Manual Therapy Reasoning

Question 1

What are the main benefits of manual therapy(6)

Answer 1

inc ROM
Inc muscle activity
Inc blood flow for healing 
Inc confidence 
Inc proprioception 
Reduce kinesiphobia 
Hypoangesic effects

Question 2

Examples of manual therapy

Answer 2

joint mobs 
SSTM 
Active assisted exercise 
Stretching 
Assessment

Question 3

How does manual therapy increase ROM

Answer 3

Manual therapy increases ROM as you physically increase the range that the joint goes through, pushing the joint mechanically into range. Follow with a self stretch and exercise to maintain.

Also, decrease kinesiphobia and guarding so may increase ROM as patient relaxes as they trust the therapist, with touch stimulating the parasympathetic “rest and digest” nervous system, decreasing amounts of cortisol- stress hormone being released.

Question 4

Explain the hypoalgesic effect of manual therapy

Answer 4

Manual therapy decreases pain through a neuromodulatory down regulation of the nervous system. It stimulates the sensory afferent nerves which triggers the autonomic nervous system to relax.

Question 5

What pathway do afferent nerves take to stimulate the parasympathetic nervous system

Answer 5

Touch receptors in the skin send afferent nerve signals to the dorsal horn in the spinal cord, up the ascending dorsal column to the sensory relay station in the thalamus where they are received by the somatosensory cortex in the parietal lobe.

Question 6

What substance levels are reduced due to manual therapy

Answer 6

Reduces the levels of substance P and cytokines, therefore reducing sensitivity to pain signals. This reduces the amount of cortisol and adrenaline in the blood, by triggering the parasympathetic nervous system and helping relaxation

Question 7

Explain how manual therapy increases proprioception

Answer 7

Touch stimulates and increases awareness of joint position and movement patterns. You can use hands to facilitate normal movement so that the patient can feel a difference and notice any abnormal patterns with awareness.

Question 8

How does manual therapy increase confidence

Answer 8

Confidence increases due to decreased kinesiphobia.

It also facilitates normal movement patterns and reassures the patient

Question 9

How does manual therapy affect pain gate

Answer 9

Pain messages are sent via a delta (quick pain) and c fibres (slow pain) nociceptors via the dorsal horn to spinothalamic tract, thalamus and sensory cortex in the parietal lobe.
Manual therapy stimulates a beta mechanoreceptors which travel via the dorsal column to the sensory cortex, which helps down regulation of the nervous system pain messaging