Intro to BLT, Still's and FPR OMT Techniques

Question 1

What does BLT stand for?

Answer 1

Balanced Ligamentous Tension (BLT)

Question 2

BLT Definition:

Answer 2

The method involves the minimization of periarticular tissue load and the placement of the affected ligaments in a position of equal tension in all appropriate planes so that the body’s inherent forces can resolve the somatic dysfunction

Question 3

BLT indications?

Answer 3

Somatic dysfunctions that involve ligamentous articular strains

Areas of lymphatic congestion or local edema

Question 4

BLT Relative Contraindications?

Answer 4

• Fractures
• Open wounds
• Soft tissue or bony infections
• Abscesses
• DVT
• Anticoagulation
• Recent post-op conditions over the site of proposed treatment
• Aortic aneurysm

Question 5

BLT Saftey and Efficacy:

Describe

Answer 5

Safe and well tolerated

No known reports of complications arising

Question 6

Steps in BLT?

Answer 6

1. Diagnose
2. Positioning (shifted neutral)
3. Activating Force: Respiratory assist
4. Reevaluate for motion improvement

Question 7

Answer 7

C. Extended, rotated left, sidebent left

Question 8

FPR Definition?

Answer 8

A treatment method in which a dysfunctional body region is addressed with a combination of neutral positioning, application of activating force (compression, torsion or distraction) and placement into a position of ease

Question 9

Advantages of using FPR?

Answer 9

• Easily applied, effective and time efficient
• Good patient satisfaction
• Thorough

Question 10

FPR indications?

Answer 10

Myofascial or articular somatic dysfunction

Question 11

FPR Absolute Contraindications?

Answer 11

1. Fracture
2. Neurological symptoms (brought on by the treatment position)
3. Life-threatening symptomatology (EKG changes, drop in O2 sat)

Question 12

FPR Relative contraindications?

Answer 12

1. Treatment not well tolerated
2. Comorbidities that place the patient at risk for fracture
3. Moderate to severe joint instability
4. Spinal stenosis/nerve root impingement

Question 13

FPR proposed mechanism?

Answer 13

Increases activity of gamma motor neurons

Stimulates muscle spindles

Result = increased tension in the muscle

Inverse spindle output

Question 14

Steps in FPR?

Answer 14

1. Setup: Neutral position
2. Activating force, add facilitating force
3. Positioning: indirect for greatest ease, hold for 3-5 seconds
4. Return and re-evaluate

Question 15

Answer 15

C. T2 Neutral, rotated left, sidebent right

Question 16

Still technique definition?

Answer 16

Combined manipulative method using both indirect and direct components

“The dysfunctional region is first placed in an indirect position, an axial force (compression, traction, torsion) is added then used to carry the region toward or through the restrictive barrier”

Question 17

Advantages of Stills?

Answer 17

SAME AS FPR

• Easily applied, effective, time efficient
• Good patient satisfaction
• Thorough

Question 18

Indications for Stills?

Answer 18

Somatic dysfunction in virtually all tissues of the body

Safe for all ages

Question 19

Contraindications for Stills?

Answer 19

Recent wounds

Fractures

Question 20

Steps to the Stills Technique?

Answer 20

1. Evaluate
2. Initial treatment position of ease
3. Add localizing force
4. Move through the restrictive barrier while maintaining the localizing force
5. Final treatment position at attaned anatomic barrier
6. Return the patient to neutral and reassess for TART

Question 21

Answer 21

D. Extended, rotated right, sidebent right