Manual Therapy Flashcards
When is manual therapy in the spine indicated? (3)
(1) mechanical dysfunctions present
(2) motion limitations/restrictions present
(3) requirements for clinical prediction rule (CPR) for manipulation met
What are the criteria for the clinical prediction rule (CPR) for manipulation for LBP? (5)
(1) no symptoms distal to knee
(2) less than 16 days duration
(3) FABQ < 19
(4) hypomobility of lumbar spine (1+ segment)
(5) hip IR > 35 degrees
What are the requirements for a treatable dysfunction? (3)
(hint: ART)
A: asymmetry of position or motion
R: range of motion restriction
T: tissue texture abnormalities (i.e. increased tone, increased histamine response, or tenderness)
What are the contraindications to manual therapy in the spine? (8)
(1) inflammatory arthritis (i.e. RA, etc.)
(2) Down’s syndrome
(3) osteoporosis
(4) spine infections
(5) fractures
(6) cancer/metastases to the spine
(7) vertebral artery compromise
(8) anticoagulation therapy
What are the precautions to manual therapy? (6)
(1) spondylolisthesis (avoid affected segment but look for dysfunctions above/below)
(2) hypermobility (look for dysfunctional segments elsewhere)
(3) pregnancy and immediately postpartum
(4) anticoagulation therapy
(5) trauma not medically evaluated
(6) anxiety/fear
Which of Fayette’s Laws does the cervical spine follow? Why?
Law II because the cervical facets are always engaged in neutral due to the orientation of the facets
What would “muscle banding” imply?
That there is dysfunction at that level
T/F: A reduced lumbar lordosis is common
True
T/F: An excess of mid thoracic kyphosis in common
False, lack of mid thoracic kyphosis is common
What are “key” areas or transition zones to observe AROM in? (3)
thoracolumbar, cervical thoracic, and lumbosacral junctions
What part of the spine does a hip drop isolate motion in?
lower lumbar spine, specifically at L5
What part of the spine does a hip hike isolate motion to?
thoracolumbar junction/upper lumbar
During manual therapy, lever arm should be [short/long] and contacts should be [narrow/broad].
During manual therapy, lever arm should be short and contacts should be broad.
What are muscle energy techniques (MET)?
They are using muscle contractions to increase ROM, muscle length or strength, or lymphatics at a joint via isometric relaxation or reciprocal inhibition
What to muscle energy techniques (MET) target? (2)
golgi tendon organs and muscle spindles
What is an ERS?
ERS = extended, rotated, and side bent
They are limited in flexion and rotation + side bending to the opposite side
When is the transverse process more prominent in an ERS?
flexion
What is an FRS?
FRS = flexed, rotated, side bent
They are limited in extension and rotation + side bending to the opposite direction
When is the transverse process more prominent in an FRS?
extension
When an ERS is identified in flexion, the transverse process will be more prominent on the [same/opposite] side of the dysfunction.
same side
When an FRS is identified in extension, the transverse process will be more prominent on the [same/opposite] side of the dysfunction.
opposite side
In an ERS, the facet on the same side will not [open/close].
open
In an FRS, the facet on the opposite side will not [open/close]
close
Where would a Type I (neutral type) of muscle energy dysfunction be found?
flexion, extension, and neutral at multiple levels (i.e. L1-L4)
