LE Manipulation

Question 1

Diagnoses with evidence for LE manipulation

Answer 1

Plantar heel pan - plantar fasciitis
Ankle sprains - ankle stability and mvmnt coord impairments - ankle ligament sprains
Hip pain - hip p and mob deficits - hip OA - nonarthritic hip joint pain

Question 2

Diagnoses with evidence for LE manipulation - Plantar heel pain case study

Answer 2

4 pts with heel pain
Manual PT augmented exercise
All pts had 7 or less tx 
Clinically meaningful reduction in pain and improvements in function
No cause-effect can be inferred though

Question 3

Diagnoses with evidence for LE manipulation - Plantar heel pain - other study

Answer 3

60 subjects
exercise + physical agents
exercise + manipulation
ANOVA should sig. with LEFS, FAAM, pain
Between group differences favored the manip group at both 4 week and 6 month follow ups

Question 4

Diagnoses with evidence for LE manipulation - Ankle sprains - practice guidelines

Answer 4

Clinicians should include MT procedures such as graded joint mobs, manips, and non WB and WB MWM to:
Improve ankle DF
Proprioception
WB tolerance
In pts recovering from lateral ankle sprain

Question 5

Diagnoses with evidence for LE manipulation - Ankle sprains - Post acute and chronic ankle sprains showed

Answer 5

improved DF ROM
Improved re-positon error
Dec pain
Improved self reported function

Question 6

Diagnoses with evidence for LE manipulation - Ankle sprain/Instability - study
Participants
Tx

Answer 6

85 participants s/p inversion ankle sprain

Tx:
ankle/foot thrust and non thrust manips
mobility exercises
advice to maintain usual activity w/in limit of p
instruction in use of ice and elevation

Question 7

Diagnoses with evidence for LE manipulation - Ankle sprain/Instability - study results

Answer 7

If your pt has 3 to 4 of these, they will benefit from the combo of manipulations
Symptoms worse when standing
Symptoms worse in evening
Navicular drop more than 5mm
Distal tibiofibular joint hypomobility 

Only short term outcomes were examined

Question 8

Diagnoses with evidence for LE manipulation - Hip pain

Answer 8

Manipulation among recommended interventions

Little supporting evidence

Question 9

Diagnoses with evidence for LE manipulation - Hip study - comparison of manual therapy and ex in pts with OA

Answer 9

109 subjects
56 got MT
53 got exercise

81% improvement in MT
50% in exercise group

Question 10

Diagnosis with evidence for UE manipulation -

Answer 10

Lateral epicondylalgia
Carpal tunnel syndrome
Cubital tunnel syndrome

Question 11

Diagnosis with evidence for UE manipulation - Lateral epicondylalgia study with injection

Answer 11

Corticosteroid or placebo injection combined with deep transverse friction massage, mills manipulation, stretching, and ecc exercise
155 subjects
Combined group = 10.6 times greater odds of success at 6 wks
No difference at 12 or 52 weeks though!

Question 12

Diagnosis with evidence for UE manipulation - Lateral epicondylalgia - accupuncture study

Answer 12

35 subjects with lat epi
Manip or Acupuncture
2x/wk for 2 wks
Results - Visit 3 should improvements in manip grou, by 8 wks saw improvements in both groups

Question 13

Diagnosis with evidence for UE manipulation - Manipulation of the wrist for lateral epicondylitis study

Answer 13

28 subjects
Wrist manip group vs. US, friction massage, mm stretch and strengthening
9 visits
At 3 wks - manip group better for global outcomes, no diff in pain
At 6 wks - manip group had more pain reduction
No diff in other outcomes

Question 14

Diagnosis with evidence for UE manipulation - Cubital tunnel syndrome - ameliorated with thrust manip of

Answer 14

elbow and carpals