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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