Mob/Manip Class Notes 2 Flashcards
What is an important way to maximize the placebo effect of mob/manip?
- appeal to research to give them confidence that you are using solid reasoning for the tx
- tell them 95% of pts benefit from the tx
What should you tell a pt to assist with recovery at home?
- they can and should move themselves
- stay active - motion is lotion
For pts who are apprehensive of spinal manip as tx, what could you tell them?
- safer than NSAIDs for treating back pain
- Indicate that “I’ve screened YOU specifically and YOU don’t have any of the red flags that would make you not a candidate”
- your l-spine is so strong that there’s no physical way I could apply enough force to cause damage. What I’m going to do is very gentle
- AFFIRMATION OF THEIR CONCERNS!
Libby has limited, painful flexion and hypomobility L > R at L4/5 and L5/S1. S&S indicate she belongs in mob/manip classification. Which of the following is the best approach for initial tx?
A. Left SI manip
B. Left sidelying lumbar rotation manip
C. Central PA mob
D. Unilateral PA non-thrust manip
D. Unilateral PA non-thrust manip
Even though the manipulation is called an “SI manip”, what should you remember?
- Don’t assume it only affects SI
- very successful manip for LBP
Why might an SI manip not be best for a pt’s first visit?
very end range/wide spread
Which side should be up in a sidelying lumbar rotation manipulation?
painful side up!
How does end range rotation affect the facets?
causes ipsilateral facets to gap (opens up the painful side)
What is central PA mob used for?
address flex/ext mobility deficits
With an asymmetrical pain distribution, what type of technique would you most likely use?
You would use a unilateral technique
non-thrust =
mobilization
HVLA =
high velocity low amplitude
Assuming you only have time to add one ex to Libby’s tx, which of the following would be the best choice?
A. Muscle energy (shot-gun technique) for flexion deficit
B. Pain-free anterior and posterior tilts
C. ADIM
D. Cat/cow to end-range
B. Pain-free anterior and posterior tilts
What is the benefit of using pain-free AP tilts following mobs/manips?
- not placing them at end-range
- focusing on lumbar without incorporating as much thoracic like cat-cow
Which of the following patients (all of the following are IR ROM measurements) has the best chance of responding to mobilization/manip, assuming all other signs and symptoms are equal?
A. L 38˚, R 18˚
B. L 38˚, R 41˚
C. L 28˚, R 45˚
D. L 28˚, R 28˚
A. L 38˚, R 18˚
C. L 28˚, R 45˚
