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OPP II > Facilitated Positional Release > Flashcards

Facilitated Positional Release Flashcards

1
Q

what is FPR used to treat

A

hypertonic muscles that may be involved in development of somatic dysfunction

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2
Q

goal in FPR treatment

A

normalize motion, restore hypertonic muscle fibers to normal motion and tone, and indirectly normalize somatic dysfunction

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3
Q

what is FPR? (direct or indirect)

A

indirect

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4
Q

what position do we place pt in when doing FPR

A

in the direction of freedom, reducing tissue tension aka indirectly

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5
Q

characteristic of FPR superficial musculature

A

larger, spanning multiple joints, can have palpable dysfunction like hypertonicity or tenderness

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6
Q

characteristic of FPR deep musculature

A

smaller only spanning 1 or 2 joint spaces and are involved in segmental somatic dysfunction

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7
Q

what occurs during initial injury that we use FPR to treat

A

overstretched muscle (or quickly contracted against a force it cannot move against), muscle spindle sends afferents to spinal cord to signal that it is stretched and needs to be shortened. spinal cord responds with efferent impulse to muscle spindle that shortens the stretched muscle fibers

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8
Q

when do muscle fibers remain in a state of hypertonicity and shortened?

A

normally, once muscle has shortened, second afferent message is sent to spinal cord to signal that efferent impulse should be shut off, but doesn’t

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9
Q

what fibers send afferent signals from the intrafusal fiber

A

Group Ia and Group II afferent in the intrafusal fibers

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10
Q

what do Group Ia fibers do

A

ascend to spinal cord and stimulate alpha motor neurons for homonymous muscle (contraction)

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11
Q

what do Group II fibers do

A

stimulate gamma motor neurons

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12
Q

what do gamma motor neurons do

A

cause ends of intrafusal fibers to contract and take up the slack and increase sensitivity of the fibers

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13
Q

why are gamma motor neurons important

A

increase sensitivity of the intrafusal fibers

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14
Q

what is the proposed mechanism of somatic dysfunction?

A

increased gamma motor neuron activity, where even if the muscle is in resting position, intrafusal fibers send signals on both group Ia and II afferent neurons leading to muscle contraction via alpha motor neurons

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15
Q

does stretching help this type of somatic dysfunction?

A

no, will get worse with stretch as stretching will accentuate the strain on the already extra sensitive intrafusal fibers, causing more dysfunction

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16
Q

mechanism of FPR

A

by placing muscle fibers in their shortened positions (into the freedom), efferent firing of nerve impulses that keep the muscle shortened will decrease and the muscle will relax

17
Q

generalized mechanism of indirect techniques

A

all indirect techniques aim to diminish the strain in the tissue so there is a decrease in afferents to spinal cord and decrease in efferent activity (motor and autonomic)

18
Q

steps of deep muscle treatment

A
  1. flatten spinal curves (neutral position) 2. add activating compression/torsion force into the dysfunction 3. maintain compressive force while moving dysfunctional segment into a position of ease in all 3 planes 4. hold 3-5 sec 5. return to neutral and release compression 6. reassess
19
Q

steps of superficial muscle treatment (trap, rhomboid, psoas, suboccipitals)

A
  1. flatten the curve 2. move segment into position of ease 3. add activating force into dysfunction 4. hold 3-5 seconds 5. return to neutral 6. reassess
20
Q

what do you need to treat a pt with FPR

A
  1. pt and consent 2. pt history 3. physical exam with structural exam 4. diagnosis that includes somatic dysfunction
21
Q

how does neutral position help FPR

A

unloads joint by removing stress on the joint capsules and soft tissue structures (includes muscles)

22
Q

what is neutral position

A

eliminating lordotic and kyphotic curves

23
Q

how does facilitating force help FPR

A

helps shorten all soft tissue and initiate soft tissue relaxation aka inverse muscle spindle output to group Ia and group II afferent neurons to decrease gamma motor neuron activity

24
Q

what is the main benefit of FPR?

A

activating force helps shorten FPR time to 3-5 seconds while counterstrain takes 90seconds

25
Q

what is the benefit of placing the muscle in the ease?

A

puts hypertonic muscle in its shortest position, resetting muscle spindles and gamma motor neurons

26
Q

what is the force vector in the Still method

A

runs from point of external compression or traction to the restricted tissue, and serves as a lever to move the tissue through its ROM

27
Q

what is the Still method

A
  1. place in position of ease 2. introduce force vector of less than 5lbs from another part of the body through the affected tissue 3. use force vector to move the affected tissue in a smooth path from its position of ease toward and through its position of restriction 4. move to neutral and reassess
28
Q

what is FPR vs Still

A

FPR: indirect technique with activating force brought to easy neutral (position of ease) for 3-5seconds. Still: indirect to direct technique with compressive force that is brought to ease then toward and through restrictive barrier then to neutral.

29
Q

what do you need to have to diagnose the AA?

A

a segmental finding and a screening

30
Q

how to position for superficial cervical region FPR

A

supine pt, neutralize the curve, E-STRT (into the ease)

31
Q

how to position for cervical region FPR

A

supine pt, flatten the curve, F-STRT (into the ease)

32
Q

how to position for superficial muscle (trapezius) FPR

A

prone pt, palpate muscle, stand on opposite side of hypertonicity, grasp anterior deltoid and acromioclavicular region, place caudad and posterior force (pull shoulder blade down and out) and compresa

33
Q

how to position for thoracic region FPR

A

pt seated, stand behind pt, sit up straight and tuck chin, compress, move pt into ease.

34
Q

how to position for lower thoracic region FPR

A

pt seated, stand behind pt, stand up straight. physician upper forearm and hand resting across upper back behind neck. apply caudad and posterior force while moving into ease. 3-5 seconds.

35
Q

how to position for lumbar FPR

A
  1. lay on opposite side of ease. face pt. right forearm and hand control anterolateral chest wall and left forearm and hand control right pubic and lumbar region. monitor lumbar vertebrae with index and 3rd finger. flex hips until area is fully flexed. (if flexed) push on shoulder to induce rotation. push pubic and lumbar region anteriorly until vertebrae fully engaged. inhale and exhale, increase force on forearms and fingers on transverse process through the rotational vectors (chest back, hips foward like wringing out towel)

OPP II (7 decks)

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