Facilitated Positional Release (FPR) and Still Technique

Question 1

What happened in 1963 for DO’s?

Answer 1

D.O.s are accepted by Civil Service as medical officers on equal footing with MDs

Question 2

What 2 things happened in 1966 for DO’s?

Answer 2

1. Robert McNamara, Secretary of Defense, directs the Army, Navy and Air Force to accept qualified D.O.s as medical officers. Viet Nam is on
2. Andrew Lovy, OD, DO CCO’62 is the first DO to be drafted into the Army Medical Corp as a physician

Question 3

4 things associated with FPR

Answer 3

1. Positional technique
2. Facilitated with compression, distraction or torque
3. Quick and efficient
4. Effective

Question 4

Define FPR

Answer 4

Facilitated positional release (FPR) is an indirect positional method of treatment for somatic dysfunction or abnormal muscle tension

Question 5

Who developed FPR?

Answer 5

Stanley Schiowitz D.O.

Question 6

What reports length and rate of stretch?

Answer 6

Muscle spindles

Question 7

FPR can provide restoring to what?

Answer 7

Hyper-shortened muscle decreases firing

Question 8

What 3 things cause neural feedback to rapidly normalize?

Answer 8

1. Compression force
2. Torque
3. Distraction

Question 9

What are the 4 facilitating forces in FPR?

Answer 9

1. Compression
2. Torque
3. Traction
4. Distraction

Question 10

5 steps to FPR

Answer 10

1. Put joint in a “loose pack “ position
2. Flatten the anterposterior spinal curve to be treated
3. Add facilitating force
4. Position into freedom of motion or shortening of the muscle
5. Hold for 3-5 seconds and release

(3 & 4 may be reversed)

Question 11

5 indications for FPR

Answer 11

 Somatic dysfunctions with a neural component
 Any area of the body
 Acute or chronic
 Need for a gentle technique
 Primary treatment or combined with other techniques.

Question 12

What is FPR useful for specifically?

Answer 12

Pain from disc herniations

Question 13

What 5 things MUST we know for FPR?

Answer 13

 Put A/P curve in neutral (if treating spinal segments)
 Introduce vector force- compression/distraction/torque- this MUST be maintained throughout the treatment!
 Position dysfunction to point of ease (localization of motions)
 Wait 3-5 seconds for release
 Return to pretreatment position.

Question 14

Who discovered techniques first used by Still?

Answer 14

Richard Van Buskirk, D.O., Ph.D., F.A.A.O

Question 15

Define Still technique

Answer 15

Indirect then direct

Question 16

The methodology for Still Technique at the American School of Osteopathy was taken by who?

Answer 16

Charles Hazzard, D.O

Question 17

Detailed steps of Still Technique

Answer 17

 A gentle, precise localization technique
 Starts out as indirect, but finishes as direct
 Utilizes localization of all planes of motion to the balance point, or position of ease
 Uses a final activating vector force through the affected tissue
 The vector force should come from a part of the body that can be used as a lever for the technique
 Then, finishes by returning the joint, tissue, fascia, etc. to the normal range of motion
 As the coupled vector force and the tissue motion takes the tissue past its restriction, a palpable release is appreciated
 The vector force is then released and the tissue is returned to its start position

Question 18

What is the activating force in Still Technique?

Answer 18

Vector force as it moves the tissue through its range of motion and through the area of restriction

Question 19

How is Still Technique articulatory?

Answer 19

It takes the tissue through the range of motion, but is not a repetitive articulation

Question 20

5 reasons why we use Still Technique

Answer 20

 Can be used for almost any type of dysfunction
 Quick and efficient
 Can retreat are without complications
 Very gentle
 Can treat in SEATED and supine positions

Question 21

4 players in Still Technique

Answer 21

 The dysfunction
 The physician’s sensing hand- passive
 The physician’s operating hand-the worker
 The force vector- compressive or distractive- 3-5 pounds

Question 22

6 steps on how Still Technique is done

Answer 22

 Find the Dysfunction

 Place sensing hand on dysfunction and localize to balance point or the pathological neutral

 Operating hand does all the work

   Introduces the force vector through the tissue to the sensing hand
   Uses the force vector as a steering rod at a low-moderate velocity motion to return the tissue to normal

 Must keep the vector force focused at all times!!

Question 23

How is Still technique similar to FPR/Counterstrain?

Answer 23

Initial start point

Question 24

How is Still technique similar to HVLA?

Answer 24

Requires precise localization

Question 25

How is Still Technique similar to Articulatory?

Answer 25

Puts tissue through its range of motion, BUT ONLY ONCE

Question 26

What are 6 things we MUST know for Still Technique?

Answer 26

 Place sensing hand on dysfunction and localize to balance point or the pathological neutral

 Operating hand does all the work
 Introduces the force vector through the tissue to the sensing hand

  Use the force vector as a steering rod at a low-moderate velocity motion to return the tissue to normal

MUST KEEP THE VECTOR FORCE FOCUSED AT ALL TIMES!!

Reassess