Intro to FPR Stills BLT

Question 1

Direct OMT Techniques

Answer 1

MFR
INR
ST
MET

Question 2

Combination OMT Techniques

Answer 2

MFR

Still’s

Question 3

Indirect OMT Techniques

Answer 3

MFR
INR
BLT
FPR

Question 4

BLT definition

Answer 4

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

Question 5

Primarily described as indirect passive treatment method

Answer 5

Balanced Ligamentous Tension (BLT)

Question 6

BLT indications

Answer 6

Somatic dysfxns of articular basis
Somatic dysfxns of myofascial basis
Areas of lymphatic congestion or local edema

Question 7

BLT Relative Contraindications

Answer 7

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

Question 8

BLT side effects

Answer 8

Similar to post-exercise soreness

BLT is generally safe

Question 9

What is the principle behind reciprocal tension ligaments?

Answer 9

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

Question 10

_____ is associated with the maintenance of a critical interfiber distance

Answer 10

Collagen fiber lubrication

Must be maintained for smooth movement

Question 11

The longer a joint is immobilized the _______ the amount of infiltration

Answer 11

Greater

Fibrofatty infiltrates found int he capsular folds and recesses

Question 12

If normal interfiber distance is not maintained, what happens?

Answer 12

Microadhesions form and new collagen is laid down in a haphazard manner

Question 13

Immobilization for >12 weeks results in ______

Answer 13

Overall loss of collagen since its rate of degradation exceeded rate of synthesis

Question 14

How much force is needed to move an immobilized joint?

Answer 14

10x the amount of a normal joint

Question 15

After repetitions of BLT, the amount of force needed to move an immobilized joint is reduced to ____

Answer 15

3x the amount of a normal joint

Question 16

FPR Definition

Answer 16

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

Question 17

Advantages of FPR

Answer 17

Easily applied, effective, time efficient
Good pt satisfaction
Thorough

Question 18

Indications for FPR

Answer 18

Myofascial or articular somatic dysfxn

Question 19

Absolute contraindications for FPR

Answer 19

Fracture
Neurological symptoms brought on by treatment position
Exacerbation of potentially life-threatening symptomology

Question 20

Relative contraindications of FPR

Answer 20

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

Question 21

In the FPR proposed mechamism, what is the involvement of the gamma motor system?

Answer 21

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

Question 22

What is the initial response of FPR?

Answer 22

Soft tissue

Articular

Question 23

Definition of Still Technique

Answer 23

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

Question 24

Advantages of Still’s Technique

Answer 24

Easily applied, effective, time efficient
Good patient satisfaction
Thorough

Question 25

Indications for Still’s Technique

Answer 25

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

Question 26

Contraindications for Still’s Technique

Answer 26

Not advisable across recent wounds (surgical or otherwise) or fx less than 6 weeks old