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Interventions II > Final - History of Mobilization > Flashcards

Final - History of Mobilization Flashcards

1
Q

Oldest statue or illustration of a manipulation

A

2500 BC Thailand

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2
Q

Hippocrates

A

father of western medicine

massage is an effective therapy for treating injuries

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3
Q

Galen

A

Greek physician
Influenced by Hippocrates
Treated Gibbus Deformity and Scoliosis

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4
Q

Bonesetters

A

Practitioner of joint manipulation

Reduce joint dislocations and “re-set” bone fractures

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5
Q

Sir Percival Pott

A

condemned traction and manipulation as useless and dangerous

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6
Q

James Mennell

A
  • Manipulation is best served by PTs

- used radiology to see what techniques achieved

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7
Q

Thomas Marlin

A
  • first published practitioner of specific joint manipulation
  • Had sound understanding of the word arthrokinematics
  • paid close attention to facet/joint planes
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8
Q

James Cyriax

A
  • UK
  • laid claim to founding orthopedic medicine
  • techniques use great force
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9
Q

Cyriax’s Theory

A
  • If back pain comes on rapidly and does not radiate down the leg, it is a torn disc that needs to be manipulated back into place
  • if pain comes on gradually or radiates, it is a disc protrusion and needs to be suck back with manual or mechanical traction
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10
Q

Freddy Kaltenborn, PT

A
  • Father of Manual Therapy
  • developed Kaltenborn-Evjenth approach
  • emphasis on restoring the gliding component of the normal joint roll-gliding movement
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11
Q

Geoff Maitland, PT

A
  • approach focused on structured clinical reasoning, taking a thorough history in order to establish a comparable sign, focuses on pain
  • comparable sign = pain or other symptoms reproduced upon physical exam that is indicated by the patient as their reason for seeking PT
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12
Q

Mariano Rocabado

A

focused on the oral/facial system

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13
Q

Robert Elvey

A

introduced neural tension concepts

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14
Q

Brian Mulligan

A

Developed mobilization/manipulation with movement

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15
Q

David Butler

A

further progressed neural tension techniques and restoring neurodynamic function

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16
Q

Stanley Paris, PT

A
  • voice of manual therapy
  • Fonded IFOMPT and AAOMPT
    0-6 PIVM grading system
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17
Q

APTA Definition of manual therapy

A

skilled hand movements intended to improve tissue extensibility, increase ROM, induce relaxation, mobilize or manipulate soft tissue and joints, modulate pain, and reduce soft tissue swelling, inflammation or restriction

18
Q

What constitutes manual therapy?

A 
Massage
manual lymphatic drainage
manual traction
mobilization/manipulation
neural mobilization
joint stabilization
sef mobilization exercises
PROM
19
Q

APTA definition of Manipulation

A

Meaning a skilled passive movement to a joint and related soft tissues which includes both thrust and non-thrust

20
Q

Thrust definition

A

high velocity, low amplitude therapeutic movements within or at end ROM

21
Q

Do practice guidelines support the use of manipulation for acute and chronic LBP?

A

yes

22
Q

Manual therapy vs. no manual therapy

A
  • improved outcome score
  • improved pain score
  • decreased cost of EOC
  • improved neurophysiological effect of multifidus
23
Q

thrust manipulation vs mobilization

A
  • no significant change in outcome/pain scores

- decreased sessions, decreased cost, decreased duration –> increased overall efficiency

24
Q

Does technique matter as much as we think?

A

no

the thrust itself may be all that is needed due to the effects of manipulation

25
Q

barriers that exist to mobilization/manipulation

A
  • other health care professions dont always recognize PTs can perform manips
  • fear by PTs to learn manips/not trained
  • many people are involved for this to be the most effective (rapid scheduling is critical)
26
Q

Clinical Prediction Rule - LBP

A
  • Duration of symptoms < 16 days
  • FABQ work sub scale 18 or less
  • Symptoms not distal to the knee
  • At least one hip internal rotation PROM > 35
  • Hypomobility at one or more lumbar levels with spring testing
27
Q

Psychological Effects of Manips

A
  • Laying on of skilled hands
  • Placebo
  • Demonstrates that movement is not painful
  • An immediate sound - “crack or pop”
  • immediate relaxation of tight musculature
28
Q

Mechanical Effects of Manips

A
  • Reposition vertebra and joints
  • Stretch out or snap adhesions
  • Restore fiber glide within the capsule
29
Q

Neurological Effects of Manips

A
  • Increases inflow of sensory information to the central nervous system
  • muscle spindle afferents are stimulated by spinal manipulation
  • smaller diameter sensory nerve fibers are likely activated
  • numerous studies show that spinal manipulation increases pain tolerance or its threshold
30
Q

Biochemical Effects of Manips

A
  • very little is known about the chemical effects
  • however, clinically evident that when the spine is subjected to a series of manips at non symptomatic levels on normal subjects, they report “that feels good” lol
  • endorphin/enkephalin release
31
Q

Are thrust and non-thrust manips included in PT licensure exam?

A

Yep

32
Q

Is there evidence of higher claims losses due to PTs utilizing manipulative procedures?

A

nope

33
Q

What has excessive use of imaging been cited to do?

A

cause escalating health care costs

34
Q

Benefits of manips outweighs the risks as long as …

A

clinical decision making is based on thorough examination and evidence based impairment based approach

  • screen for red flags
  • consider contraindications
  • modify techniques when appropriate
35
Q

Subjective indications for manips

A
  • short duration of episodic pain
  • minor triggers
  • mild to mod pain intensity
  • mild to mod pain referral
  • maintains function although it may be modified
36
Q

objective indications for manips

A
  • ROM limitation proportional to the pain intensity
  • no neurological signs or symptoms/mild referral
  • unidirectional restriction
  • joint hypomobility or restriction
  • jammed or pathomechanical end feel with joint glides
  • last few degrees of range limited or unobtainable by mobilization
37
Q

Contraindications of Manips

A
  • local infection
  • inflammatory disease
  • active cancer
  • long term steroid use
  • osteoporosis
  • systemically unwell
  • hypermobility syndromes
  • connective tissue disease
  • RA/systemic arthritis
  • cervical anomalies
  • throat infections in children
  • recent manipulation by another health professional
38
Q

more contraindications for manips

A
  • uncontrolled diabetes
  • cauda equina
  • pregnancy
  • bleeding disorders
  • unwilling patient
  • empty end feel
  • multi-level nerve root pathology
  • worsening neurological function
  • unremitting, severe, non-mechanical pain
  • unremitting night pain
  • relevant recent trauma
  • UMN lesion
  • spinal cord damage
  • symptom fabrication or severe amplification
  • hx or cancer
39
Q

risk factors associated with an increased risk of either internal carotid or vertebrobasilar arterial pathology

A
  • past history of trauma to c spine/ cervical vessels
  • history of migraine type headache
  • hypertension
  • hypercholesterolemia/ hyperlipidemia
  • cardiac disease, vascular disease, previous CVA, TIA
  • diabetes mellitus
  • blood clotting disorder
  • anticoagulant therapy
  • long term use of steroids
  • hx of smoking
  • recent infection
  • immediately post partum
  • trivial head or neck trauma
  • absence of plausible mechanical explanation for the patients symptoms
40
Q

risk factors associated with the potential for bony or ligamentous compromise of the upper cervical spine

A
  • hx of trauma
  • throat infection
  • congenital collagenous compromise
  • inflammatory arthrities
  • recent neck/head/dental surgery
41
Q

informed consent

A
  • recommended that the disclosed of information and the obtaining of IC be recorded in pt’s record
  • recommended to document each time pt receives a manipulation

Interventions II (8 decks)

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