Final: Spinal Manual Therapy

Question 1

Goals of Spine Manual Therapy

Answer 1

• Pain Relief
• Increase Motion
• Stability

Question 2

Elements Involved in Spinal Manual Therapy

Answer 2

• Disc
• Ligaments
• Facets
• Muscle
• Bone
• Neural

Question 3

Physical Evaluation: Contents

Answer 3

• ROM
• Overpressure
• PPIVM
• PAIVM
• response to movement/position
• Ligament Tests
• Strength
• Special Tests

Question 4

PPIVM

Answer 4

(Passive Physiologic Intervertebral Movement)

- Osteokinematics - Angular movement occurring between bones (((ROM)))

Question 5

PAIVM

Answer 5

(Passive Accessory Intervertebral Movement)

- Arthrokinematics - Movement occurring between joint surfaces

Question 6

Physical Evaluation: Special Tests

Answer 6

• VAT
• SLR
• Sensation
• Neural Tension (slump, Lhermitte’s, etc.)
• Reflexes
• Foraminal Compression

Question 7

Intervention:

Answer 7

• STM
• Physiologic motion
• Accessory motion
• Muscle energy techniques
• Traction
• Posturing
• Mobs / Manipulation
• Stabilizing

Question 8

Intervention Systems

Answer 8

• McKenzie
• Mulligan
• Myofascial Release
• Craniosacral Therapy
• Neuromobilization
• Strain Counterstrain

Question 9

Indications for Manual Therapy (((YES)))

Answer 9

• Pain
• Hypomobility
• Hypermobility

Question 10

Indications for Manual Therapy: PAIN

Answer 10

BIOMECHANICAL pain

• Mild pain
• Non-irritable condition (pain from motion)
• Intermittent Musculoskeletal pain
• Pain relieved by REST
• Pain relieved/provoked by motions / positions
• Pain altered by postural positions

Question 11

Indications for Manual Therapy: HYPOMOBILITY

Answer 11

• Soft Tissue

- Joint

Question 12

Indications for Manual Therapy: HYPERMOBILITY

Answer 12

• Stabilization

Question 13

Contraindications to Manual Therapy: ABSOLUTE (NO)

Answer 13

• bacterial infection
• malignancy
• systemic localized infection
• cellulitis
• fever
• acute circulatory condition
• open wound at tx site
• osteomyelitis
• advanced diabetes
• hypersensitive skin
• inappropriate end feel
• constant, severe pain
• extensive pain radiation
• pain unrelieved by rest
• severe irritability

Question 14

Contraindications to Manual Therapy: RELATIVE (maybe)

Answer 14

• joint effusion/inflammation
• RA
• presence of neurological signs
• osteoporosis
• spondylolisthesis
• hyper mobility
• pregnancy (SPINE)
• dizziness
• steroid / anticoagulant therapy

Question 15

Manipulation (Thrust / Grade V) Indications:

Answer 15

Best indicated when pain is present and/or mobility is restricted

• <16 days
• Low FABQ (fear avoidance)
• NO pain below knee
• good hip IR
• lumbar stiffness

Question 16

Manual Therapy General Rule:

Answer 16

DO NO HARM

- risk assessment

Question 17

Manual Therapy Application: need to know

Answer 17

• Patient safety (POSITION)
• Anatomy (know whats under skin)
• Body mechanics (keep PT safe)
• Know when and when NOT to apply
• Patient Response = greatest measure