Manual Therapy (Pod med) Flashcards

1
Q

What’s the two main mechanism of action of manual therapy:

1?

2?

A
  1. Promotion of healing tissue
  • Superficial fluid techniques (efflurage)
  • Specific Soft Tissue Mobilisation
  1. Improvement in tissue extensibility
  • Neuromuscular techniques
  • Connective Tissue techniques
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2
Q

What are the indications for manual therapy?

1?

2?

3?

4?

5?

A
  1. Pain
  2. Effusion
  3. Muscle spasm
  4. Reduced muscle extensibility
  5. Reduced connective tissue extensibility (scar)
  6. Reduced Muscle Integrity
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3
Q

What are the contraindication or precautions for manual therapy?

A
  1. Diabetes
  2. Blood disorders
  3. Anticoaugulant medication
  4. Infection
  5. Thrombosis
  6. Malignancy
  7. Vascular insifficinecy
  8. Cellulitis
  9. Fever
  10. Poor skin condition
  11. Open wound
  12. Loss of sensation
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4
Q

What are the endageroud sites?

A
  1. Throat/Thrachea
  2. Ant/Post neck
  3. Kidney
  4. Popliteal fossa area
  5. Femoral triangle (Nerve, artery, vein)
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5
Q

What are some of the effect of STM and massage?

  1. M
  2. P
  3. P
  4. R
  5. PNI
A
  1. Mechanical: physically moving the tissue
  2. Reflex: Change mediated by nervous system, sedation and arousal of mechanoreceptors
  3. Physcological: thoughts, emotions, behaviours
  4. Physiological: Change in biological process
  5. Psychoimmunological, decrease in stress hormone
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6
Q

What are general practice guidlines for manual therapy?

1?

2?

3?

4?

5?

A
  1. Locate the tissues: Assess during treatment /Palpate
  2. Observe pt
  3. Penetrate deeper through repetition
  4. Rate = 1/depth
  5. Adjust technique to :

Patient needs

Region and condition

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7
Q
  1. What is the Efflurage technique?
  2. Which stage of healing?
  3. Promote?
  4. Indicated in ?
  5. Remove?
A
  1. Superficial fluid technique
  2. Early stages of healing (0-3days)
  3. the resorption of inflammatory exudate
  4. the presence of swelling / effusion/ inflammation
  5. chemical inflammatory mediators that are pain sensitizing (prostaglandins)  decrease pain and sensitivity to movement
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8
Q

What are some clinical examples for Effluerage?

1?

2?

3?

A
  1. Acute ankle sprain
  2. Hamstring strain (day 0-3)
  3. Removing excess fluid post cellulitis/ would infection
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9
Q

What are some of the function for specific soft tissue mobilisation?

  1. Which stage of healing?
  2. Controlled graded loading to promote ?
  3. Promote ?
  4. Prevent?
  5. Stimulate the proliferation of?
  6. Type III collagen is replaced by?
A
  1. Later stage of healing (7-10 days)
  2. Collagen synthesis
  3. Promote Collagen alingment and links within the tissue
  4. Prevent inappropriate crosslink between the tissue layers
  5. Fibroblast
  6. strong type I
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10
Q

Explain the deep transverse friction mobilisation:

A

Small amplitude, specfic, repetitive, non-gliding technique on the superficial tissue surface

Movement is between tissue layers to prevent/break down inappropriate cross-link regenerates in muscle or tendon

Causes hyperaemia

Breaks down adhesions

Stimulates mechanoreceptors (analgesic effects)

Promote collagen orientation

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11
Q

What are some clinical examples for Deep transverse frictions:

A

Accessory SSTM:

Achilles Tendonopathies

Patella Tendon

Deep Transverse Frictions: Plantar Fascia Anterior Talofibular ligament

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12
Q
  1. When is the neuromuscular techniques indicated?
  2. What are the stages of healing?
  3. What the intend of treatment?
A
  1. Indicated when an impaired movement is present, limited by an active myofascial restriction
  2. 10 days- 4 weeks
  3. Intent of treatment not to produce a longer bit of tissue but to induce muscle relaxation
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13
Q

What are the different NMT techniques:

1?

2?

3?

A
  1. Kneading
  2. Stripping
  3. Myofascial trigger point release
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14
Q

What is the kneading technique?

A

Repetitive compression, shear & release of a muscle with varying degrees of drag, lift and glide

Picking up, wringing and squeezing

Used on large muscles that can be easily lifted (eg. Calf, quads)

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15
Q

What is the Stirpping technique?

A

Deep, slow and very specific glidng techniqe along the line of the muscle

“Deep Effleurage”

Deep enough to engage muscle but should cause minimal pain

Hand contact needs to be soft and broad

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16
Q

Trigger Point Release:

A

TrP is a focus region of hyperirratability within a muscle

‘Knot’ or MTrP develops as a characteristic clinical presentation

Taut ropey band of muscle fibers

Initially can illicit pain and a twitch response on palpation

Latent response- Tender on palpation yet no symptoms

Active response- reproduces the patient symptoms , especially referred pain

17
Q

What the technique for Myofascial trigger point release?

A

Technique:

Direct pressure for flat muscles or pincer grip when the muscle can be picked up

Put muscle under slight stretch

Find the ropey fibres via gentle pressure and cross fibre movement

Apply pressure until symptoms are reproduced

Hold until pain decreases

Increase pressure as pain decreases and stops

Re-assess muscle length, pain and function

Acupuncture and dry needling

18
Q

Connective tissue techniques:

A

Engages connective tissue and attempt to lengthen and remodel the tissue

Passive myofascial restriction

Movement impairment secondary to a passive limitation of movement (eg, ITB)

Deep Tissue Massage:

Consent is crucial – can be painful and has potential to cause slight skin discoluration

Deep, slow, gliding technique that applied moderate tensile load on the passive elements of muscle

Used in combination with joint positioning to place maximal tensile load on the tissues

Proceed the techniques with some lighter NMT techniques

Gradually increase pressure, with constant re-assessment of symptoms (ie. Pain)