Subgrouping Classification Criteria Fritz et al 2007

Subgrouping Classifications:
Manipulation:

• No symptoms distal to knee
  
• Recent onset of symptoms (<16 days)
• Low FABQ score (<19)
• Hip internal rotation ROM (>35 for at least 1 hip)
• Hypomobility of the lumbar spine

Stabilization

• Younger age (<40 y)
• Positive findings for the prone instability test
• Instability catch or aberrant movement during lumbar flexion/extension ROM
• Greater flexibility (postpartum, average SLR ROM >91 degrees)

Specific exercises
Extension

•  Symptoms centralize with lumbar extension
• Symptoms peripheralize with lumbar flexion
• Directional preference for extension
• Symptoms distal to buttock

Flexion

•   Older age (>50 y)
•  Imaging evidence of lumbar stenosis
•  Direction preference for flexion

Lateral Shift

• Visible frontal plane deviation of the shoulders relative to the pelvis
• Directional preference for lateral translation movements of the pelvis

Traction

• Signs and symptoms of nerve root compression
• No movement centralize symptoms 

Intervention Procedures:
 Manipulation

• Active ROM exercise
• Manipulation of the lumbopelvic region

Stabilization

• Strengthening of large spinal stabilizing muscles (erector spinae, oblique abdominals)
• Isolated contraction and cocontraction of the deep stabilizing muscles (multifidus, transverse abdominis)

Specific Exercise
Extension

• Avoid flexion exercise
• End range extension exercise
• Mobilization to promote extension

Flexion

• Body weight supported treadmill walking
• Exercises to address impairments of strength or flexibility
•  Mobilization or manipulation of the spine or lower extremities

Lateral Flexion

•   Mechanical or autotracion
• Exercises to correct lateral shift

Traction

•  Mechanical or autotraction