Intro to FPR Stills BLT Flashcards
Direct OMT Techniques
MFR
INR
ST
MET
Combination OMT Techniques
MFR
Still’s
Indirect OMT Techniques
MFR
INR
BLT
FPR
BLT definition
Minimize peri-articular tissue load and placement of affected ligaments in a position of equal tension in all appropriate planes so the body’s inherent forces can resolve SD
Primarily described as indirect passive treatment method
Balanced Ligamentous Tension (BLT)
BLT indications
Somatic dysfxns of articular basis
Somatic dysfxns of myofascial basis
Areas of lymphatic congestion or local edema
BLT Relative Contraindications
Fx Open wounds Soft tissue or bony infections Abscess DVT Anticoagulation, disseminated, or focal neoplasm Recent post-operative conditions over site of treatment Aortic aneurysm
BLT side effects
Similar to post-exercise soreness
BLT is generally safe
What is the principle behind reciprocal tension ligaments?
As the joint changes position, the tension distributed throughout the ligaments of any given joint is balanced
As the joint changes position, the relationships between the joint’s ligaments also change, but the total tension within the ligamentous articular mechanism does not
_____ is associated with the maintenance of a critical interfiber distance
Collagen fiber lubrication
Must be maintained for smooth movement
The longer a joint is immobilized the _______ the amount of infiltration
Greater
Fibrofatty infiltrates found int he capsular folds and recesses
If normal interfiber distance is not maintained, what happens?
Microadhesions form and new collagen is laid down in a haphazard manner
Immobilization for >12 weeks results in ______
Overall loss of collagen since its rate of degradation exceeded rate of synthesis
How much force is needed to move an immobilized joint?
10x the amount of a normal joint
After repetitions of BLT, the amount of force needed to move an immobilized joint is reduced to ____
3x the amount of a normal joint
FPR Definition
Dysfunctional body region is addressed with a combination of neutral positioning, application of activating force (compression, torsion, or distraction), and placement into position of ease
Advantages of FPR
Easily applied, effective, time efficient
Good pt satisfaction
Thorough
Indications for FPR
Myofascial or articular somatic dysfxn
Absolute contraindications for FPR
Fracture
Neurological symptoms brought on by treatment position
Exacerbation of potentially life-threatening symptomology
Relative contraindications of FPR
Treatment is not well tolerated or significant sx or signs occur during the process
Comorbidities that place the pt at risk for fx
Moderate to severe joint instability
Spinal stenosis/nerve root impingement where positioning could exacerbate the condition
In the FPR proposed mechamism, what is the involvement of the gamma motor system?
Stimulates the muscle spindles
Positioning the muscle in neutral results in inverse spindle output, eliminating the afferent excitatory input to the spinal cord through Group 1a and 2 fibers
What is the initial response of FPR?
Soft tissue
Articular
Definition of Still Technique
Combined manipulative method using both indirect and direct techniques
Dysfxnal region first placed in an indirect position, axial force is added then used to carry the region toward or through the restrictive barrier
Advantages of Still’s Technique
Easily applied, effective, time efficient
Good patient satisfaction
Thorough
Indications for Still’s Technique
Somatic dysfxn in virtually all tissues of the body
Efficacy only limited by the practitioner’s knowledge of fxnal anatomy
Safe for pts of all ages
Contraindications for Still’s Technique
Not advisable across recent wounds (surgical or otherwise) or fx less than 6 weeks old
