Manual Therapy (Cervical) Flashcards
What are invasive soft tissue techniques used for cervicothoracic regions?
Dry Needling (Deep/Superficial).
What is the ‘Bend and Stretch’ technique?
A noninvasive soft tissue technique used to improve myofascial mobility and decrease myofascial pain.
What is the purpose of ischemic compression?
To release myofascial trigger points by applying sustained pressure.
What is sub-occipital release?
A technique to relieve tension in the sub-occipital muscles by applying sustained pressure under the occiput.
What are trigger points?
Hyperirritable spots in the fascia surrounding skeletal muscle that can cause referred pain.
How is ischemic compression performed?
By applying sustained pressure to a trigger point until the pain decreases.
What comes next after soft tissue techniques?
Additional mobilization or therapeutic exercises.
What is the purpose of upper cervical joint-specific distraction?
To improve upper cervical segmental mobility and decrease pain from the upper cervical joints.
How is the patient positioned for upper cervical joint-specific distraction?
Supine with the head in slight ipsilateral side-bend and contralateral rotation.
How is the mobilizing hand positioned for upper cervical joint-specific distraction?
The radial border of the 2nd finger applies pressure to the occiput with a cranial and slightly medial force.
What is C0-1 dorsal capsule mobilization?
A technique to improve mobility and decrease pain in the C0-1 joint.
What indicated the need for upper cervical techniques?
Upper cervical hypomobility or pain, cervicogenic headaches.
What is C1-2 dorsal capsule mobilization?
A technique to mobilize the dorsal capsule of the C1-2 joint.
What is C1-2 ventral capsule mobilization?
A technique to mobilize the ventral capsule of the C1-2 joint.
What is the purpose of lower cervical posterior-to-anterior mobilization?
To decrease cervical joint pain and improve generalized cervical joint mobility.
How is the patient positioned for lower cervical posterior-to-anterior mobilization?
Supine or prone, with finger-over-finger contact on the spinous process or articular pillar.
What is uncovertebral joint side-bending mobilization?
A technique to improve cervical side-bending mobility by applying medial force to the articular pillar.
How long is uncovertebral joint side-bending mobilization performed?
For 30-45 seconds, 4 times or until capsular change.
What is the purpose of lower cervical extension mobilization?
To reduce cervical facet pain and improve cervical ipsilateral rotational mobility.
How is the patient positioned for lower cervical extension mobilization?
Supine with the head in rotation and side-bend towards the mobilization hand.
What is the direction of force for lower cervical extension mobilization?
Posterior-inferior-medially towards the patient’s upper back.
What is the purpose of lower cervical flexion mobilization?
To reduce cervical facet pain and improve cervical contralateral rotational mobility.
How is the patient positioned for lower cervical flexion mobilization?
Supine with the head in rotation and side-bend away from the mobilization hand.
What is the direction of force for lower cervical flexion mobilization?
Anterior-superior-medially towards the patient’s eye.
What is cervical axial separation?
A technique to relieve pressure on the cervical spine by applying traction.
What is the intent of lower cervical techniques?
To address pain and hypomobility in the lower cervical spine.
What indicated the need for lower cervical techniques?
Cervical pain and/or hypomobility.
What comes next after lower cervical techniques?
Further mobilization or therapeutic exercises.
What is the purpose of thoracic posterior-to-anterior mobilization?
To improve thoracic joint mobility and decrease thoracic joint pain.
How is the patient positioned for thoracic posterior-to-anterior mobilization?
Prone, with arms oriented at 60 degrees to the curvature of the thoracic spine.
What is the direction of force for thoracic posterior-to-anterior mobilization?
Anterior and caudal.
What is thoracic extension mobilization?
A technique to improve thoracic joint mobility in extension.
How is the patient positioned for thoracic extension mobilization?
Sitting or in hands-and-knees position with arms propped up.
What is the direction of force for thoracic extension mobilization?
Anterior and slightly caudal.
What is thoracic axial separation?
A technique to relieve thoracic pain suggestive of discogenic involvement by applying force caudally and cranially.
How long is thoracic axial separation performed?
Up to 5 minutes or to patient tolerance.
What is the purpose of cervical manipulation for neck pain?
To improve neck mobility and pain relief for patients with certain criteria.
What are the criteria for cervical manipulation according to Puentedura 2012?
Symptom duration < 38 days, difference in cervical rotation side to side > 10°, pain with PA spring testing in the mid-cervical spine, belief that manipulation will help.
What is the purpose of thoracic manipulation for neck pain?
To improve neck mobility and pain relief for patients with certain criteria.
What are the criteria for thoracic manipulation according to Cleland 2007?
Symptom duration < 30 days, no symptoms distal to the shoulder, looking up does not aggravate symptoms, cervical extension ROM < 30°, FABQPA score < 12, diminished upper thoracic spine kyphosis.
What is the purpose of lumbar manipulation for back pain?
To improve lumbar mobility and pain relief for patients with certain criteria.
What are the criteria for lumbar manipulation according to Flynn 2002?
Symptom duration < 16 days, no symptoms distal to the knee, FABQ < 19, one or more hypomobile lumbar segments, hip IR > 35° on one or both sides.
What is the manipulation take away?
Spinal manipulation is most appropriate for acute spine-related pain that is non-radicular in nature in a patient who isn’t overly fearful or catastrophizing.
What is lower cervical opening manipulation?
A technique to improve neck mobility and pain relief by applying HVLA thrust toward the eyes.
What is thoracic anterior-to-posterior manipulation?
A technique to improve thoracic and shoulder mobility by applying HVLA thrust through the patient’s arms.
How is the patient positioned for thoracic anterior-to-posterior manipulation?
Supine in the hook-lying position with arms pre-positioned.
What is the direction of force for thoracic anterior-to-posterior manipulation?
A-to-P through the patient’s arms with the therapist’s chest.
What indicated the need for thoracic techniques?
Thoracic back pain and/or hypomobility.
What comes next after thoracic techniques?
Further mobilization or therapeutic exercises.
What is the purpose of 1st rib mobilization?
To improve rib mobility, decrease cervical pain, and decrease strain on the brachial plexus.
How is the patient positioned for 1st rib mobilization?
Supine with the head rotated away from the side of treatment.
What is the direction of force for 1st rib mobilization?
Inferior and medial toward the opposite side hip.
What is the purpose of 2nd-10th rib costotransverse mobilization?
To improve rib mobility and modulate sympathetic excitation.
How is the patient positioned for 2nd-10th rib costotransverse mobilization?
Prone with the head rotated away and arm off the table.
What is the direction of force for 2nd-10th rib costotransverse mobilization?
Towards the armpit.
