Non-Thrust Manipulation

Question 1

Passive Accessory Intervertebral Motion (PAIVM) Arthrokinematic

Answer 1

Central PA
Unilateral PA
Manual Lumbar Traction

Question 2

Central PA

Answer 2

Patient prone
Therapist stride standing at side of plnth
PLace tumb pads over spinous process
Use trunk to apply force
Feel for R1 and then back out

Question 3

Documentation of Central PA

Answer 3

State spinal level, direction of motion, grade, duration, number of sets, re-assessment findings

Question 4

Unilateral PA

Answer 4

Patient prone
Therapise stride standing at side of plinth
Place thumb pads over area of facet joints or over transverse processes
Use trunk to apply force

Question 5

Manual Lumbar Traction

Answer 5

Patient supine or prone - depends on what you would like to accompish
Traction force is aplied through lower extremities
Used as intervetnion when radicular sx are present

Question 6

Passive Physiological Intervertebral Motion (PPIVM) Osteokinematic

Answer 6

Flexion
Extension
Lateral Flexion
Rotation
Localizing a Segment

Question 7

PPIVM Flexion

Answer 7

Patient in side-lying position with hips and knees flexed
Therapist stands facing the pt and supports patients knees on therapist thighs
Therapist holds patient ankles in one hand and uses fingers of opposite hand to palpate the spinous processes for movement as patient is passively guided into lumbar flexion through hip flexion

Question 8

PPIVM Extension

Answer 8

Patient in side-lying position with hips and knees flexed
Therapist stands facing the pt and supports patients knees on therapist thighs
Therapist holds patient ankles in one hand and uses fingers of opposite hand to palpate the spinous processes for movement as patient is passively guided into lumbar extension through hip extension- palpate for spinous processes to approximate during extension

Question 9

PPIVM Lateral Flexion

Answer 9

Patient and therapist positioned as others and the patients legs are flexed and supported on the plinth and knees are just over the edge
THerapist grasps patients ankles and moves them toward the ceiling to create a LF movement
Spinous processes should be palpated as they move toward the plinth - Repeat on both sides

Question 10

PPIVM Rotation

Answer 10

Patient in side lying in spinal neutral with knees over the edge of the plinth
Therapist palpates spinous processes
Patients thorax is passively rotated away from examiner
Upper segments should be palpated as they rotate toward the plinth
Spine must be retunred to neutral each time new level is examined
Rep on both sides

Question 11

PPIVM Localizing a Segment

Answer 11

Used for grade 4 and 5
most widely used with unilateral symptoms
Patient is positioned side lying - therapist facing the patient
Use fingers of one hand to palpate spinous processes
Rotate patient trunk away from you to lock facets
Flex patients lumbar spine through the hips to take up slack in the interspinous ligament
Palpate spinous processes
Force is transmitted from therapist trunk through forearms to posterior aspect of patients pelvis with minimal pressure on their shoulder, ribs