Manual Therapy Flashcards
1
Q
Term: Distance
A
Amplitude
1
Q
Q: What distal wrist/hand glide facilitates radial deviation?
A
Ulnar
2
Q
Content: limitation to motion - arthrokinematics (4)
A
- Ligaments
- Bone congruence
- Intra-articular cartilage
- Joint capsule
2
Q
T/F: Grades 1-4 are assessment and Grade 5 is treatment
A
True
2
Q
Q: What manual technique would you choose for pain? (3)
A
- Least painful technique
- Low speed, shorter treatment (1-2 bouts of 20-30 sec)
- Grade 1 and 2
3
Q
Q: What glenohumeral joint glide facilitates IR, flexion, horizontal ADD?
A
Posterior
4
Q
Q: What distal MCP glide facilitates ADD?
A
Ulnar
5
Q
Q: What is the biggest difference between mobilizaiton and manipulation?
A
Speed, mob = slow, manipulation = fast
6
Q
Content: PAM tests - Assessment of joint glides/accessory motion (3)
A
- un-restricted accessory glide
- excessive accessory glide
- restricted accessory glide
7
Q
Q: What manual technique would you chosse for distraction for resistance?
A
Grade 3
8
Q
Content: Indications for manual therapy (5)
A
- mild or moderate pain of musculoskeletal origin
- joint hypomobility
- a non-irritable mild/moderate irritable condition
- remodeling stage of recovery - subacute
- acute spinal pain without neurological symptoms
9
Q
Q: What knee glide facilitates extension?
A
Anterior
10
Q
Q: Which 3 states do not allow grade 5 manipulation?
A
- Arkansas
- West Virginia
- Washington
10
Q
Content: Manual technique selection (2)
A
- Stages of healing vs. level of irritability
- Treating pain vs. resistance with mobilization
11
Q
Q: _____ seconds of static hold for pain, ______ seconds for stretching joint capsule (Kaltenborn).
A
10-20, 30-60
12
Q
Q: What is the difference between PT and Chiropractors?
A
- Philosophy is different
- Chiropractor - manipulation can treat and cure any aliment
- PT - use manipulation to decrease pain and increase mobility - Technique is different
- Chiropractor = long levers
- PT = short levers
13
Q
Q: Some approaches advocate preliminary _____ ________ therapy or ____________ therapy prior to joint mobilization.
A
soft, tissue, modality
13
Q
Q: What scapular glide facilitates depression?
A
Inferior
13
Q
Q: What humeroulnar PAM facilitates joint mobility?
A
Distraction
14
Q
Content: Manual technique selection - joint restriction (3)
A
- Manipulation
- Grade 3 or 4 mob
- PPM
14
Q
Content: Manual technique selection - CPR (3)
A
- Grade 4 mob
- Prolonged stretch
- Distraction with or w/o movement
15
Q
Term: a passive movement technique performed by an operator in a manner that is at all time within the ability of the pt. to prevent the movement
A
Mobilization
16
Q
Q: What humeroulnar glide facilitates elbow flexion?
A
Lateral
17
Q
Q: What humeroulnar glide facilitates elbow extension?
A
Medial
18
Q: How does the therapists perspective alter the placebo effect?
Communication, use the placebo effect to your advantage
19
Q: What subtalar joint PAM facilitates joint mobility and pain control?
Distraction
20
Q: What knee glide facilitates flexion?
Posterior
21
Q: Which should you pay more attention to the broad, nationwide practice act or the state specific practice act?
State practice acts
22
Content: Relative contraindications for manual therapy (12 - general idea)
1. RA
2. Osteoporosis
3. Spondylolisthesis
4. Hypermobility/instability
5. Pregnancy
6. Previous malignant disease
7. Acute trauma
8. Protectice spasm
9. Gross degenerative changes
10. Psychological pain
11. Steroid or anitcoagulant
12. Severe nerve root pain
23
Q: What hip distraction facilitates joint mobility and pain relief?
Lateral
23
Q: What distal MCP glide facilitates flexion?
Volar
24
Content: Absolute contraindications for manual therapy (8)
1. Malignancy
2. Neurological - cauda equina syndrome
3. Vascular
4. Bone disease
5. Inflammatory conditions
6. Infection
7. Acute symptomatic disc herniation
8. Undiagnosed pain
25
Q: What glenohumeral joint glide facilitates ER, extension, horizontal ABD?
Anterior
27
T/F: Grade 5 manipulation is within KS state practice act
True
28
T/F: PT and Chiropractors are solely responsible for manual therapy.
True
28
Q: What talocural joint glide facilitates dorsiflexion?
Posterior or dorsal glide
29
Term: force
Thrust
30
Content: Maitland grading system (5)
Grade 1 = small amplitude in the resistance free range (1st 25%)
Grade 2 = large amplitude in the resistance free range (middle 50%)
Grade 3 = large amplitude into resistance or up to resistance (last 50%)
Grade 4 = small amplitude into resistance (last 25%)
Grade 5 = (manipulation) high velocity, small amplitude, thrust movement to the limit of available range or mid range
31
Content: Incorporating mob/man into the assessment (4)
1. Knowledge of joint surface and biomechanics
2. Irritability of symtpoms
3. Type of technique selection
4. What is the focus of treatment - pain vs. resistance
32
Q: What scapular glide facilitates ADD/retraction?
Medial
33
Q: What subtalar joint glide facilitates inversion?
Medial
34
Q: What scapular glide facilitates elevation?
Superior
35
Diagram: Maitlan grading system - grades of movement for accessory glides
37
Term: Manual therapy techniques comprised of skilled passive movements to joints that are applied at varying speed and amplitudes.
Mobilization/manipulation
38
Term: A passive movement technique performed at the limit of the available passive range at a speed that is beyond the pt.'s control
Manipulation
39
T/F: PTs perform chiropractic manipulations.
False
40
Content: Neurophysiological mechanism (4)
1. descending pain inhibitory system
2. endogenous opioid release
3. gate control theory
4. change in reflex excitability
40
Q: Mobilization: __________ pain, __________ joint play, _____ vigorous, may ______ with it and __________ to manipulation.
Decrease, restore, less, start, progress
41
Q: What hip glide facilitates extension and ER?
Anterior
42
Q: What humeroradial PAM facilitates joint mobility?
Distraction
43
Q: What distal MCP glide facilitates extension?
Dorsal
45
Content: Mechanical mechanism (3)
1. free up entrapped/torn meniscoid
2. mechanical disruption to intra-articular adhesion
3. stretching of joint capsule
46
Content: Manual technique selection - extreme hypomobility or pain through ROM
PPM
47
Q: What manual technique would you choose for distraction that is for pain?
Grade 1 and 2
48
Q: What distal MCP PAM facilitates joint mobility?
Traction
49
Content: PAM tests - documentation (4)
1. Specify direction of glide
2. Quantity and quality of motion
3. Reproduction of symtpoms/relief of pain
4. Presence of muscle spasms
50
Q: What talocural joint PAM facilitates joint mobility and pain relief?
Distraction
51
Diagram: Fill in the table below
52
T/F: Manipulation is within the scope of PT practice.
True
54
Term: Ligament or severe degeneration of joint surfaces
Excessive accessory glide
55
Q: What is are examples of PPM?
Flexion/extension, ABD/ADD, IR/ER
56
Content: Precautions for manual therapy (5)
1. Recent trauma
2. Ligament injury
3. Post-op
4. Empty end feel or muscle spasm
5. acute inflammation
57
Q: What are 3 reasons for using manual therapy?
1. Pain modulation 2. Increase ROM 3. Decrease soft tissue inflammation
59
T/F: These grades are progressive.
False: Grade 1 and 4 are similar just performed at different ranges
60
Q: What subtalar joint glide facilitates eversion?
Lateral
61
Q: What glenohumeral joint glide facilitates elevation?
Inferior
62
Q: What glenohumeral joint glide facilitates general hypomobility?
Lateral
63
Q: What distal radioulnar glide facilitates pronation?
Volar
64
Q: What distal wrist/hand glide facilitates wrist extension?
Volar
65
Q: What distal wrist/hand glide facilitates ulnar deviation?
Radial
66
Q: What manual technique would you choose for resistance? (3)
1. More end range techniques - increase vigor as tolerated
2. Quicker speed, longer treatments (3-5 bouts of 45-60 sec)
3. Grade 3 and 4
67
Q: What distal radioulnar glide facilitates supination?
Dorsal
68
Q: What hip glide facilitates joint mobility and pain relief?
Inferior
69
Content: PAMS tests - Assessment of joint distraction
71
Content: Kaltenborn distraction grading system (3)
Grade 1 = unloading and decompressing the joint surfaces
Grade 2 = separation of joint surfaces
Grade 3 = joint capsule and ligament stretch
72
Content: limitation to motion - osteokinematics (3)
1. muscle or soft tissue
2. joint capsule
3. joint play
74
Term: Skilled hand movements to mobilize soft tissue and joints for the purpose of pain modulation, increase ROM, decrease soft tissue inflammation
Manual therapy
75
Q: What distal MCP glide facilitates ABD?
Radial
76
Q: What manual technique would you use for spinal pain?
Grade 5/manipulation
77
Content: Two types of mobilization
1. Passive physiological movement (PPM) or osteokinetmatics
2. Passive accessory movement (PAM) or arthrokinematics or joint play
79
Q: What knee PAM facilitates joint mobility and pain relief?
Distraction
81
Q: What talocural joint glide facilitates plantarflexion?
Anterior or ventral glide
82
Q: Manual therapy is ____________ for certain people when __________ with certain \_\_\_\_\_\_\_\_\_\_.
Beneficial, performed, exercises
83
Q: In what position should you perform manual techniques?
Loose packed, with sligh distraction
84
Term: speed
Velocity
85
Content: Manual technique selection - muscle restriction (2)
1. Muscle stretching
2. Hold/relax
86
Q: Manipulation: ___________ pain, _________ joint motion, ________ adhesions, _________ loose bodies, requires ______ \_\_\_\_\_\_, when progress _________ or ___________ do not improve with the use of \_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Decrease, restore, break, remove, more, skills, plateaus, symtpoms, mobilization
87
Q: What distal wrist/hand glide facilitates wrist flexion?
Dorsal
88
Q: What hip glide facilitates flexion and IR?
Posterior
90
Content: Possible mechanism for manual therapy (3)
1. Neuorphysiological
2. Mechanical
3. Psychological/placebo
91
Term: Motion limitaitons due to contractile tissues
Un-restricted accessory glide
92
T/F: Students do not follow the practice pattern of their CIs and their decisions are not influenced by their CIs practice patterns.
False
93
Term: High velocity, low amplitude therapeutic movements applied within or at end ROM
Thrust manipulation
94
Q: What is are examples of PAM?
Roll, glide, spin, distraction/compression
95
Q: What scapular glide facilitates ABD/Protraction?
Lateral
96
Term: Limited joint glide and connective tissues
Restricted accessory glide
97
T/F: The grades are based on the normal range.
False, based on restrictions
98
T/F: If a pt. has CPR, a manipulation is indicated.
False: mobilization would be indicated
