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MSK PT > Intro to Manual Therapy > Flashcards

Intro to Manual Therapy Flashcards

1
Q

a passive mvmt performed by PT at various speeds and amplitudes

A

mobilization/manipulation

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2
Q

4 types of mobilization/manipulation

A
  • oscillatory
  • sustained
  • manip
  • mob w/ mvmt
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3
Q

3 types of passive ST mob

A

friction massage
Instrument assisted STM (grastin)
positional release

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4
Q

3 types of active ST mob

A

contract-relax
reciprocal inhibition
muscle energy

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5
Q

what is the purpose of neural tissue mob

A

improve mobility of dura mater, n roots or peripheral n

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6
Q

what are the 4 functional classificaitons of synovial joints

A
  • unmodified ovoid
  • modified ovoid
  • unmodified sellar
  • modified sellar
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7
Q

how many DOF does an unmodified ovoid joint have?
list some examples

A

3DoF
- ball and socket, triaxial
- hip and shoulder

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8
Q

how many DoF does a modified ovoid have?
examples

A

2 DoF
- ellipsoid, biaxial
- MCP joints

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9
Q

How many DoF does an unmodified sellar joint have
examples?

A

2 DoF
saddle, biaxial
1st CMC

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10
Q

how many DoF does a modified sellar joint have?
examples?

A

1 DoF
hinge, uniaxial
IP and elbow joint

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11
Q

what are the 2 types of accessory motions

A

component and articular/arthrokinematic

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12
Q

motions accompany active motion but not under voluntary comtrol

A

component/coupled motion

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13
Q

motions that occur b/w joint surfaces

A

articular/arthrokinematic/accessory motions

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14
Q

new points on one joint surface meet new points on another surface when joint surfaces are incongruent

A

roll

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15
Q

one bone segment rotates around a fixed axis

A

spin

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16
Q

one joint surface moves across another so the same point on one surface always contacts a new point on the other surface

A

glide/slide

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17
Q

2 joint surfaces approximate each other

A

compression

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18
Q

2 joint surfaces are separated

A

distraction

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19
Q

position when the peri-articular structures are most lax and allowing the greatest motion

A

resting / open-packed position

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20
Q

what do we use the open-packed position for

A
  • evaluate joint play and end feel
  • relaxation, stretch and joint mob
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21
Q

joint position when the capsule and ligaments are the tightest with maximal contact b/w joint surfaces

A

close-packed position

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22
Q

what do we use close-packed position for

A

stabilize the joint, test ligament integrity

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23
Q

a plane perpendicular to a line running from the axis of rotation to the middle of the concave articular surface

A

treatment plane

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24
Q

traction and compression is applied in a direction that is ______ to the treatment plane

A

perpendicular

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25
Q

glides are performed in a direction that is _________ to the treatment plane

A

paraller

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26
Q

what 2 effects are we attempting to generate when we mobilize or manipulate

A
  • neurophysiological effects
  • mechanical effects
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27
Q

5 indications of joint mob/manip

A
  • decrease pain, m guarding/spasm
  • reversible joint hypomobility
  • positional fault (sublux)
  • progressive limitation
  • functional immobility
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28
Q

what is the #1 contraindication of manual therapy

A

pt denies treatment

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29
Q

what 2 end feels can not have manual therapy

A

empty end feel
spasm end feel

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30
Q

caution or contraindication for manual therapy?
- bone disease
- acute RA episode
- joint effusion
- active inflammation

A

contraindication

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31
Q

lumbar root signs of ______ or cervical root signs of ____ are contraindications to manual therapy

A

lumbar >/= 3
Cervical >/= 2

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32
Q

what ligament instability is a contraindication to manual therapy

A

craniovertebral (transverse) ligament

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33
Q

what end feel is a caution to manual therapy

A

springy

34
Q

caution or contraindication to manual therapy?
- paresthesia with strong pain
- no local symptoms
- primary posterolateral protrusion
- joint pain from isometric testing

A

caution

35
Q

caution or contraindication to manual therapy?
- osteoporosis
- neurological signs
- spondylolisthesis
- acute signs and symptoms
- pregnancy

A

cautions

36
Q

is repeated steroid use a contraindication or a caution to manual therapy

A

caution - weakens the CNT

37
Q

how do we describe joint mobilization/manipulation?
7 categories

A
  • type of mobilization
  • grade of mobilization
  • location in range of available mvmt
  • direction of force
  • target of force
  • pt and PT position
  • duration of mobilization
38
Q

what are the 3 types of mobilizations?
what does this refer to?

A
  • rate of force
  • oscillation, sustained, thrust
39
Q

small amplitude rhythmic oscillation performed at the beginning of available range

A

grade 1 oscillation

40
Q

large amplitude rhythmic oscillations performed within the range, not reaching the limit

A

grade 2 oscillation

41
Q

large amplitude rhythmic oscillation performed thru the available range and into the resistance

A

grade 3 oscillation

42
Q

small-amplitude rhythmic oscillations performed at the limit of available range and into the resistance

A

grade 4 oscillation

43
Q

why do we use grade 1 and 2 oscillation

A

relieve pain in acute/sub-acute stage

44
Q

why do we use grade 3 and 4 oscillations

A

maintain and increase joint mobility

45
Q

which sustained technique is considered “loosening”

A

grade 1

46
Q

small amplitude traction, no stress applied to the capsule, nullifies normal joint compressive force

A

grade 1 sustained

47
Q

which sustained technique is considered “tightening or taking up the slack”

A

grade 2 sustained

48
Q

enough traction or glide to tighten the tissue around the joint

A

grade 2 sustained

49
Q

which sustained technique is considered “stretching”

A

grade 3

50
Q
  • a large traction or glide places a stretch on the joint structures
A

grade 3 sustained

51
Q

why do we use grade 1 sustained technique

A
  • relieve pain with oscillation
  • m relaxation
52
Q

why do we use grade 2 sustained technique

A
  • relieve pain
  • m relaxation
    ** test joint play traction and glide mvmts
  • increase and maintain joint mobility
53
Q

why do we use grade 3 sustained technique

A
  • test joint play end-feel
  • increase joint play
54
Q

massive mvmt using physiological or accessory motions

A

manipulation

55
Q

2 types of manipulation

A

thrust and manip under anesthesia

56
Q

how is a thrust manipulation performed

A

with high velocity, small amplitude motion

57
Q

why is manip under anesthesia used?

A

when pts have contractures or conservative tx fails

58
Q

in the Kaltenborn convex-concave rule for directions of mobilizations,
convex is in the ______ direction and
concave is int the ______ direction

A

convex - opposite
concave - same

59
Q

what is the most important joint mobilization rule?

A

both pt and PT should be relaxed

60
Q

9 joint mobilization rules

A
  • pt Supported
  • Relaxed
  • Stabilize one and Mobilize the other
  • Uninvolved comparison
  • Stop if painful
  • hands close to the joint
  • Loose packed position
  • work with gravity
61
Q

which traction/glide is used to assess joint motion

A

grade 2

62
Q

what progression of manual therapy is used to relieve pain

A
  • sustained grade 1 or 2 manual traction
    OR
  • grade 1 and 2 short amplitude oscillation
63
Q

what progression is used to maintain or increase joint motion

A

grade 2 traction and glide mob in resting –> grade 3 in resting –> grade 3 at end range

64
Q

simultaneous application of therapist applied accessory mob and pt generated active mvmts

A

mobilization with mvmt

65
Q

what type of MWM is used for the spine

A

SNAGS (sustained natural apophyseal glides)

66
Q

when is MWM indicated

A

to increase function and decrease pain

67
Q

where can SNAGS be applies

A

cervical, thoracic and lumbar spine

68
Q

what is the purpose of deep transverse friction

A
  • maintain or restore mobility of CNT
  • produce motion of damaged tissue over sm area
69
Q

what are the 3 desired effects of deep transverse friction

A
  • traumatic hyperemia
  • mechanical
  • temporary analgesia
70
Q

what is traumatic hyperemia

A
  • increase in blood flow and reduction of inflammtion/pain
71
Q

what are the mechanical effects of deep transverse friction

A
  • improve motion b/w fibers
  • prevent cross link, stretch apart adhesion
72
Q

how does deep transveres friction create a temporary analgesia

A

stimulates type 1 and 2 mechanoreceptors

73
Q

3 indications of DFM

A
  • acute or subacute partial tears of ligament, tendon or m
  • adhesion in ligament or m or b/w tissues
  • pre-treatment to manip or strong stretch
74
Q

7 contraindications of DFM

A
  • hyper-acute inflammation
  • recent hematoma
  • arterial insufficiency
  • bleeders
  • multiple injection of cortisone, LT steroid
  • open would
  • uncontrolled diabetes
75
Q

how is contractile tissue placed for application of DFM

A

relaxed

76
Q

how are tendons and ligaments placed for application of DFM

A

taut

77
Q

manual procedure that involves the voluntary contraction of pt m in a precisely controlled direction at various level of intensity against a resistance applied by operator

A

muscle energy technique

78
Q

what are the 2 types of MET techniques we use?

A
  • post isometric relaxation
  • reciprocal inhibition
79
Q

for MET contraction, how long do you hold the contraction

A

8-10 sec

80
Q

how long should you wait for isometric relaxation of MET

A

1-2 sec before moving to next barrier

81
Q

myofascial release technique is a combo of what 3 things?

A

MET, craniosacral technique and ther ex

MSK PT (7 decks)

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