Direct Osteopathic Tecniques

Question 1

How do restrictive barriers relate toward restrictive barriers?

Answer 1

Direct techniques take the joint/muscle toward the restrictive barrier

Question 2

What are soft tissue techniques?

Answer 2

• Stretching
• Kneading/cross fiber stretching
• Deep pressure
• Effleurage, Petrissage, and tapotement
• Stroking of tissues

Question 3

What are contraindications of soft tissue techniques?

Answer 3

Relative:

• Severe osteoporosis
• Acutely injured muscles/tendons/ligaments

Absolute:

• Fracture/dislocation
• Serious vascular compromise
• Opened sounds and localized infections
• Localized malignancies
• Severe bleeding disorders

Question 4

Describe Direct Myofascial Release techniques.

Answer 4

A restrictive barrier is identified in the myofascial tissue and is engaged with a loaded, constant, directional force until the tissue releases and motion is restored.

Question 5

What are activating forces for DMFR?

Answer 5

• Inherent tendency toward homeostasis
• Respiratory force
• Physician guided force
• Springing/vibration

Question 6

Describe direct articulately techniques.

Answer 6

• Clinician repetitively takes the part of the body being treated directly to restrictive barrier in order to improve physiological ROM
• ex. Low velocity - High amplitude

Question 7

What are indications for articulatory techniques?

Answer 7

• Postoperative pts
• Elderly patients - osteoarthritis
• When more invasive techniques are contraindicated

Question 8

Describe direct muscle energy techniques.

Answer 8

The patients muscles are actively used on request, from a precisely controlled position, in a Specific direction, and against a distinctively executed physician counterforce

Question 9

What are indications for muscle energy techniques.

Answer 9

• Relax hypertonic muscles

- Treat joint restrictions

Question 10

What type of contraction is used in ME techniques?

Answer 10

Isometric contraction

Question 11

What must be done at the end of a ME treatment?

Answer 11

After the final cycle, you must approach the barrier one last time prior to coming out of treatment position.

Question 12

What are the 3 theories related to neurophysiological concepts of muscle energy techniques?

Answer 12

1. Post-isometric relaxation theory: Refractory period of muscle occurs and muscle cannot fire allowing further unopposed stretch
2. Golgi tendon organ inhibitory effects theory: Muscle contraction Golgi tendon threshold is reached. GTO is Activated Nd inhibits motor neuron activity
3. Muscle fatigue theory: Isometic contraction produced several times over fatigues muscle which is holding joint out of place.

Question 13

What are contraindications to DME techniques?

Answer 13

• individual is unwilling
• Internal bleeding
• Post-surgical patient
• Pt initially following MI
• Areas of acute injury

Question 14

Define Direct high velocity Low amplitude techniques.

Answer 14

Osteopathic technique employing a rapid, therapeutic force of brewing duration that travels a short distance within an anatomical range of motions of a joint and engages the restrictive barrier in one or more planes of motion to elicit release of restriction

Question 15

What is the purpose of HVLA?

Answer 15

To correct Joint restriction/somatic dysfunction

Question 16

What are steps in HVLA?

Answer 16

1. Bring Joint to barrier - reverse for diagnosis
2. Position carefully/fine tune
3. Use relaxation/distract or technique
4. Apply thrust in a specific direction without letting off barrier

Question 17

What is the mechanism of action of HVLA?

Answer 17

• Gapping of Joint sautés Release of NO

- Gapping will cause a sudden muscle stretch reflex

Question 18

What are indications and contraindications of HVLA?

Answer 18

• Careful with patients of Osteoporosis and atherosclerosis

- Acute injures