Muscle Energy (MET) and Articulatory (ART) OMT Flashcards
This type of contraction lengthens the muscle, increasing the distance between the origin and insertion
Eccentric
This type of contraction shortens the muscle
Concentric
This type of contraction is against a steady counterforce to maintain constant tone
Isotonic
This type of contraction includes the joint maintaining constant speed
Isokinetic
This type of contraction involves the muscles concentric contraction being overpowered to lengthen the muscle
Isolytic
This type of contraction is maintained at a constant length, such as wall squats
Isometric
What type of technique is Muscle Energy?
Direct and Active! - pt is involved and active
What is the most common physiological principle used by muscle energy?
Post-isometric relaxation
Describe post-isometric relaxation
Immediately after an isometric contraction, the neuromuscular apparatus is in a refractory state and passive stretching may be performed without muscle opposition
Also, increased tension in a golgi organ proprioceptors in the tendons inhibit active muscle contraction
Describe the set up for post-isometric relaxation
Physician moves pt to restrictive barrier (direct)
Pt contracts away from the restrictive barrier
Physician resists for 3-5 seconds
Both pt and physician relax
Physician moves pt to a new restrictive barrier and the process is repeated 3-5 times
Describe reciprocal inhibition
Physician moves pt to restrictive barrier and then the pt contracts TOWARDS the restrictive barrier while the physician resists
Describe the crossed extensor reflex
pt contracts the opposite muscle group in order to affect the actually injured muscle
- ex. if right hamstring is injured, contract left hamstring
Describe the oculocephalogyric reflex
Use eye movements to contract the cervical spine muscles
What are some muscle energy indications?
Balance muscle tone, improve symmetry, enhance circulation and lengthen a shortened, contractured muscle group
What are some muscle energy contraindications?
Local fracture/dislocation, post-surgery, unable to follow verbal commands
What factors influence successful muscle energy?
Contract too hard or in wrong direction, sustain contraction for too short a time, not giving accurate instructions or enough time between contractions
What type of technique is the articulatory approach?
Direct and passive
Describe how to perform ART?
Pt is passive, the physician uses gentle and repetitive motions through the restrictive barrier to restore physiological motion
Who may benefit from ART?
Arthritic patients, elderly, very young patients and those who cannot follow verbal commands
What are contraindications for ART?
Vertebral A. compromise - avoid extension and rotation of neck
Local infection/malignancy
Fracture/dislocation
Where do you place monitoring hand fingers on vertebrae?
Thumb and first finger go to transverse processes of affected segment and then middle finger goes to the transverse process of the segment below to monitor motion of dysfunctional segment
What do you move if the segment that has dysfunction is between T1-T6?
HEAD
Describe the setup for a lower thoracic and upper lumbar treatment?
Step away from the PTP
Pt places hand on same side as PTP behind neck and opposite hand on bent elbow
Physician monitors with one hand will treat with the other
Describe the physicians hands for a type 1 SD
Hand goes over 1 bicep
Describe the physicians hands for type 2 SD
Hand goes over the top of both biceps
Describe the lumbar ART sidebending dysfunction treatment
Pt lays lateral recumbant facing me
Flex pts knees/hips 90 degrees while monitoring SP of lumbar spine
Lifts ankles towards the ceiling to induce sidebend
Hold for a few seconds then rest, and repeat
For MET describe the lumbar neutral setup
pt lateral recumbant with PTP down; face physician
Find neutral position, move pts top leg off table
Grasp table sidearm and pull anterioinferiorly
Move top shoulder posteriorly
For MET describe the lumbar flexed setup
pt lateral recumbant with PTP down; face physician
Extend bottom him and flex top hip until motion felt, place flexed leg foot behind extended popliteal fossa
Grasp table sidearm and pull anterosuperiorly
Move top shoulder posteriorly
For MET describe lumbar extended setup
pt lateral recumbant with PTP down; face physician
Flex bottom and top hip and move top hip off table
Grasp table sidearm and pull anterosuperiorly
Move top shoulder posteriorly
What are the options for treatment when pt is setup in the lateral recumbant position with a lumbar dysfunction?
MET, ART, HVLA
