FPR comps

Question 1

FPR for Cervical segmental dysfunction

Answer 1

• patient supine
• support patients head with one hand and monitor at articular pillars with other
• slightly flex head and neck to flatten cervical curvature
• apply axial compression
• move segment into ease of motion and hold for 3-4 seconds

Question 2

FPR for thoracic hypertonic muscles

Answer 2

• patient seated
• monitor at site of dysfunction with one hand and place other arm on patient’s shoulder on side of dysfunction, with forearm behind patient’s neck
• instruct patient to sit upright to flatten kyphosis
• apply downward compression and side-bend down to the monitoring finger
• hold for 3-4 seconds and release

Question 3

FPR for thoracic segmental dysfunction, seated

Answer 3

• patient seated, doc monitors at PTP
• ask patient to sit up straight to flatten curve
• reach across patient’s posterior aspect of chest for proper control of trunk
• apply downward axial compression and put patient into the ease of motion in the coronal, transverse, and sagittal planes
• hold for 3-4 seconds and wait for relaxation

Question 4

FPR for segmental type II dysfunction, prone technique

Answer 4

• patient prone; place pillow under patient to flatten curvature
• stand beside table opposite the dysfunction
• monitor with cephalad hand on PTP
• with caudad hand, grasp patient’s shoulder over the accordion process, and pull caudally to induce side-bending and posteriorly to induce rotation
• hold for 3-4 seconds for tissue relaxation

Question 5

FPR for lumbar hypertonic muscles

Answer 5

• patient prone with pillow under abdomen to flatten curvature
• stand on same side as dysfunction
• monitor at hypertonic muscles with cephalad hand
• doc places knee on table at patient’s hip to use as fulcrum
• use caudad arm to pull patient’s legs toward doc to induce side-bending to same side as dysfunction
• cross patient’s contralateral leg over the other to rotate–increase rotation by pulling posteriorly at the contralateral thigh or ASIS (extending the leg) and externally rotate until a torsional motion is felt at the monitoring hand

Question 6

FPR Lumbar Extension dysfunction, alternate technique

Answer 6

• patient laying lateral recumbent with PTP up
• doc monitors at PTP
• grasp top knee and abduct leg until motion is felt at monitoring hand
• internally rotate hip and extend until motion is felt
• hold for 3-4 seconds waiting for relaxation

Question 7

FPR Lumbar extension dysfunction alternate technique suitable for patients who

Answer 7

-cannot tolerate lying prone such as in pregnancy, psoas syndrome, post-surgical, etc

Question 8

FPR Lumbar flexion dysfunction

Answer 8

• patient prone at edge of table with pillow under abdomen to flatten curvature
• doc steamed next to table on side of PTP and monitors PTP
• grasp patient’s ipsilateral knee and flex hip until motion is felt at monitoring hand
• adduct and internally/externally rotate at the hip until motion is felt
• hold for 3-4 seconds waiting for tissue relaxation

Question 9

FPR for piriformis muscle

Answer 9

• patient prone with pillow under abdomen
• doc seated beside the table on the side of dysfunction
• doc monitors at dysfunctional tissue at piriformis insertion on greater trochanter
• doc flexes patient’s knee and drops patient’s flexed knee and thigh off table, allowing hip to flex forward until motion is felt at monitoring hand
• doc adducts/abducts and internally rotates the patient’s knee until motion is felt
• induce compression force at knee toward the monitoring hand

Question 10

FPR for gluteus maximus muscle

Answer 10

• patient prone with pillow under abdomen
• doc seated ont he side of dysfunction
• doc monitors at dysfunction (usually at iliac crest)
• doc flexes patient’s knee to 90 degrees brings ipsilateral hip and knee into full abduction to rest knee on doc’s thigh farthest from the patient
• Doc raises their heel of the floor until motion is felt at monitoring hand. This induces extension
• Doc pushes patient’s knee externally (or pulls patient’s ankle medially) causing external rotation at the hip

Question 11

FPR for anterior rib cage and costochondral dysfunctions

Answer 11

• patient seated
• doc places arm opposite side of dysfunction around the front of the patient, and monitors at dysfunction
• Doc’s ipsilateral hand monitors at the cervicothoracic junction, while other arm rests on patient’s shoulder
• have patient sit upright to flatten curvature
• compress downward through the spine
• flex patient forward until motion felt at monitoring hand (may need to flex neck as well)
• Side-bend patient toward dysfunction (may need to rotate as well)

Question 12

FPR for posterior rib dysfunctions, seated

Answer 12

• patient seated
• monitor posteriorly at dysfunction
• patient sits upright to flatten curvature
• doc places arm anteriorly across patient’s shoulders
• compress downward on shoulders and side-bend towards dysfunction.
• Induce posterior rotation down to the level of the somatic dysfunction