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MSK: LQ > lecture 2: introduction to manual therapy and neuroprovatin testing > Flashcards

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

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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

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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

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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)

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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)

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6
Q

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

A

passive 2 x
active

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7
Q

soft tissue mobilizations always fall under type of what techniques

A

manual therapy

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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

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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

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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

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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

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12
Q

who developed a system of sustained hold joint mobs

A

freddy kaltenborn

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13
Q

who developed the system of graded oscillations

A

geoffrey maitland

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14
Q

what are the 3 philosophies on manual therapy assessment

A
  1. biomechanical method
    2.pateint based response methods
  2. hybrid method
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15
Q

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

A

arthokinematic

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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

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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

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18
Q

what does the rate of force application mean

A

the rates at which the force was applied during the procedure

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19
Q

what are the autonomic nervous system changes related to manual therapy

A

changes in HR , BP and skin conductance

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20
Q

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

A

spinal cord

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21
Q

what system decreases inflammatory mediators at local sites

A

PNS

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22
Q

what system alters pain experience in brain , inhabits mechanical nociception

A

CNS

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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

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24
Q

is an audible pop required to achieve neurophysiological changes ??

A

NOOOO

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25
Q

what type of soft tissue technique is used for light superficial techniques designed to improve circulation

A

lymphatic

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26
Q

what type of soft tissue technique is used for deep technigies to improve actual performance

A

muscular

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27
Q

what type of end feel is produced by bone to bone approximation

A

bony

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28
Q

what type of end feel is elbow extension

A

bony

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29
Q

what type of end feel is produced by mm - tendon until . may occur w adaptive shortening

A

elastic

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30
Q

what end feel is produced by contact of 2 mm bulks on either side of a flexion joint where joint range exceeds other restraints

A

soft tissue approximation

31
Q

what end feel is wrist flexion w finger flexion

A

elastic

32
Q

what end feel is elbow flexion in muscular people

A

don’t tissue approximation

33
Q

what end feel is produced by capsule or ligaments

A

capsular

34
Q

what end feels is wrist flexion , extension in supination and knee extension

A

capsular

35
Q

what type of end feel is characterized by abrupt and unyielding; gives impression that further forcing will break something

A

bony

36
Q

what end feel is characterized by Stretches w/ elastic recoil & exhibits constant-length phenomenon; further forcing feels as if it will snap something

A

elastic

37
Q

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

A

soft tissue approximation

38
Q

what type of abnormal end feel is produced by articular surface rebounding from intra articular meniscus or disk

A

springy

39
Q

what kind of abnormal end feel is knee flexion or extension with displaced meniscus

A

springy

40
Q

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

A

springy

41
Q

what type of abnormal end feel is produced by viscous fluid (blood) w/in the joint

A

boggy

42
Q

a hemarthosis at the knee is what kind of abnormal end feel

A

boggy

43
Q

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

A

boggy

44
Q

what type of abnormal end feel is Produced by reflex & reactive muscle contraction in response to irritation of nociception; predominantly in articular structures & muscle

A

spasm

45
Q

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

A

spasm

46
Q

what abnormal end feel is produced solely by pain

A

empty

47
Q

what abnormal end feel is a sub deltoid bursitis or sing of buttock

A

empty

48
Q

what kind of technique do u do for capsular end feel

A

oscillation mobs (1-2)

49
Q

what type of technique do u do for bony end feel

A

none

50
Q

what is strong indicated and rarely indicated in the acute phase of healing (<3 days)

A

muscle energy technique (active) is strong and HVLAT (manip) is rarely

51
Q

what joint mobs do u do in a acute phase of healing

A

grade 1-2

52
Q

what is strong indicated and mod to strong indicated in subacute phase of healing (3 days to 3 months)

A

Mm energy tech is strongly and HVLAT is mod

53
Q

what joint mods do u do in the subacute phase of healing

A

grade 2-3

54
Q

during the chronic stage of healing what is MET used for and what is strong indicated

A

MET is used to prepare tissues for HVLAT and HVLAT is strongly indicated

55
Q

what joint mods do u do for chronic phase of healing

A

3-4

56
Q

what is the amplitude for the oscillatory grade 1 joint mob

A

small amplitude (25%0
beginning of avaible joint play

57
Q

what is the amplitude movement for the oscillatory grade 2 joint mob

A

large amplitude movement (mid 50% so 25-75%)
in middle of joint play

58
Q

what is the amplitude of movements for oscillatory grade 3 for joint mob

A

large amplitude (last 50%)
at the end of joint play to tissue resistance

59
Q

what is the amplitude for oscillatory grade 4 for joint mobs

A

small amplitude (last 25%)
at the end of joint play to tissue resistance

60
Q

what is the amplitude of oscillatory grade 5 joint mobility

A

quick movements that exceeds resistance barrier (high velocity low amplitude )

61
Q

If a pateint presents with pain dominant what is the recommended joint mob

A

lower grades to decrease pain : oscillatory grades 1-2

62
Q

If a pateint presents with stiffness dominant what is the recommended joint mob

A

higher grades to increase mobility : sustained grad or oscillatory grades 3-4

63
Q

what is the difference in technique is target specific joint manipulation (HVLST) and generalized

A

target is localized
generalized is general

64
Q

what is the purpose os the target specified joint mainupulations and when does it occur

A

intended to apply passive or assisted movements toward 1 specific functional unit ‘

occurs past 2nd tissue resistance

65
Q

what is the purpose of the generalized specified joint mainupulations and when does it occur

A

designed to isolate thrusts to specified region

occurs slightly past 2nd tissue resistance

66
Q

what is designed to address multiple structures including

• Muscles
• Tendons
• Ligaments
• Fascia
• Venous/lymphatic structures

A

soft tissue mobilization techniques

67
Q

• ↑ 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

A

soft tissue mobilization

68
Q

what are the goals for STM

A

• ↑ tissue length
• Break up scar tissue
• Break up adhesions
• Remodeling of collagen fibers
• ↑ circulation
• Improve venous function
• Improve lymphatic function • ↓ pain

69
Q

• 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

A

manual therapy

70
Q

any condition that has not been fully evaluated is a contraindication for manual therapy ???

A

true

71
Q

what are the 14 contraindications for manual therapy

A
  • 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
Q

what are teh 3 goals of manual therapy techniques

A

-reduce pain
-alter stiffness
- pateint education

73
Q

what is teh 3 purposes of manual therapy

A
  1. decrease pain
  2. increase mobility
  3. increase function

MSK: LQ (10 decks)

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