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Orthopedic clinic physical therapy for a patient with chronic low-back pain and a L5-S1 disc herniation
A patient with chronic low back pain and herniated L5-S1 disc was seen for physical therapy treatment for nine sessions over a span of 13 weeks in an outpatient setting under the supervision of a licensed physical therapist The patient was evaluated at the initial encounter with body structure and function outcomes that consisted of measurements of active range of motion by lumbar spine flexion and extension in standing with the modified Schober’s test and fingertip to floor test, strength with the bridge test, joint play, pain by the numeric pain rating scale, straight-leg-raise, femoral nerve tension test, Thomas test, and tissue mobility with skin and bony palpation.. Measures of activity included sitting endurance, sleeping quality, and lifting mechanics. A plan of care was established. Main outcomes measured activities of daily living by the Oswestry Disability Index, ability to independently participate in gym program, fear beliefs about work and physical activity by the Fear Avoidance Beliefs Questionnaire, and working without restrictions and symptoms. The main interventions used were lumbar stabilization, a stretching program, postural awareness, pain management, and ergonomic training. The patient achieved goals of decreased pain, increased trunk active range of motion in standing flexion and extension, improved sleep quality, improved sitting tolerance, improved lifting mechanics, and decreased disability on the Oswestry Disability Index. The patient was discharged with a home exercise program.