Muscle Energy (MET) and Articulatory (ART) OMT

Question 1

This type of contraction lengthens the muscle, increasing the distance between the origin and insertion

Answer 1

Eccentric

Question 2

This type of contraction shortens the muscle

Answer 2

Concentric

Question 3

This type of contraction is against a steady counterforce to maintain constant tone

Answer 3

Isotonic

Question 4

This type of contraction includes the joint maintaining constant speed

Answer 4

Isokinetic

Question 5

This type of contraction involves the muscles concentric contraction being overpowered to lengthen the muscle

Answer 5

Isolytic

Question 6

This type of contraction is maintained at a constant length, such as wall squats

Answer 6

Isometric

Question 7

What type of technique is Muscle Energy?

Answer 7

Direct and Active! - pt is involved and active

Question 8

What is the most common physiological principle used by muscle energy?

Answer 8

Post-isometric relaxation

Question 9

Describe post-isometric relaxation

Answer 9

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

Question 10

Describe the set up for post-isometric relaxation

Answer 10

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

Question 11

Describe reciprocal inhibition

Answer 11

Physician moves pt to restrictive barrier and then the pt contracts TOWARDS the restrictive barrier while the physician resists

Question 12

Describe the crossed extensor reflex

Answer 12

pt contracts the opposite muscle group in order to affect the actually injured muscle
- ex. if right hamstring is injured, contract left hamstring

Question 13

Describe the oculocephalogyric reflex

Answer 13

Use eye movements to contract the cervical spine muscles

Question 14

What are some muscle energy indications?

Answer 14

Balance muscle tone, improve symmetry, enhance circulation and lengthen a shortened, contractured muscle group

Question 15

What are some muscle energy contraindications?

Answer 15

Local fracture/dislocation, post-surgery, unable to follow verbal commands

Question 16

What factors influence successful muscle energy?

Answer 16

Contract too hard or in wrong direction, sustain contraction for too short a time, not giving accurate instructions or enough time between contractions

Question 17

What type of technique is the articulatory approach?

Answer 17

Direct and passive

Question 18

Describe how to perform ART?

Answer 18

Pt is passive, the physician uses gentle and repetitive motions through the restrictive barrier to restore physiological motion

Question 19

Who may benefit from ART?

Answer 19

Arthritic patients, elderly, very young patients and those who cannot follow verbal commands

Question 20

What are contraindications for ART?

Answer 20

Vertebral A. compromise - avoid extension and rotation of neck
Local infection/malignancy
Fracture/dislocation

Question 21

Where do you place monitoring hand fingers on vertebrae?

Answer 21

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

Question 22

What do you move if the segment that has dysfunction is between T1-T6?

Answer 22

HEAD

Question 23

Describe the setup for a lower thoracic and upper lumbar treatment?

Answer 23

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

Question 24

Describe the physicians hands for a type 1 SD

Answer 24

Hand goes over 1 bicep

Question 25

Describe the physicians hands for type 2 SD

Answer 25

Hand goes over the top of both biceps

Question 26

Describe the lumbar ART sidebending dysfunction treatment

Answer 26

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

Question 27

For MET describe the lumbar neutral setup

Answer 27

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

Question 28

For MET describe the lumbar flexed setup

Answer 28

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

Question 29

For MET describe lumbar extended setup

Answer 29

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

Question 30

What are the options for treatment when pt is setup in the lateral recumbant position with a lumbar dysfunction?

Answer 30

MET, ART, HVLA