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Table 1 Outcome measures and treatment strategies during chiropractic care.

From: Use of conventional and alternative treatment strategies for a case of low back pain in a F/A-18 aviator

Tx#/Wk# Functional Outcomes Pain Control Flight/USMC Fitness Training
1/1 • VAS = 1.5 current, 7.1 upon waking, 9.5 worst •Medication needed for pain control
• RMDQ = 5/24
• Significant pain with flight
• Unable to run/do sit-ups
• HVLAM [11] (T11-L2 & SI joint)
• AMRT [12,13] & PIR or PCS [14] of (g. medius, g. max, QL and PVTs)
• Home TrP Tx (g. medius)
• Moist heat pack
• See flight surgeon if pain increased
• G. medius stretch (2 @ 30 sec)
• Double knee-chest stretches (10 reps @ 10 sec each)
• Continue stretches recommended by PT and DO
• Walking, elliptical and bicycle to tolerance
5/5 • No sharp pain
• No medication needed to control pain
• Mild ache after flying high G several times per week
• Minimal pain with activities of daily living
Same as above As above +
• Supine leg raises (Dead Bugs 50 reps)
• Static crunch to tolerance (90 sec)
• Prone isometric core endurance (plank) for 90 sec
11/15 • Verbal pain scale = 0
• Mild tightness associated with prolonged sitting
• Full activities
• Able to perform plank exercise > 2 minutes
• No pain with running
Periodic HVLAM, PCS and AMRT as necessary As above +
• Oblique crunches (50/side)
• Isometric side bridge (60 sec)
• Static lunge psoas stretch
• Oblique crunches on gym ball
• Latissimus pull downs
• Seated rows
• Gradual return to running
16/30 • VAS = 0
• RMDQ = 0/24
• Able to perform plank exercise > 120 sec, side-bridges > 60 sec, 100 crunches in < 120 sec, 50 oblique crunches per side
• Able to fly multiple times/wk including long and high G flight with only mild tightness afterward
• Passed required physical fitness test with no pain
No treatment required • Maintain core stability and coordination exercises as part of routine exercise
• 3 mi run 3x/wk, elliptical or stationary bike on other days
  1. Tx = treatment; Wk = week; VAS = visual analog scale; RMDQ = Roland Morris disability questionnaire; HVLAM = high velocity low amplitude manipulation; T = thoracic; L = lumbar; AMRT = active myofascial release technique; PIR = post-isometric relaxation; PCS = post-contraction stretch; QL = quadratus lumborum; PVT = paravertebral muscles; TrP Tx = trigger point therapy