BLT, FPR And Still's Techniques Flashcards
What is a direct technique?
Method of action engage the restrictive barrier directly
What is an indirect technique?
Method of action involve positioning away from the restrictive barrier
Why use indirect?
Pt/practitioner preference
Direct tx contraindicated
Direct tx just isn’t working
Still’s technique is a combination of what?
Direct and indirect technique
BLT/LAS and FPR are both
Indirect techniques
History of indirect techniques
Dr. W Sutherland - cranial techniques (BMT)
Dr. Harold Hoover - dynamic neutral point of joint motion
Dr. Anne Wales - first used term BLT*
Dr. Lawrence Jones - strain counterstrain
Dr. Schiowitz and DiGiovanna - faciliated positional release*
What is balanced ligamentous tension (BLT)?
Diagnose somatic dysfunction Place in indirect position Utilize activating force Hold until “air hunger” Reassess
What are the three principles of BLT?
Disengagement of the dysfunctional area
Exaggeration of dysfunctional pattern
Balanced tension of ligaments
Explain the steps of BLT
- Position the segment in an indirect manner (position at shifted neutral position)
- Utilize activating force: inherent respiration
- Return to neutral
- Reevaluate for TART findings
Explain respiratory assist during the second step of BLT
Breathing/respiratory phase associated with greatest ease
Inhalation flattens the spine in the A-P direction
Exhalation increases AP spinal curves
Instruct pt to hold until air hunger
What is the goal of BLT?
Balance the articular surfaces’ direction of physiologic motion that are common to that articulation
Physician helps the body help itself (2nd tenet)
Little to no pressure is exerted into the body to accomplish the technique
Generally very tolerable to pts
What is facilitated positional release?
Make diagnosis Flatten (neutralize) the curve Add compression Indirect positioning Hold 3-5 seconds Return to neutral Reassess
Explain the mechanism for FPR
Pt-passive, indirect technique
Interaction between 1 alpha afferent and gamma efferent activity
Intrafusal fibers allowed to return to normal length (1-alpha afferent signals decrease)
Decreases tension in extrafusal fibers
Muscles achieve normal length and tone
What are the secondary effects of FPR?
Improved lymphatic drainage, venous drainage, and improved fluid dynamics
What are the steps for FPR?
- Neutralize/flatten spinal curve
- Utilize compression
- Place pt in shifted neutral (hold for 3-4 seconds)
- Return to neutral
- Reassess for TART findings