Hello!
I have a patient who is diagnosed L4 degenerative spondylolisthesis.
(Patient profile)
70 years old female. Aggravating activity is standing and walking.
She has a left buttock pain and squeezing feeling in left lateral area of leg and foot.
Left ankle reflex is absent. Motor loss is nil. There is a hypomobility in all the lumber spines.
I tried P-A mobilization for L5 spinous process protrusion and made her worse.
I wonder if any mobilization technique(tech.) as below are efficient for spondylolisthesis.
1. A-P mobilization in Maitland tech.
When PT mobilize L4 with A-P movement, can he move slipped vertebrae to posteriorly?
2. Test tech. of posterior lumber spine instability by David Magee
This is not described for a mobilization tech., but I wonder if it might be efficient.
(Procedure)
The patient sits on the edge of the table. PT stands in front of the patient. The patient places the pronated arms with elbows bent on the PT’s shoulders. The PT puts both hands around the patient so the fingers rest over the lumber spine and with the heels of the hands gently pull the lumber spine into full lordosis. To stress L5 on S1,the PT stabilize the sacrum with the fingers of both hands and asks the patient to push through the forearm while maintaining the lordotic posture. This produces a posterior shear of L5 on S1. In my case I wonder if it is effective to stress L4 on L5.

Thanks in advance.

Novice PT

Similar Threads: