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PTRS 745 - Orthopedic PT 1 > Manual Therapy > Flashcards

Manual Therapy Flashcards

1
Q

Who is Maitland?

A

grades of accessory glides and subjective test/scale

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2
Q

Who is Grimsby?

A

Holten curve

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3
Q

What is Manual Therapy

A

skilled hand movements to mobilize soft tissue and joints

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4
Q

Purpose of Manual Therapy

A
  1. Pain modulation
  2. Increase in ROM
  3. Decrease in soft tissue inflammation
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5
Q

What is Mobilization/Manipulation

A

manual therapy techniques comprised of skilled passive movements to joints that are applied at varying speed and amplitudes

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6
Q

Mobilization

A

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

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7
Q

Manipulation

A

A passive movement technique performed at the limit of the available passive range at a SPEED that is beyond the patient’s control

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8
Q

Thrust Manipulation

A

High velocity, low amplitude therapeutic movements applied w/n or at the end range of motion

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9
Q

Limitations of Osteokinematics

A

Muscle, Joint capsule, Joint play

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10
Q

Limitations of Arthokinematics

A

Ligaments, Bony structures, Intra-articular menisci, Joint capsule

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11
Q

PT manipulations help with ______

A

musculoskeletal issues

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12
Q

Manipulations - Neurophysiological effects

A
  1. Descending pain inhibitory system
  2. Endogenous opioid release
  3. Gate control theory
  4. Change in reflex excitability
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13
Q

Manipulations - Mechanical effects

A
  1. Free up entrapped/torn meniscoid
  2. Mechanical disruption to intra-articular adhesions
  3. Stretching of joint capsule
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14
Q

ABSOLUTE contraindications of Manipulation

A
  1. Malignancy
  2. Neurological - cauda equine syndrome, spinal cord compression
  3. Vascular - vertebral artery insufficiency, hemophilia, open wound
  4. Bone diseases - bone diseases, fracture
  5. Inflammatory conditions - RA, active inflammation
  6. Infection
  7. Acute symptomatic disc herniation
  8. Undiagnosed pain
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15
Q

Contraindications/precautions for Peripheral joint manipulation

A
  1. Recent trauma
  2. Ligament injury
  3. Post op
  4. Empty end-feel or muscle spasm
  5. Acute inflammation
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16
Q

Indications for manual therapy

A
  1. Mild or moderate pain of musculoskeletal origin
  2. Joint hypomobility
  3. A non-irritable, mild irritable condition
  4. Remodeling stage of recovery: subacute
  5. Acute spinal pain w/o neurological symptoms
17
Q

What is Irritability

A

How long it takes for symptoms to come on and how long it takes for symptoms to go away

18
Q

Kaltenborn distraction grading system

A

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

19
Q

How long of holds for Kaltenborn scale?

A

10-20 seconds static hold for pain

30-60 seconds for stretching joint capsule

20
Q

Maitland grading system

A

Grade 1-4

Grade 5 = manipulation

21
Q

Maitland Grade 1

A

small amplitude in the resistance free range (first 25%)

22
Q

Maitland Grade 2

A

large amplitude in the resistance free range (middle 50%)

23
Q

Maitland Grade 3

A

large amplitude into resistance or up to resistance (last 50%)

24
Q

Maitland Grade 4

A

small amplitude into resistance (last 25%) - oscillate

25
Q

Maitland Grade 5

A

Manipulation - high velocity, small amplitude (oscillate a few times), thrust movement to the limit of available range or mid-range

26
Q

Mobilization Maitland Grade 1-4

A
  1. Amplitude: small/large
  2. Range: into resistance or no resistance
  3. Velocity: slow
  4. Force: varies
  5. Repeated oscillations
27
Q

Manipulation Maitland Grade 5

A
  1. Amplitude: small
  2. Range: mid range or end range, distraction
  3. Velocity: fast
  4. Force: small
  5. One or two attempts
28
Q

Use of Mobilization

A
  1. Decrease pain, restore joint play

2. Less vigorous, may start with it and progress to manipulation

29
Q

Use of Manipulation

A
  1. Decrease pain, restore joint motion, break adhesions, remove loose bodies
30
Q

Treating pain with mobilization

A
  1. Choose least painful technique, low speed, shorter treatment - grade 1 or 2
  2. Grade 1 or 2 distraction
31
Q

Treating resistance with mobilization

A
  1. May begin with more end range techniques or increase vigor, quicker speed, longer treatment - grade 3 or 4
  2. Grade 3 distraction
32
Q

What do you use Grade 3 for?

A

Pain AND Mobilization

33
Q

Technique Selection: Muscle restriction

A

muscle stretching; hold/relax

34
Q

Joint restriction

A

manipulation, grade 3 or 4 mob, passive physiological motion

35
Q

Capsular restriction

A

grade 4 mob, prolonged stretch, distraction with or w/o movement, NO manipulation

36
Q

Extreme hypomobility or pain through ROM

A

PROM

PTRS 745 - Orthopedic PT 1 (4 decks)

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