C-Spine Muscle Energy

Question 1

Fryette’s Laws

Answer 1

1. When the spine is in neutral, side bend and rotation occur in opposite directions (type I)
2. When the spine is flexed or extended, side bend and rotation occur to the same side (type II)
3. When motion is introduced in one plane, available motion in the other planes is reduced

Question 2

Basic exercise MET using post-isometric relaxation (PIR) in acute context

Answer 2

• pt placed at resistance barrier
• slowly introduced isometric contraction to 20% max strength
• hold 7-10 sec then pt relaxes and jt brought to new resistance barrier
• 10 sec rest max (10-20 sec = latency period)
• -ideal for releasing tone, relieving spasm esp. in acute stage
• repeat as neccessary

Question 3

MET using PIR followed by stretch, in chronic context

Answer 3

• contraction in more relaxed mid-range position
• 20-35% contract 7-10, rest 2-3
• stretch to just beyond resistance barrier with pt assisting
• repeat as neccessary

Question 4

Reciprocal Inhibition

Answer 4

• good for acute pt, when muscle is traumatized or painful and can’t safely produce sustained contractions
• tissues placed just short of barrier

Question 5

Important components of MET (4)

Answer 5

1. from a controlled position
2. in a specific direction
3. met by PT applied distinct counterforce
4. involving a controlled intensity of contraction

Question 6

neurological model of MET

Answer 6

-7 to 10 seconds is time required to “load” golgi tendon organs to neurologically influence the intrafusal fibers of the muscle spindles, inhibiting muscle tone and providing opportunity to move to new resting length

Question 7

MET should not cause pain

Answer 7

nuff said

Question 8

Flexed Lesions C2-C7

Answer 8

• posteriorly prominent TP on CONTRALATERAL side
• for prominent R TP, left facet is stuck open (upsloped)
• Positional Diagnosis = FRSR
• Movement barrier = ERSL (also position of treatment)

Question 9

Flexed lesion treatment

Answer 9

• extend to level of involved segment
• introduce rotation then sidebend
• back off to ibz
• resist isometric contraction in any direction 6-10 seconds, repeat 3-5 times

Question 10

Extended Lesions C2-C7

Answer 10

• posteriorly prominent TP on IPSALATERAL side
• positional diagnosis = ERSR (for right sided lesion)
• movement barrier = FRSL

Question 11

Extended lesion treatment

Answer 11

• flex to level of segment, rotate, sidebend

- resist 6-10 sec 3-5 times

Question 12

Documentation

Answer 12

-O: MET for ERSL (positional dx)
OR
-O: MET in FRSR (movement barrier)