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MSK II > Manual Therapy > Flashcards

Manual Therapy Flashcards

1
Q

What is manual therapy

A

PTs movement of soft tissue or joints

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2
Q

What are the 3 general categories of manual therapy

A

Joint techniques
soft tissue techniques
manual ROM/Stretching techniques

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3
Q

What are joint techniques

A

PT movements that are performed on the joint

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4
Q

What is an example of a joint technique

A

mobs

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5
Q

What is soft tissue techniques

A

performed on soft tissue

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6
Q

what is an example of soft tissues techniques

A

massage

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7
Q

What is manual ROM/stretching techniques

A

peformed manually by therapist

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8
Q

How is ROM and stretching performed in manual ROM/stretching techniques

A

ROM: PROM or AROM with therapist guidance
Stretching: PROM with therapist overpressure

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9
Q

How is manual ROM/stretching techniques peformed

A

therapists needs to stabilize one side of the joint, control amount of motion, monitor stretch effects during treatment

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10
Q

What is example of manual ROM/stretching techniques

A

Posterior shoulder stretch with scapular stabilization

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11
Q

What are joint techniques used for

A

increase joint mobility

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12
Q

what are the main categories of joint techniques

A

mobilization (non thrust)
mobilization with movement (Mulligan)
manip (thrust)
muscle energy technique (MET)

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13
Q

how is force applied in MET

A

pts muscle contraction

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14
Q

How is force apply in non thrust manip

A

passive, variable amplitude, slower velocity

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15
Q

How is force applied in thrust manip

A

passive, low amplitude, high velocity

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16
Q

What is a non thrust manip

A

a skilled passive movement perfumed with variable amplitudes and speeds, perfumed slow enough for a patient to stop mobilization

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17
Q

What are non thrust manips (mobilizations) used for

A

pain and limited motion

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18
Q

What is the mulligan technique

A

therapist applied mobilization during patient active motion, can also be patient self mobilization technique

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19
Q

What is a pathological barrier

A

end of available ROM when there is a restriction

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20
Q

what is a phsyiologic barrier

A

point at which voluntary range of motion of an articulation is limited by soft tissue tension, further motion can be induced into the anatomic barrier

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21
Q

What is anatomic barrier

A

point at which passive range of motion is limited by bone contour, soft tissues, especially ligaments, or both. the anatomic barriers serves as a final limit to the motion in an articulation, movement past this barrier causes tissue damage

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22
Q

what is a direct technique

A

movement and force are in the directionof the motion restriction

23
Q

what is an indirect technique and when is it used

A

movement and force are both not in the direction of the motion restriction commonly used/indicated in acute phase

24
Q

what is general technique

A

force is transmitted to a number of joints

25
Q

What is specific technique

A

force is transmitted only one to one joint

26
Q

what are indications for joint techniques

A

as prior to improve joint or soft tissue mobility or reduce pain

27
Q

what are contraindications for joint techniques

A

fx, infections arthritis, tumor, joint ankylosis, OP, RA, presence of pathologic end feel, lack of diagnosed joint lesion

28
Q

what are the 10 contraindications for thrust manips

A

positive vertebral artery test

dizziness

bilateral or multisegment neurologic signs or sx

paralysis in non perisperhal nerve distribution

hyperreflexria,

pathologic reflexes

presence of emotional disorders

anticoagulant meds or steroidal meds for a long time

29
Q

Are manips successful without a pop

A

yes

30
Q

what should you assess for with accessory joint motion testing

A
  • pain before and during testing
  • amount of motion
  • end feel
  • all sections at the joint
  • in open packed position
  • functional measures
  • review of contraindications/precautions
31
Q

What are the different non thrust manip system types

A

maitland
kaltenborn
MWM mulligan
self mob

32
Q

what is matilatnd non thrust manips

A

graded oscillation techniqeus

33
Q

what is kaltenborn non thrust manip

A

sustained translators joint play technique

34
Q

what is MWM mulligan non thrust manip

A

sustained accessory mob while the the pt is performing an active physiological movement to end ROM

35
Q

what is self mob non thrust manip

A

self stretching techniques that specifically use traction or glides

36
Q

what are the diferret grades for Maitland approach

A

Grade 1: small amplitude at begining of range
grade 2: large amplitude near begining of range
grade 3: large amplitude near end of range
grade 4: small amplitude at end or range

37
Q

what are the grades for kaltenborn

A

grade I : loosen; no joint separation; only enough traction appleid to nullify the compression on the joint

grade II: tighten; the slack is taken up in the tissue surrounding the joint are tightened

grade III: stretch; after the slack has been taken up more traction force is applied, and tissues are stretched

38
Q

what are Maitland and kaltenborn systems both used for

A

examination and treatment

39
Q

what is the reliability of the examination and treatment using Maitland and kaltenbonr systems

A

poor

40
Q

what is the purpose of addressing pain with manual therapy

A

reduce pain, reduce muscle spasm/guarding, increase muscle relaxation

41
Q

how to reduce pain neurolligicaly with manual therapy

A

stimulate pain receptors to inhibit pain trasmnsmission

42
Q

how to reduce pain mechanically with manual therapy

A

increase synovial fluid movement and nutrient exchange for joint, particularly articular cartilage

43
Q

what techniques are used with manual therapy to treat pain

A
  • low grade, small amplitude
  • oscillations
  • slowly applied mobs
  • traction/distraction with or without accessory glides
  • direction of mob: determined by pain/relaxation response
44
Q

what is the joint position for treating pain with manual therapy

A

open packed or lease provocative joint position

45
Q

what is the frequency for treating pain with manual therapy

A

low grade; 30 sec x 2-5 reps; w/ oscillations

or

Maitland I and II for 30 secs x 2-5 reps w/oscillations

46
Q

what is the purpose of treating limited motion with manual therapy

A

improve moitn

47
Q

what techniques are used for treating limited motion with manual therapy

A
  • Hi grade, small or large amplitude
  • sustained stretch to hold at ed ROM or oscillations to aid with pain relief
  • traction/distraction with or without accessory glides
  • direction of mob: determined by convex-convace roll or anatomy/mechnics and or by accessory motion testing findings
48
Q

what is the guideline for joint position when treating limited motion with manual therapy

A

Position that is the least painful position to start, progress the position as patient tolerates

49
Q

what is the frequency for treating limited motion with manual therapy

A

hi grade; 30 sec x 3-5 reps; sustained stretch

50
Q

what is the frequency for treating pre conditioning with manual therapy

A
  • hi grade; 30 sec x 1-3 reps; oscillations or sustained stretch
  • Kaltenborn II and III, 30 secs x 1-3 reps, oscillations
  • Mailtand III and IV, 30 secs x 1-3 reps, oscillations
51
Q

what are contraindications for manual therapy

A

hypermobile
joint effusion
inflammation

52
Q

what are precautions for manual therapy

A
  • execessive pain
  • hyper mobility
  • diseased joint
  • patient with hemiplegia or hemiparisis
  • recent fx
  • total joint replacement
  • recent surgery
  • systemic disease
  • elderly
53
Q

what are the guildlines for manual therpay

A
  • determine purpose
  • determine techniques to be used based on purpose
  • use of heat may be beneficial before starting
  • patient posisitoning
  • examiner is relaxed
  • joint position
  • treat only one joint at a time
  • no forceful or abnormal movmeents
  • compare bilaterally
  • movement stopped pain is elicited
54
Q

where do you want your hands during manual therapy

A

as close to joint as possible

MSK II (10 decks)

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