Skip to Main Content

++

A 60-year-old semi-retired female with a diagnosis of degenerative spondylolisthesis (DS) was referred to physical therapy by an orthopaedic spine surgeon. She first experienced pain about 4 weeks ago after walking a golf course and using a pull cart during a tournament. She indicates that she generally rides in a golf cart; however, use of golf carts was prohibited during tournament play. She notices that her pain is localized to her central low back, buttocks, and posterior thighs. Her symptoms worsen as the day progresses. She denies bowel or bladder signs/symptoms, sensation changes, weakness, or episodes of her legs "giving way." She is moderately overweight (BMI = 28 kg/m2) and does not participate in a regular exercise program aside from her biweekly golf game. Her previous medical history includes a history of episodic low back pain and a cesarean section associated with the birth of her second child 35 years ago. She has a history of hyperlipidemia and type 2 diabetes mellitus. Her goals are to reduce her pain to allow her to cook meals for her family and to resume 18 holes of golf twice weekly without use of a golf cart.

++
++
++

Based on the patient's diagnosis, what do you anticipate may be the contributing factors to her condition?

++
++

What are the most appropriate examination tests?

++
++

What are the most appropriate physical therapy interventions?

++
++

What are possible complications that may limit the effectiveness of physical therapy?

++
++

What is her rehabilitation prognosis?

++

DEGENERATIVE SPONDYLOLISTHESIS (DS): Acquired anterior displacement of one vertebra over the subjacent vertebra, associated with degenerative changes and without a disruption or defect in the vertebral ring

++

NEUROGENIC CLAUDICATION: Pain, paresthesias, and cramping of one or both legs due to neurologic compromise; typically brought on by standing or walking and relieved with sitting

++

SEGMENTAL INSTABILITY: Decreased capacity of the spine's stabilizing system to maintain the spinal neutral zones within physiological limits so that there are no neurologic deficits, major deformities, or incapacitating pain

++

SPINAL STENOSIS: Narrowing of the central spinal canal or intervertebral foramen at a single or multiple levels that can compress nerves and adjacent structures

++

SPONDYLOLYSIS: Defect in the pars interarticularis portion of the vertebrae; typically occurs in the lower lumbar vertebrae

++

SPONDYLOSIS: Degenerative changes in the intervertebral discs and osteophytic changes in the associated vertebral bodies

++

  1. Describe degenerative spondylolisthesis (DS) and potential risk factors associated with this condition.

  2. Provide appropriate educational interventions for the individual with DS.

  3. Design and implement manual therapy interventions to address the impairments common to individuals with DS.

  4. Prescribe appropriate strength, endurance, flexibility, and motor control exercises for individuals with DS.

++

PT considerations during management of the individual with ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.