Manual Therapy Flashcards
Who is Maitland?
grades of accessory glides and subjective test/scale
Who is Grimsby?
Holten curve
What is Manual Therapy
skilled hand movements to mobilize soft tissue and joints
Purpose of Manual Therapy
- Pain modulation
- Increase in ROM
- Decrease in soft tissue inflammation
What is Mobilization/Manipulation
manual therapy techniques comprised of skilled passive movements to joints that are applied at varying speed and amplitudes
Mobilization
A passive movement technique performed by an operator in a manner that is at all times w/n the ability of the patient to prevent the movement
Manipulation
A passive movement technique performed at the limit of the available passive range at a SPEED that is beyond the patient’s control
Thrust Manipulation
High velocity, low amplitude therapeutic movements applied w/n or at the end range of motion
Limitations of Osteokinematics
Muscle, Joint capsule, Joint play
Limitations of Arthokinematics
Ligaments, Bony structures, Intra-articular menisci, Joint capsule
PT manipulations help with ______
musculoskeletal issues
Manipulations - Neurophysiological effects
- Descending pain inhibitory system
- Endogenous opioid release
- Gate control theory
- Change in reflex excitability
Manipulations - Mechanical effects
- Free up entrapped/torn meniscoid
- Mechanical disruption to intra-articular adhesions
- Stretching of joint capsule
ABSOLUTE contraindications of Manipulation
- Malignancy
- Neurological - cauda equine syndrome, spinal cord compression
- Vascular - vertebral artery insufficiency, hemophilia, open wound
- Bone diseases - bone diseases, fracture
- Inflammatory conditions - RA, active inflammation
- Infection
- Acute symptomatic disc herniation
- Undiagnosed pain
Contraindications/precautions for Peripheral joint manipulation
- Recent trauma
- Ligament injury
- Post op
- Empty end-feel or muscle spasm
- Acute inflammation
Indications for manual therapy
- Mild or moderate pain of musculoskeletal origin
- Joint hypomobility
- A non-irritable, mild irritable condition
- Remodeling stage of recovery: subacute
- Acute spinal pain w/o neurological symptoms
What is Irritability
How long it takes for symptoms to come on and how long it takes for symptoms to go away
Kaltenborn distraction grading system
Grade 1: unloading and decompressing the joint surfaces - very little distraction force
Grade 2: separation of joint surfaces
Grade 3: joint capsule and ligament stretch
How long of holds for Kaltenborn scale?
10-20 seconds static hold for pain
30-60 seconds for stretching joint capsule
Maitland grading system
Grade 1-4
Grade 5 = manipulation
Maitland Grade 1
small amplitude in the resistance free range (first 25%)
Maitland Grade 2
large amplitude in the resistance free range (middle 50%)
Maitland Grade 3
large amplitude into resistance or up to resistance (last 50%)
Maitland Grade 4
small amplitude into resistance (last 25%) - oscillate
