indications, therapeutic mechanisms, parameters

Question 1

articulation indications

Answer 1

1. Painful joint
2. Reduced ROM (due to joint restriction)
3. Altered quality of joint motion

Question 2

articulation therapeutic mechanisms

Answer 2

1. Decrease pain – pain gate + PAG stimulation.
2. Fluid drainage – movement changes pressure in and out of joint, promotes lymphatic drainage.
3. Stretch and remodelling the CT that produces longer term increased ROM.

Question 3

articulation parameters

Answer 3

Move joint rhythmically into restricted barrier for 60-90 sec or until a TTC is achieved

Question 4

HVLA indications

Answer 4

1. Pain
2. Reduced ROM
3. TART findings

Question 5

HVLA therapeutic mechanisms

Answer 5

1. Change in joint pressures creates tribonucleation, leading to decreased force needed for increased rom.
2. Decrease pain – pain gate + PAG stimulation.

Question 6

MET indications

Answer 6

1. Pain
2. Reduced ROM (due to joint and muscle restriction)
3. TART findings

Question 7

MET Therapeutic mechanisms

Answer 7

1. Decrease pain – pain gate + PAG stimulation.
2. Fluid drainage – movement changes pressure in and out of joint, promotes lymphatic drainage.
3. Improved proprioception and motor control -
4. Muscle and tissue lengthening – stretches CT elements.

Question 8

MET parameters

Answer 8

Move joint into restricted barrier, Get pt to contract into your resistance for 3-7 seconds, Repeat 3-5 times, Retest

Question 9

soft tissue indications

Answer 9

1. Pain
2. Reduced ROM
3. TART Findings (particularly hypertonicity)

Question 10

soft tissue therapeutic mechanisms

Answer 10

1. Decrease pain – pain gate + PAG stimulation.
2. Fluid drainage – movement changes pressure in and out of joint, promotes lymphatic drainage.
3. Muscle and tissue lengthening – stretches CT elements.
4. Promotion of healing and tissue repair - improve tissue mobility by breaking collagen crosslinks and connective tissue adhesions. + Mechanotransduction= mechanical signals are converted into cellular biological events (gene expression) that promote growth and repair
5. Reflex muscle relaxation
6. Reduce anxiety and promote relaxation.

Question 11

soft tissues parameters

Answer 11

Apply technique to affected tissue for 60 – 90 sec or until TTC

Question 12

counterstrain indications

Answer 12

1. Pain (especially extreme tenderness)
2. Reduced ROM
3. TART findings

Question 13

counterstrain therapeutic mechanisms

Answer 13

1. Nociceptive model – putting tissue in ease decreases nociceptive afferent input, decreasing pain
2. Fibroblast model - putting tissue in ease reduces fibroblast activity, decreasing inflammation, decreasing pain
3. Circulatory model – allows refilling of blood vessels in the muscle, alleviating ischemia, alleviating pain
4. Ideomotion model – expression of instinctive movement response in humans, allows movement to occur to promote relaxation.
5. Neurological model – putting tissue in ease decreases muscle spindle activation, decreasing pain

Question 14

counterstrain parameters

Answer 14

Find a tender point, that is 7/10 pain, that then becomes new 10/10, we want to get pain down to 3/10. Find that position, hold for 90 sec, slowly return to neutral and retest.

Question 15

stretching indications

Answer 15

1. Pain (shortened or hypertonic muscle)
2. Reduced ROM (in direction that would stretch the muscle)
3. TART findings

Question 16

stretching therapeutic mechanisms

Answer 16

1. Pain (shortened or hypertonic muscle)
2. Reduced ROM (in direction that would stretch the muscle)
3. TART findings

Question 17

stretching parameters

Answer 17

Hold for 15-30 seconds, repeat 2-4 times, retest.