MPT 2 MDT Flashcards
McKenzie method
a classification system used for both eval and treatment of a patient according to the mechanical and symptomatic response to mechanical loading
what are 3 types of LBP impairments that MDT works best on
1 - acute LBP w/ mobility deficits
2 - acute LBP w/ radiating pain
3 - chronic LBP w/ radiating pain
T or F: MDT and manual therapy both have strong evidence for treating LBP with referred pain and or mobility deficits
T
what are the 3 MDT mechanical syndromes
1 - derangement
2 - posture
3 - dysfunction
*also have an “other” subgroups
postural syndrome
pain associated with prolonged static loading on normal tissues
dysfunction syndrome
mechanical deformation of structurally impaired soft tissues
derangement syndrome
a disturbance in the normal resting position of the affected joint surfaces
T or F: postural syndrome has a true pathology associated with it
F
is there ROM loss with postural syndrome? deformities?
No
typical population affected by postural syndrome
younger, typically female, sedentary lifestyle
*seen a lot in gamers
what kind of pain with postural syndrome?
- local and intermittent
- no pain during movement
- end range pain only with sustained positions
- correct position and pain improves
what is the treatment for postural syndrome
education and posture correction
is there a pathology associated with dysfunction syndrome
yes
is there deformity with dysfunction syndrome? what about ROM loss?
deformity = no
ROM loss = yes
what kind of pain with dysfunction syndrome
consistent end range pain
what is the treatment for dysfunction syndrome
remodeling tissue
how is a dysfunction syndrome named
for the direction of the ROM loss
Ex: loss of flexion = flexion dysfunction
3 dysfunction syndrome subgroups
1 - flexion dysfunction
2 - extension dysfunction
3 - adherent nerve root (ANR)
you treat flexion dysfunction with repeated ______ while you treat extension dysfunction with repeated ________
flexion
extension
adherent nerve root
- intermittent symptoms in legs/arm
- go to end range and then goes down arm/leg
how to treat ANR
remodel with dural glides
what must you rule out with adherent nerve root
derangement
what is the most common MDT syndrome
derangement
what is the biggest difference between dysfunction and derangment
with derangement, you have pain through the entire movement… not just at end range
how to tell the difference between ANR and derangement
if you take away the neural tension and still have pain it is derangement
if the pain goes away, it is ANR
irreducible derangements
- chronic, unchanging, constant
- no movements provide lasting relief
how to treat irreducible derangements
PNE
encourage activity
directional preferance
movement in this direction results in reduction of pain and improved ROM
what do interventions based on directional preference promote
centralization of symptoms
T or F: centralization only occurs with derangement syndrome
T
how do you name a derangement
based on the direction it is deranging
stages of derangement management (4)
1 - reduction of derangement
2 - maintenance of reduction
3 - recovery of function
4 - prevent recurrence
how do you reduce a derangement
- directional preference to END RANGE
- progression of forces
typically, what is the directional preference with derangements
towards the pain
red light
increases sx, produces, and remains worse
yellow light,
increases sx, produces, and no worse after
green light
decreases sx, abolishes, and remains better
do you start with sagittal or lateral plane movements in MDT? What is the exception?
sagittal
*unless there is a lateral shift and then you need to correct that first
extension progression of forces
1 - prone
2 - prone on elbows
3 - standing
4 - repeated ext in lying
5 - overpressure exhalation from pt
6 - overpressure from PT
7 - mobilization
8 - manipulation
T or F: centralization during eval indicates good prognosis
T
