Foundations of Manual Therapy

Question 1

What is manual therapy?

Answer 1

A multi-modal, evidence informed APPROACH to treatment.

Question 2

List 8 mandatory upper quadrant scanning questions.

Answer 2

i) 5D’s and 2N’s
ii) headaches
iii) cranial nerve signs
iv) parasthesias
v) periodic LOC
vi) Effect of cough
vii) Bladder/bowel/saddle parasthesia
viii) Upper respiratory tract infections

Question 3

What are the 5D’s and 2N’s of the upper quadrant scan?

Answer 3

i) dizziness
ii) double vision (diplopia)
iii) dysphagia
iv) drop attacks
v) dysarthria
vi) numbness
vii) nystagmus/nausea

Question 4

List 4 lower quadrant screening questions.

Answer 4

i) bowel/bladder
ii) saddle parasthesia
iii) groin/thigh pain
iv) medications

Question 5

What was the focus of manual therapy for Freddy Kaltenborn?

Answer 5

Diagnosis and biomechanical contributions. Ex. resting position/closed packed, concave/convex rule etc.

Question 6

Who was the inventor of deep friction massage?

Answer 6

James Cyriax.

Question 7

Describe the Kaltenborn grading system for passive accessory joint mobilizations.

Answer 7

I: Before onset of R1
II: To R1
III: To R2

Question 8

Which kinds of joint mobilizations does Kaltenborn grading system apply to?

Answer 8

i) passive accessory movements only

ii) sustained mobilizations only

Question 9

What are the benefits of a Kaltenborn grade I and II joint mobilization?

Answer 9

i) Maintain available ROM without injuring the joint acutely
ii) Pump out swelling/remove inflammatory waste
iii) Improve circulation

Question 10

What was the manual therapy focus of Geoffrey Maitland?

Answer 10

Comparable signs: symptom reproduction.

Question 11

What types of joint mobilizations does the Maitland grading system apply to?

Answer 11

i) either accessory OR physiologic movements

ii) oscillatory

Question 12

Describe the Maitland grading system for joint mobilizations.

Answer 12

I: small amplitude, prior to R1
II: large amplitude, prior to R1
III: large amplitude, between R1-R2
IV: small amplitude, between R1-R2
V: Very small amplitude, past R2 (manipulation)

Question 13

What are the benefits of small amplitude oscillatory joint mobilizations?

Answer 13

i) mild exposure to movement, decrease guarding
ii) alter tone
iii) improve circulation
iv) move synovial fluid (remove waste products)

Question 14

What are the benefits of joint mobilization?

Answer 14

i) increase ROM
ii) reduce pain
iii) reduce muscle tone
iv) improve accessory motion

Question 15

Are mobilizations effective in isolation?

Answer 15

No. They are only effective when paired with exercise in a multi-modal approach ex. strengthening and exercising in new ROM.

Question 16

Name 5 contraindications to joint mobilization.

Answer 16

i) suspected or history of malignancy
ii) pregnancy
iii) spinal cord/multiple nerve root invovlement
iv) fracture/dislocation
v) non-mechanical cause of restriction