Intro to BLT, FPR, Still's Techniques

Question 1

Direct techniques

Answer 1

method of action engage the restrictive barrier directly

Question 2

indirect techniques

Answer 2

method of action involve positioning away from restrictive barrier

Question 3

Why indirect?

Answer 3

pt/practitioner preference

direct treatment contraindicated

direct treatment isn’t working

Question 4

Who was the most instrument for indirect techniques?

Answer 4

Dr. Sutherland (cranial techniques)

Question 5

Who first used BLT term?

Answer 5

Dr. Anne Wales

Question 6

Who first used strain-counterstrain?

Answer 6

Dr. Lawrence Jones

Question 7

Who first used facilitated positional release?

Answer 7

Dr. Stanley Schiowitz & Dr. DiGiovanna

Question 8

BLT (balanced ligamentous tension)

Answer 8

3 principles:

disengagement of dysfunctional area (allow to bring tissue to neutral point)

exaggeration of dysfunctional pattern

balanced tension of ligaments (help resolve SD)

Question 9

steps of BLT

Answer 9

place segment into indirect manner

utilize activating force: inherent respiration

return to neutral & re-evaluate

Question 10

respiratory assist

Answer 10

assoc w/ greatest ease

feel preference for inhalation or exhalation

instruct pt to hold until feel “air hunger” (need to take break again)

Question 11

spine during inhalation & exhalation

Answer 11

inhalation: flattens spine
exhalation: increases AP spinal curves

Question 12

indications for BLT

Answer 12

ligament articular strain

lymphatic congestion or local edema

Question 13

contraindications for BLT

Answer 13

fracture, dislocation, instability

open wounds

soft tissue/bony infections

abscesses

DVT

malignancy

Question 14

goal of BLT

Answer 14

balance the articular surfaces’ directions of physiologic motion that are common to that articulation

physician helps the body help itself

Question 15

what is the position of treatment for T7 using a BLT technique?

Answer 15

extended, rotated left, sidebent left

single segment so type 2 dysfunction (rotaton & SB in same direction)

Question 16

what is consistent with BLT treatment?

Answer 16

asking the pt to hold in exhalation

use of respiratory assist

Question 17

Facilitated Positional Release

Answer 17

pt passive, indirect technique

interaction between afferent & efferent activity

Question 18

Mechanism of FPR

Answer 18

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)

Question 19

goal of FPR

Answer 19

decrease tension in extrafusal fibers

muscles achieve nnormal length & tone

Question 20

what is the secondary effect of FPR?

Answer 20

improved lymph drainage, venous drainage & improved fluid dynamics

Question 21

FPR steps

Answer 21

position segment in neutral

use compression (downward force)

place pt in indirect position (hold 3-5 sec)

return to neutral & reassess

Question 22

indications of FPR

Answer 22

muscle hypertonicity
all SD
time crunch

Question 23

contraindications of FPR

Answer 23

unstable fracture
neuro symptoms
life-threat symptoms
wound<6weeks
joint instability

Question 24

left posterior TP @ T1-3

what position for FPR technique?

Answer 24

T2 N Rl Sr

Question 25

what is the 1st step of treating pt w/ FPR?

Answer 25

neutralizing the curve

Question 26

Still’s technique

Answer 26

pt passive, combined technique

coined by Dr. Richard van Buskirk

Question 27

steps of Still’s technique

Answer 27

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

Question 28

indications for Still’s technique

Answer 28

all SD

short on time

Question 29

contraindications for Still’s technique

Answer 29

fractures or wounds <6 weeks