Manual therapy

Question 1

Professionalism

Answer 1

Introduce yourself
Greet patient
Ask about patient
Explain what your doing and why
Ask about Consent and comfort constantly
Patient being appropriately undressed and instructed on bed

Question 2

Manual therapy effects on pain

Answer 2

• Pain gate
• Opioid response

Question 3

Nociceptors

Answer 3

specialised nerve endings that are
activated by a biological stimulus of sufficient intensity
to threaten tissue damage.

Question 4

Acute pain

Answer 4

• Pain that lasts for a short time and
  occurs following surgery or trauma or other condition

Question 5

Sub-acute pain

Answer 5

• Pain that is progressing towards chronic pain, but this progression may be prevented.
• This is known as the transition phase.

Question 6

Recurrent pain

Answer 6

Pain that occurs on a cyclical basis,

• EG: a migraine or pelvic pain

Question 7

Chronic pain

Answer 7

Pain that lasts beyond the time expected for healing following surgery or trauma

Question 8

Pain gate theory (1965)

Answer 8

A mechanism in the spinal cord, in which pain signals can be sent up to the brain to be processed to make prominent the possible perceived pain.

Question 9

The gate part of the theory

Answer 9

The ‘gate’ is the mechanism where pain signals can be let through or restricted.

One of two things can happen, the gate can be ‘open’ or the gate can be ‘closed’

Question 10

Open gate

Answer 10

If the gate is open, pain signals can pass through and will be sent to the brain to perceive the pain

Question 11

Closed gate

Answer 11

If the gate is closed, pain signals will be restricted from travelling up to the brain, and the sensation of pain won’t be perceived

Question 12

Gate mechanism neurons

Answer 12

1. A-β fibres
2. A-δ fibres
3. C fibers

Question 13

A-β fibers (Alpha-Beta)

Answer 13

• large diameter fibers,
• have a quick transmission of impulses, due to their myelination
• these type of fibers are activated by light touch, pressure, and hair movement
• These stop the transmission of pain neurons

Question 14

Myelination

Answer 14

Material surrounding nerve cells to insulate them and increase rate at which electrical impulses pass along the axon

Question 15

A-δ fibers (Alpha-Delta)

Answer 15

• smaller diameter fiber
• they are thinly myelinated, and are stimulated by pain and temperature, specifically sharp, intense, tingling sensations
• Responsible for sharp pains received at the time of injury

Question 16

C fibers

Answer 16

• have the slowest transmission of impulse since they are not myelinated
• these type of fibers are activated by pain and temperature, namely prolonged burning sensations
• Result in dull longer lasting pain

Question 17

How rubbing and manual therapy helps pain in terms of fibers

Answer 17

This helps sooth and reduce the pain.

The non-noxious A-β fibers are activated and inhibit the A-δ and/or C fibers causing the pain.

Question 18

Opioids

Answer 18

A class of drugs that provide pain relief by acting on areas in the spinal cord and brain to block the transmission of pain signals.

EG: Morphine, codeine, fentanyl.

Question 19

Concave

Answer 19

bone that is rounded inwards

Question 20

Convex

Answer 20

joint that is rounded outwards

Question 21

Glide test

Answer 21

involves the application of passive gliding movements in all achievable directions
helps find out in which directions joint gliding is reduced

Question 22

Kaltenborn Convex-Concave Rule

Answer 22

to allow ease in identifying the direction of limitation and subsequently the direction that treatment is to be applied.

Question 23

When a convex joint surface is moving

Answer 23

the roll and glide transpire in the opposite direction

• The therapist moves a convex joint surface opposite to the direction of reduced movement

Question 24

When a concave joint surface is moving

Answer 24

the roll and the glide takes place in the same direction

• The therapist moves a concave joint surface in the same direction of the reduced movement