What assessment questions should be asked to an 11-year-old patient with lower back pain (LBP) related to a motor vehicle accident (MVA) upon discharge from physical therapy (PT)?

From the Guidelines

For an 11-year-old discharged from physical therapy for lower back pain after a car accident, I recommend asking assessment questions that focus on pain levels, functional abilities, and emotional well-being. Ask the child to rate their pain on a scale of 1-10 and describe where exactly they feel discomfort. Inquire about their ability to perform daily activities like sitting in class, participating in physical education, playing with friends, and sleeping through the night without pain. Ask if they can bend, twist, and move without discomfort. Question whether they're able to carry their backpack and for how long. Assess their compliance with any home exercise program by asking which exercises they're doing regularly and if they understand why these exercises help. Inquire about any fear or anxiety related to movement or reinjury, as psychological factors can impact recovery. Ask about their understanding of body mechanics for proper sitting, lifting, and moving to prevent future pain. These questions help evaluate physical recovery progress while addressing the psychological aspects of injury recovery, which is particularly important in children who may not always verbalize their concerns directly. Regular reassessment using these questions can help monitor long-term recovery and identify any need for follow-up care, as suggested by the American College of Physicians and the American Pain Society 1.

Some key areas to focus on include:

• Pain levels and location
• Functional abilities, such as sitting, standing, and moving
• Emotional well-being, including fear or anxiety related to movement or reinjury
• Compliance with home exercise programs
• Understanding of body mechanics for proper sitting, lifting, and moving
• Ability to perform daily activities, such as carrying a backpack or participating in physical education.

By asking these assessment questions, clinicians can gather valuable information to inform treatment decisions and promote optimal recovery outcomes for the child, as recommended by the American College of Physicians and the American Pain Society 1.

From the Research

Assessment Questions for an 11-Year-Old Discharged from Physical Therapy for Lower Back Pain

To assess the progress and well-being of an 11-year-old discharged from physical therapy for lower back pain related to a car accident, the following questions can be asked:

• Can you describe your current level of pain, and how it has changed since starting physical therapy?
• What activities are you now able to perform without experiencing pain or discomfort?
• Have you experienced any setbacks or flare-ups since discharge, and if so, how did you manage them?
• Are you able to maintain good posture and use proper body mechanics during daily activities?
• Have you noticed any improvements in your sleep quality or ability to participate in physical activities?
• Are there any specific exercises or stretches that you found helpful during physical therapy, and are you continuing to practice them?

Medication and Treatment

It is also important to inquire about any medications the child may be taking for their lower back pain, as studies such as 2 suggest that medications like NSAIDs and muscle relaxants may be effective in reducing pain for acute low back pain, while 3 found that paracetamol combination therapy can reduce pain intensity in some cases.

Physical Therapy and Exercise

Asking about the child's experience with physical therapy and exercise is crucial, as research like 4 recommends spinal manipulative therapy, low-level laser therapy, core stability exercise, and massage for acute and sub-acute low back pain. Questions may include:

• What physical therapy interventions did you find most helpful during your treatment?
• Are you continuing to practice any exercises or stretches recommended by your physical therapist?
• Have you noticed any improvements in your flexibility, strength, or overall physical function?

Follow-Up and Support

Finally, it is essential to assess the child's need for follow-up care or support, including:

• Do you have any ongoing concerns or questions about your lower back pain or physical therapy treatment?
• Are there any additional resources or support systems that you feel would be helpful in managing your condition?
• Have you experienced any emotional or psychological challenges related to your injury or treatment, and if so, how are you coping?