OMM - Intro to Direct Techniques

Question 1

direct techniques

Answer 1

Engages the restrictive barrier. useful for chronic problems.

Question 2

Indirect techniques

Answer 2

Disengages the restrictive barrier. Techniques of choice when treating acute conditions and conditions in patients who are otherwise compromised

Question 3

Articulatory Techniques

Answer 3

Direct technique, repeatedly engaging barrier (5-10 times or more if needed). Passive, smooth rhythmic motion designed to stretch contracted muscles, ligaments and capsules, descreasing tension. Enhances lymphatic flow and circulation. Useful in transitional zones (C7/T1, L5/S1)

Question 4

Soft Tissue Techniques

Answer 4

Used to lengthen or relax muscles, fascia, and connective tissue. Force used must be slowly applied, with sufficient duration, and appropriate contact.

Question 5

Direct Myofascial Release

Answer 5

Load and hold the tissue. Lowers inappropriate afferent input in increased tissue sensitization.

Question 6

Muscle Energy Technique

Answer 6

the patient contracts a muscle from a previously controlled position as specifically directed by the physician; against a controlled resistance by the physician.

Question 7

Extrafusal muscle fibers

Answer 7

Contraction of the main muscle mass. Innervated by alpha motor neurons from ventral root of the spinal cord. Afferent sensory nerve fibers group Ia, Ib, and II travel to the dorsal spinal roots.

Question 8

Golgi tendon

Answer 8

Prevents excessive muscle tension by monitoring muscle force. Lie within muscle tendons. Respond to changes in force, not length. Inhibits alpha motor neurons.

Question 9

Intrafusal muscle fibers (muscle spindle)

Answer 9

Protects the muscle from tearing by monitoring length and tone. Innervated by gamma motor neuron. Afferent proprioceptive nerve fibers group Ia and II travel to the dorsal spinal roots. Allows one to judge the position of the muscle (proprioception) and the rate at which it is changing position

Question 10

Muscle spasm

Answer 10

inappropriately high set point

Question 11

Indirect techniques (counterstrain)

Answer 11

relax the intrafusal muscle fibers resetting the gamma gain to a new, lower level.

Question 12

Direct techniques (ME)

Answer 12

stretch the extrafusal fibers of the muscle pulling on the golgi tendon receptors which inhibit alpha motor neurons that decrease the muscle’s contraction.

Question 13

Joint restriction

Answer 13

may be due to a muscle which is shortened and will not lengthen. The muscle spindle reports increased tension, with resultant increase in gamma tone and muscle spasm.

Question 14

Muscle Energy Theory

Answer 14

Muscle is lengthened to the barrier, then the patient contracts the muscle. Golgi tendon receptors are pulled, producing reflex relaxation of the muscle’s extrafusal fibers. Following the contraction, the muscle spindle reports less tension, the gamma gain is reduced, allowing the muscle to be lengthened. The muscle spindle has been “reset” to reduce gamma gain.

Question 15

Isometric Muscle Contraction

Answer 15

Contraction of a muscle against resistance while maintaining constant muscle length

Question 16

Isotonic Muscle Contraction a. Concentric: with shortening of the muscle b. Eccentric: with lengthening of the muscle

Answer 16

Contraction of a muscle against resistance with a change in length.

Question 17

Isolytic

Answer 17

an eccentric contraction where the speed of muscle lengthening is very rapid

Question 18

Isokinetic

Answer 18

an isotonic contraction where the length change occurs at a constant velocity

Question 19

Make diagnosis. Engage barfrier in all planes. Instruct patient to contract muscles againsrt your holding force (isometric). Time of contraction 3-5 seconds. Relax for 2 seconds. Engage new barrier, repeat several times. Only need 2 lbs of force. Stop treatment if no response.

Answer 19

Principles of Muscle Energy

Question 20

High Velocity Low Amplitude Technique

Answer 20

A direct technique where the joint is placed against the barrier, and a low amplitude, high velocity thrust is delivered moving the joint beyond its pathologic barrier (restrictive barrier).

Question 21

HVLA Theory

Answer 21

Motion becomes dysfunctionally limited. Decreases affernt input of joint mechanoreceptor, reducing firing.

Question 22

HVLA Technique

Answer 22

The surrounding tissues should be relaxed utilizing other techniques prior. The dysfunctional segment is placed into the barrier addressing all planes of motion.Technique must localize force to the area of restriction of motion. Treatment is specific. Final activating force is a sudden gentle increase of force (high velocity) through a small distance (low amplitude). The patient is returned to neutral and the motion is reassessed.

Question 23

No consent, fracture. Relative: inflammatino, instability, weakness/deformity, potential vasculature compromise, trauma, neurologic deficit.

Answer 23

HVLA Contraindications.

Question 24

Cavitation theory Pop

Answer 24

Sudden distraction of joint surfaces produces nitrogen gas bubble.

Question 25

Volume theory for Pop

Answer 25

A slight sudden increase in joint volume within an enclosed joint results in a popping sound as the surface tension of the joint fluid is broken.