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MSK > Manual Therapy > Flashcards

Manual Therapy Flashcards

1
Q

Manual Therapy

A

-skilled hand mmts and passive mmts of joints

-improved tissue exttensibility, ROM, relaxation, pain, restrictions

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2
Q

Mobilizations

A

-passive
-rhythmic, repetitive mmt
-varied amplitudes
-high tolerance
-Restore full, painfree joint motion

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3
Q

Manipulations

A

-passive
-single, quick, decisive mmts
-small amplitude
-important set up
-Restore full, painfree joint motion
-faster, not always safe

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4
Q

Biomechanical Method

A

-biomechanical theory to assess abnormalities
-athrokinematic principals
-anatomical causes for presentation

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5
Q

Patient-Based Response Method

A

-pain reproduction and reduction w/ mmt
-does not rely on biomechanical
-findings to determine Tx

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6
Q

Manual Therapy Terminology

A

-Rate of force
-Location in Range: availability of segment
-Direction of force
-Targe of force: PT applied force
-Relative structural mmt
-Pt Position

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7
Q

Biomechanical Effects of Manual Therapy

A

-Improved movement
-Improved position

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8
Q

Neurophysiological Effects of Manual Therapy

A

ANS: change in vitals, skin conductance

Spinal Cord: inhibit pain receptors, decreased hypertonicity

CNS: altered pain experience in brain, inhibits mechanical nociception (gate control)

PNS: decreased inflammatory mediators

Temporal: last 20-30min, need to supplement with exercise to maintain effects

Placebo

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9
Q

Muscle Energy Technique

A

-active assits technique within or beyond normal ROM
-against PT counterforce
-less agressive and most tolerated
-RROM

ex: Pelvic SIJ Dysfuction: Alternating Add/Abd isometrtic holds

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10
Q

Normal End Feels

A

Bony/Hard: bone on bone
-elbow ext
-hard ending
-no joint play

Elastic: muscle tendon unit
-stretches with recoil
-wrist flextion causing finger flexion
-muscle adhesions= passive stretch

Soft: soft tissue
-elbow flexion

Capsular: produced by capsule or ligaments
-with pain= 1-2 Oscillation
-Adhesions= 3 sustained and 3-4 oscillation mobilization

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11
Q

Abnormal End Feels

A

Springy: articular surface
-rebound sensation
-knee flexion with displaced meninscus

Boggy: viscous fluid in joint
-squishy sensation
-blood in joint or sepsis

Spasm: reactive muscle reaction
-unyielding spasm
-recent trauma or tear
-no joint play

Empty: pain stops you
-no joint play if with assessment

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12
Q

Acute Stage of Healing

A

-inflammatory
-pain early in ROM
-0-10 (or 3) days
-chemicals irritate nerve endings

PT:
-prevent negative effects of rest
-reduce inflammation, edema, pain
-protect area

Teqniques:
-soft tissue/estim/US
-joint mobilizations (I-II)
-Muscle Energy Tecniques

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13
Q

Subacute Stage of Healing

A

-proliferation and repair
-pain at endfeel
-2 days - 3 months
-growth of capillaries, collagen formation, wound is covered, granulation tissue

PT:
-mobilize scar
-promote healing and function (PROM>AAROM>AROM)
-develop neurmuscular control
-pt education about 6w healing

Manual Therapy Teqniques:
-soft tissue/estim/stretch
-joint mobilizations (II-III)
-MET
-HVLAT if MET not successful

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14
Q

Chronic Stage of Healing

A

-maturation and remodeling
-pain at overpressure
-12 days -1+ yr
-new collagen (type 2) to align with stress
-scar formation

PT:
-return to function
-increase tensile quality of scar
- develop functional independence
-mobilize scar
-improve neurmuscular control

Manual Therapy Teqniques:
-soft tissue/estim/strength
-joint mobilizations (III-IV)
-MET to prepare for HVLAT
-HVLAT Strong indication

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15
Q

Grade I Oscillatory Mobilization Grades

A

-small amplitude
-0-25%
-beginning of available joint play
-Pain
-acute stage

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16
Q

Grade II Oscillatory Mobilization Grades

A

-large amplitude
-25-75%
-middle joint play
-acute and sub acute stage
-pain

17
Q

Grade III Oscillatory Mobilization Grades

A

-large amplitude
-50-100%
-end of joint play
-joint adhesions
-Subacute and chronic stages

18
Q

Grade IV Oscillatory Mobilization Grades

A

-small amplitude
-75-100%
-end of joint play
-intense
-joint adhesion
-chronic stage

19
Q

Grade V Oscillatory Mobilization Grades

A

-high velocity low amplitude thrust
-quick movement that exceeds resistance
-100+%
-Subacute to chronic stages

20
Q

Grade I Sustained Mobilization Grades

A

-loosen to neutralize joint pressure
-no stress on capsule
-decrease compression
-used with gliding motion

21
Q

Grade II Sustained Mobilization Grades

A

-take up slack to separate joint surfaces
-eliminate joint play
-determine joint sensitivity

22
Q

Grade III Sustained Mobilization Grades

A

-stretch
-large distraction w/ 6 sec hold
-increase mobility
-treat hypomobility
-joint adhesions

23
Q

Oscillatory Joint Mobilizations

A

-pain dominant
-III-IV for stiffness

24
Q

Sustained Joint Mobilizations

A

-stiff dominant

25
Q

High Velocity Low Amplitude Thrust Manipulations

A

Target-Specified:
-localized
-movement toward 1 specific functional unit
-at or slightly past 2nd ttissue resistance
-pre-position joint before

Generalized
-isolate thrust to region
-at or slightly past 2nd ttissue resistance
-less pre-positioning

26
Q

Indications for Manual Therapy

A

-MSK pain
-MSK condition w/ low irrittability (relieved at rest)
-pain changes with movements

27
Q

Contraindications for Manual Therapy

A

-infection
-Fever
-Cancer
-Acute Circulatory Condition
-Open Wound
-Fracture
-Hematoma
-Advanced DM
-Hypersensitivity
-Abnormal Endfeel
-RA
-Cellulitis
-Constant, Severe pain
-Extensive radiation of pain
-Condition not evaluated

28
Q

Precautions for Manual Therapy

A

-Joint effusion or inflammation
-RA (non-exacerbation)
-Osteoporosis
-Pregnancy (over spine)
-Dizziness
-Steroid or anti-coagulant

29
Q

Examination to Treatment w/ Mobilizations

A
  1. Baseline Assessment
    -pain, s/s, ROM, Strength
  2. Determine Grade
    -impairment, stage, irritability
  3. Contraindications and Precautions
  4. Take up Slack
    -assess joint play
  5. Arthrokinemattics and Pt Position
  6. Only 1 Surface Moves
  7. Re-assess after Treatment
    -pain, s/s, ROM, Strength
30
Q

Convex on Concave

A

-roll and glide in opposite direction
-pt move with glide

31
Q

Concave on convex

A

-roll in glide in same direction
-pt move with glide

32
Q

Joint Play

A

-Hypomobile, Normal, Hypermobile
-Only skip if they have normal, pain free motion

  1. Know joint surface shape
  2. Determine hand placement
    3.Grade Motion compared to other side and expected motion
  3. Assess Pain/no pain and mobility
33
Q

Joint Distractions

A

-improve all motions available to the joint

MSK (34 decks)

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