Principles of Manual Therapy

Question 1

(true/false) No deaths have been attributed to PTs providing cervical spine manipulation

Answer 1

True

Question 2

What is the needed force of a PA thoracic thrust?

Answer 2

145 N (32.5 pounds)

Question 3

What is the force needed to fracture a cadaveric T-spine with osteoporosis?

Answer 3

479 N (107.5 pounds)

Question 4

Which is more fragile when discussing joint mobilizations? Ligaments or articular sites?

Answer 4

ligaments

Question 5

In literature comparing aggressive mobilization to conservative mobilization, greater effectiveness and improvement was seen with (aggressive/conservative) techniques).

Answer 5

aggressive

Question 6

Mobilization with (compression/distraction) is better based on mobilization to a largely geriatric population.

Answer 6

compression

Question 7

(True/false) Mobilization may make the patient feel worse.

Answer 7

True

Question 8

Stretching requires a (greater/lesser) amount of force within the joint compared to mobilization.

Answer 8

greater

Question 9

Passive hamstring stretching uses about __-__ N of force

Answer 9

600-800 N(135-180 pounds)

Question 10

What are the neurophysiological effects of manual therapy?

Answer 10

• changing of the muscle tone
• release of chemicals

Question 11

Grade V mobilizations (do/do not) need to be at the end of range

Answer 11

do not

Question 12

How does a PT determine the grade of mobilization they should use on a joint?

Answer 12

They determine the amount of joint restriction

Question 13

A PT should mobilize/manipulate a joint when it is ___.

Answer 13

hypomobile

Question 14

(true/false) A PT should use aggressive manipulation/mobilization when treating a hypermobile patient

Answer 14

False (only gentle mobilization)

Question 15

What method of manual therapy is usually better for a joint with a capsular pattern of restriction?

Answer 15

Mobilization or traction

Question 16

What is it called when a joint has restriction in ONE direction?

Answer 16

non-capsular pattern

Question 17

Non-capsular patterns normally respond well to Grade __ mobilization.

Answer 17

Grade V

Question 18

(true/false) You CAN manipulate a joint if it is inflamed

Answer 18

FALSE!!!!

Question 19

If you identify an abnormal boney end-feel during ROM, how should you proceed with mobilization?

Answer 19

Mobilization is NOT indicated

Question 20

If you identify an empty end-feel, How should you proceed with mobilization?

Answer 20

You can use mobilizations for pain relief (Grades I and II)

Question 21

If you identify a capsular end feel, how should you proceed with mobilization?

Answer 21

Mobilization is indicated

Question 22

Use grades __ and __ when treating acute cases.

Answer 22

I and II

Question 23

Use grades __ and ___ when treating a subacute condition.

Answer 23

II and III

Question 24

Use grades __ and ___ when treating chronic conditions.

Answer 24

III and IV

Question 25

What are ABSOLUTE contraindications for manual therapy?

Answer 25

• evidence of something other than soft tissue or joint lesion exists
• evidence of acute trauma (Fx, dislocation, ligament rupture)
• acute inflammation
• infection
• worsening neuro compromise
• spinal cord involvement
• neuro or vascular compromise
• bony end feel

Question 26

What type of end-feel is a contraindication for using manual therapy?

Answer 26

bony

Question 27

What are RELATIVE contraindications to manual therapy?

Answer 27

• Osteoporosis
• RA (unless the patient has no acute inflammation and danger of ligamentous changes)
• spondylolisthesis
• hypermobility
• pregnancy (after 6-8 months)
• dizziness
• previous malignant disease (unless possibility of metastasis is ruled out)

Question 28

(speed/force) is the effective part of the HVLAT technique

Answer 28

speed

Question 29

In the body, junctions tend to be ___ and mid-regions tend to be ___.

Answer 29

stiff, hypermobile

Question 30

(true/false) Hypermobile areas are often painful. Stiff areas are NOT painful.

Answer 30

true