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Physical Therapy Case Study

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Given the prevalence of back injuries within all sectors of the community, the potential roles / opportunities for physical therapists to improve community health is nearly limitlessness. Elementary teachers are at a particularly high risk of a lumbar injury because their work environment requires considerable lumbar flexion as well as prolonged periods of sitting to grade papers or develop lesson plans.26-28 After discussing her work environment with the patient, an educational opportunity was recognized to potentially help teachers prevent back injuries. A service learning project called Back Care for the Pre-School Employee had been previously developed during the tDPT course PT543 Emerging Professional Roles of Physical Therapy Practitioners. …show more content…

According to Carnes et al, nearly half of the patients who receive manual therapy will experience a minor to moderate adverse event afterwards, which is usually in the form of short-lived muscle soreness.30 The MDT approach is designed to rarely use manual therapy as a treatment technique. According to McKenzie, only about 30% of lumbar patients will require manual therapy.23(p445) This limits the for potential adverse reactions thereby minimizing the risk for the patient, the physical therapist and the …show more content…

This approach initially uses patient generated forces in the form of active range of motion (AROM), usually to the end of the available range. If the patient generated forces are successful to improve the patient’s presentation, then there is no need to employ manual therapy techniques. If the patient generated forces are unable to fully resolve the patient’s symptoms, then manual therapy techniques are utilized; however, the initial manual therapy techniques are applied with the least amount of force possible in an attempt to resolve the patient’s symptoms, and are only progressed to a more forceful technique if the patient’s symptoms failed to resolve with the initial technique. In other words, manual therapy is only used when the patient is unable to resolve their symptoms through end range AROM.23(p446) The MDT approach offers an additional safeguard. If manual therapy is needed, the integrity of the structures to be mobilized would have been fully tested by virtue of the patient performing numerous end range AROM exercises prior to the manual therapy, and any potential issues with structures to be mobilized or manipulated would likely have been exposed prior to the manual technique. 23(p446) Being trained and certified as a MDT therapist helps to mitigate the risk associated with treating patients with an acute lumbar

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