Intro to BLT, FPR, Still's Techniques Flashcards
Direct techniques
method of action engage the restrictive barrier directly
indirect techniques
method of action involve positioning away from restrictive barrier
Why indirect?
pt/practitioner preference
direct treatment contraindicated
direct treatment isn’t working
Who was the most instrument for indirect techniques?
Dr. Sutherland (cranial techniques)
Who first used BLT term?
Dr. Anne Wales
Who first used strain-counterstrain?
Dr. Lawrence Jones
Who first used facilitated positional release?
Dr. Stanley Schiowitz & Dr. DiGiovanna
BLT (balanced ligamentous tension)
3 principles:
disengagement of dysfunctional area (allow to bring tissue to neutral point)
exaggeration of dysfunctional pattern
balanced tension of ligaments (help resolve SD)
steps of BLT
place segment into indirect manner
utilize activating force: inherent respiration
return to neutral & re-evaluate
respiratory assist
assoc w/ greatest ease
feel preference for inhalation or exhalation
instruct pt to hold until feel “air hunger” (need to take break again)
spine during inhalation & exhalation
inhalation: flattens spine
exhalation: increases AP spinal curves
indications for BLT
ligament articular strain
lymphatic congestion or local edema
contraindications for BLT
fracture, dislocation, instability
open wounds
soft tissue/bony infections
abscesses
DVT
malignancy
goal of BLT
balance the articular surfaces’ directions of physiologic motion that are common to that articulation
physician helps the body help itself
what is the position of treatment for T7 using a BLT technique?
extended, rotated left, sidebent left
single segment so type 2 dysfunction (rotaton & SB in same direction)
what is consistent with BLT treatment?
asking the pt to hold in exhalation
use of respiratory assist
Facilitated Positional Release
pt passive, indirect technique
interaction between afferent & efferent activity
Mechanism of FPR
decrease length of intrafusal fibers, signal that is less stress in muscle
decrease excitatory info to alpha motor neurons & less signal to gamma neurons intrafusal fibers (muscle spindle)
goal of FPR
decrease tension in extrafusal fibers
muscles achieve nnormal length & tone
what is the secondary effect of FPR?
improved lymph drainage, venous drainage & improved fluid dynamics
FPR steps
position segment in neutral
use compression (downward force)
place pt in indirect position (hold 3-5 sec)
return to neutral & reassess
indications of FPR
muscle hypertonicity
all SD
time crunch
contraindications of FPR
unstable fracture neuro symptoms life-threat symptoms wound<6weeks joint instability
left posterior TP @ T1-3
what position for FPR technique?
T2 N Rl Sr
what is the 1st step of treating pt w/ FPR?
neutralizing the curve
Still’s technique
pt passive, combined technique
coined by Dr. Richard van Buskirk
steps of Still’s technique
place dysfunctional segment in indirect position
add localizing force
move thru the restrictive barrier while maintaining localizing force (maintain compression as move indirect to direct)
end in direct position (attain anatomic barrier)
return to neutral & reassess
indications for Still’s technique
all SD
short on time
contraindications for Still’s technique
fractures or wounds <6 weeks
