Cervical Treatment Flashcards
How is treating spinal patients similar to other body parts?
Education/ Reassurance/ Reduce threat
Address the patients beliefs and any yellow flags
Exercise(strength, endurance, power,control, proprioception and stretching)
Manual therapy (PPIVM’S, PAIVM’s, MWM’s/ SNAG’s, NAG’s?)
Activity modification/ function
Problem list vs treatment plan
Stiff/ Reduced ROM- Mobilise it (manual therapy)
Reduced muscle length- stretch it
Reduced strength- strengthening exercise (high load, low reps)
Reduced balance- balance exercises
Reduced control of movement/ poor quality- movement control exercises
Reduced endurance- endurance exercise (lower load, high reps)
Reduced capacity or tolerance to load- Graded exposure and load progression
Maladaptive movement patterns- normalise movement patterns
What is a MWM
Mobilisation with movement
What is a SNAG?
Sustained Natural Apophyseal Glide
What is a NAG
Natural Apophyseal Glide
What is a PMWM?
Peripheral mobilisation with movement
What is SMWAM?
Spinal mobilisation with arm movement
How do you perform a PAIVM for cervical treatment?
Patient lays in supine position and therapist sits on stool at top of bed, hand placed under chin and head is pulled, distract from caudad-cephlahad
Or hand under occiput and hand on forehead and pull.
How to perform a SNAG on a patient?
The thumb is placed on the distal phalanx over the superior spinous process? This movement is reinforced with the other thumb, force is applied and the joint is guided. Sustain the movement for 2-3 seconds and do reps <6x
How is a self snag performed so the activity is more functional?
A hand towel is used and is hooked around the spinous process. It is pulled in the direction of the facet. The pulling hand moves round with the head
Rotation OP
Done twice hourly
What does PILL stand for?
Pain free, instantaneous and long lasting
What soft tissue techniques are there to do?
SSTM’s
Massage
TrP work
Stretches
What are the targets for cervical pain?
ROM(AROM, AAROM,OP,PASSIVE) Strength Pain Dose(frequency,duration, reps) Magnitude-MVC% or pain levels
