which ICD-10 association?
A. Spinal instabilities
B. Lumbosacral segmental/somatic dysfunction
C. Lumbago with sciatica
D. All of the above
32. Acute low back pain is considered to be a duration of:
A. 2 months
B. Less than 1 month
C. More than 3 months
D. Less than 1 hour
33. Clinicians should consider diagnostic classifications associated with serious medical conditions or psychosocial factors and initiate referral to the appropriate medical practitioner, when?
A. The patient's clinical findings are suggestive of serious medical or psychological pathology
B. The reported activity limitations or impairments of body function and structure are not consistent with those presented in the diagnosis/classification section of these guidelines
C. The patient's symptoms are not resolving with interventions aimed at normalization of the patient's impairments of body function
D. All of the above
34. In regards to Progressive Endurance Exercise and Fitness Activities, clinicians should consider low-intensity exercise for patients with chronic low back pain WITHOUT generalized pain, and incorporate moderate to high-intensity endurance activities in the pain management and health promotion strategies for patients WITH chronic low back pain with generalized pain.
A. True
B. False
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