lecture 2: introduction to manual therapy and neuroprovatin testing Flashcards

1
Q

what are skilled hand movements and passive movements of joints/soft tissue

A

manual therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is manual therapy techniques intended to do

A

-• Improve tissue extensibility
Loading…
• ↑ ROM
• Induce relaxation
• Mobilize or manipulate soft tissues & joints
• Modulate pain
• ↓ soft tissue swelling, inflammation & restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a PASSIVE technique designed to restore full painless joint function by rhythmic , repetitive passive movement , shell within the pateints tolerance in voluntary and/or accessory ranges

A

mobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what manual therapy technique is an accurately localized or globally applied SINGLE , QUICK AND DECISIVE movement of small amplitude , following a careful positioning of the patient

A

manipulation (passive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what manual therapy technique is a manually assisted method of stretching/ mobilization where the patient actively uses his or her mm, on repeat , while maintaining a targeted preposition against a distinctly execute counterforce

A

muscle energy technique (active)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tell me these are active or passive
- mobs
-manip
-mm energy tech

A

passive 2 x
active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

soft tissue mobilizations always fall under type of what techniques

A

manual therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

• Passive technique
• Rhythmic, repetitive movements • Varied amplitudes
• Well within pt’s tolerance
• Goal: restore full, pain-free joint motion

what manual therapy techniqgue does this describe

A

mobilizations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

for mobilizations…

• ______ technique
• _____ movements
• _____ amplitudes
• Well within pt’s tolerance
• Goal:

A

• Passive technique
• Rhythmic, repetitive movements • Varied amplitudes
• Well within pt’s tolerance
• Goal: restore full, pain-free joint motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

• Passive technique
• Single, quick & decisive movement
• Small amplitude
• Careful pt set-up
• Goal: restore full, pain-free joint motion

what manual therapy technique dies this describe

A

manipulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

for manipulations …

• _____ technique
• ____, _____ & _____ movement
• ____ amplitude
• Careful pt set-up
• Goal:

A

• Passive technique
• Single, quick & decisive movement
• Small amplitude
• Careful pt set-up
• Goal: restore full, pain-free joint motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

who developed a system of sustained hold joint mobs

A

freddy kaltenborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

who developed the system of graded oscillations

A

geoffrey maitland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 3 philosophies on manual therapy assessment

A
  1. biomechanical method
    2.pateint based response methods
  2. hybrid method
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

for the biomechanical method for manual therapy these treatments target using ___ principles

A

arthokinematic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

• Addresses pain reproduction & reduction w/ movements
• Does NOT rely on biomechanical models for diagnostic assessment
• Relies on assessment findings to determine treatment
• Treatment techniques similar to assessment method (reproduce pt’s pain apply movement in a way to ↑ ROM and/or ↓ symptoms

what method of manual therapy does this describe

A

patient based response methods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

• Uses components of BOTH
• Allows ID of significant biomechanical findings that have prognostic influence & should drive tx decisions

what does this method of manual therapt describe

A

hybrid method

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does the rate of force application mean

A

the rates at which the force was applied during the procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the autonomic nervous system changes related to manual therapy

A

changes in HR , BP and skin conductance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what effectively inhibits pain receptors , has a non localized/ non specific effect on vitals and decreases mm hypertonicity

A

spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what system decreases inflammatory mediators at local sites

A

PNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what system alters pain experience in brain , inhabits mechanical nociception

A

CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are temporal neurophysiological changs related to manual therapy

A

effects last 20-30 mins only , needed to back up with exercises to maintain motion and strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

is an audible pop required to achieve neurophysiological changes ??

A

NOOOO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what type of soft tissue technique is used for light superficial techniques designed to improve circulation
lymphatic
26
what type of soft tissue technique is used for deep technigies to improve actual performance
muscular
27
what type of end feel is produced by bone to bone approximation
bony
28
what type of end feel is elbow extension
bony
29
what type of end feel is produced by mm - tendon until . may occur w adaptive shortening
elastic
30
what end feel is produced by contact of 2 mm bulks on either side of a flexion joint where joint range exceeds other restraints
soft tissue approximation
31
what end feel is wrist flexion w finger flexion
elastic
32
what end feel is elbow flexion in muscular people
don’t tissue approximation
33
what end feel is produced by capsule or ligaments
capsular
34
what end feels is wrist flexion , extension in supination and knee extension
capsular
35
what type of end feel is characterized by abrupt and unyielding; gives impression that further forcing will break something
bony
36
what end feel is characterized by Stretches w/ elastic recoil & exhibits constant-length phenomenon; further forcing feels as if it will snap something
elastic
37
what end feel is characterized by Very forgiving end-feel that gives impression that further normal motion is possible if enough force could be applied
soft tissue approximation
38
what type of abnormal end feel is produced by articular surface rebounding from intra articular meniscus or disk
springy
39
what kind of abnormal end feel is knee flexion or extension with displaced meniscus
springy
40
what abnormal end feel does this characterize … Rebound sensation as if pushing off from a rubber pad; impression is that if forced further, something will give way
springy
41
what type of abnormal end feel is produced by viscous fluid (blood) w/in the joint
boggy
42
a hemarthosis at the knee is what kind of abnormal end feel
boggy
43
Squishy” sensation as joint is moved toward its end range; further forcing feels as if it will burst joint this characterizes which abnormal end feel
boggy
44
what type of abnormal end feel is Produced by reflex & reactive muscle contraction in response to irritation of nociception; predominantly in articular structures & muscle
spasm
45
Abrupt & “twangy” end to movement that is unyielding while the structure is being threatened but disappears when threat is removed W/ joint inflammation, it occurs early in range, towards CPP, to prevent further stress W/ irritable joint hypermobility, it occurs at end of what should be normal range, as it prevents excessive motion from further stimulating the nociceptor Spasm in grade II muscle tears becomes apparent as muscle is passively lengthened & is accompanied by painful weakness of that muscle this characterizes what abnormal end feel
spasm
46
what abnormal end feel is produced solely by pain
empty
47
what abnormal end feel is a sub deltoid bursitis or sing of buttock
empty
48
what kind of technique do u do for capsular end feel
oscillation mobs (1-2)
49
what type of technique do u do for bony end feel
none
50
what is strong indicated and rarely indicated in the acute phase of healing (<3 days)
muscle energy technique (active) is strong and HVLAT (manip) is rarely
51
what joint mobs do u do in a acute phase of healing
grade 1-2
52
what is strong indicated and mod to strong indicated in subacute phase of healing (3 days to 3 months)
Mm energy tech is strongly and HVLAT is mod
53
what joint mods do u do in the subacute phase of healing
grade 2-3
54
during the chronic stage of healing what is MET used for and what is strong indicated
MET is used to prepare tissues for HVLAT and HVLAT is strongly indicated
55
what joint mods do u do for chronic phase of healing
3-4
56
what is the amplitude for the oscillatory grade 1 joint mob
small amplitude (25%0 beginning of avaible joint play
57
what is the amplitude movement for the oscillatory grade 2 joint mob
large amplitude movement (mid 50% so 25-75%) in middle of joint play
58
what is the amplitude of movements for oscillatory grade 3 for joint mob
large amplitude (last 50%) at the end of joint play to tissue resistance
59
what is the amplitude for oscillatory grade 4 for joint mobs
small amplitude (last 25%) at the end of joint play to tissue resistance
60
what is the amplitude of oscillatory grade 5 joint mobility
quick movements that exceeds resistance barrier (high velocity low amplitude )
61
If a pateint presents with pain dominant what is the recommended joint mob
lower grades to decrease pain : oscillatory grades 1-2
62
If a pateint presents with stiffness dominant what is the recommended joint mob
higher grades to increase mobility : sustained grad or oscillatory grades 3-4
63
what is the difference in technique is target specific joint manipulation (HVLST) and generalized
target is localized generalized is general
64
what is the purpose os the target specified joint mainupulations and when does it occur
intended to apply passive or assisted movements toward 1 specific functional unit ‘ occurs past 2nd tissue resistance
65
what is the purpose of the generalized specified joint **mainupulations** and when does it occur
designed to isolate thrusts to specified region occurs slightly past 2nd tissue resistance
66
what is designed to address multiple structures including • Muscles • Tendons • Ligaments • Fascia • Venous/lymphatic structures
soft tissue mobilization techniques
67
• ↑ tissue length • Break up scar tissue • Break up adhesions • Remodeling of collagen fibers • ↑ circulation • Improve venous function • Improve lymphatic function • ↓ pain these are goals of what
soft tissue mobilization
68
what are the goals for STM
• ↑ tissue length • Break up scar tissue • Break up adhesions • Remodeling of collagen fibers • ↑ circulation • Improve venous function • Improve lymphatic function • ↓ pain
69
• Mild MSK pain • MSK condition w/ low irritability • Pain provoked w/ motion • Pain relieved w/ rest • Intermittent MSK pain • Pain that is relieved or provoked w/ specific motions or positions • Pain related to Δ’s in sitting or standing postures these are all indications for what
manual therapy
70
any condition that has not been fully evaluated is a contraindication for manual therapy ???
true
71
what are the 14 **contraindications** for manual therapy
infection * febrile state * acute circulatory condition * malignancy * open wound * recent fx * hematoma * DM * hyerpsensitivity of skin * inappropriate end feel * RA * cellulitis * severe pain * radiattion of pain
72
what are teh 3 goals of manual therapy techniques
-reduce pain -alter stiffness - pateint education
73
what is teh 3 purposes of manual therapy
1. decrease pain 2. increase mobility 3. increase function