Review: MET Lumbar & Sacrum Flashcards
MET Lumbar Type 1 (Neutral) SD, Lateral Recumbent Long Lever Technique
NUDR — Neutral dysfunction, PTP Up, Pt force Down, Recumbent
Pt lateral recumbent, PTP up, doc faces pt. Monitor at the apex of the curve with cephalad hand. Flex hips and knees until motion is felt under monitoring hand.
Lift pts ankles, sidebending th elumbar spine into barrier. Pt gently pushes ankles toward floor against doc’s counterforce x3-5 seconds, then relaxes while barrier is re-engaged by pulling up on the ankles
MET Lumbar Type 2 Extended SD, Lateral Recumbent Long Lever Technique
SUUE — Modified Sims, PTP Up, Pt force Up, Extension dysfunction
Pt in modified sims with PTP up and doc facing patient. Monitor dysfunction with cephalad hand. With caudad hand, flex hips and knees through the dysfunctional segment, engaging the flexion barrier.
Pt’s legs are dropped off the table to engage SB barrier. Pt instructed to raise both ankles up toward ceiling against resistance x3-5 seconds, then relax as barrier is reengaged by lowering the legs further
MET Lumbar Type 2 Flexed SD, Lateral Recumbent Long Lever Technique
FDDR - Flexed dysfunction, PTP Down, Pt force Down, lateral Recumbent
Monitor dysfunction with caudad hand, grasp pts arm and pull anterior/superior, engaging rotation and SB barriers
Switch monitoring hands. Straighten bottom leg, engaging extension barrier. Engage SB barrier by lifting ankles. Pt pushes down towards floor against resistance
MET Lumbar Type 1 (neutral) lateral recumbent long restrictor technique
Pt lateral recumbent, PTP down, doc facing pt
Caudad hand or thigh to flex pts knees and hips while cephalad hand monitors apex of curve. Fine tune flexion/extension of hips until dysfunctional segment/curve is neutral
Pts top leg is lowered off the edge of the table, causing anterior rotation of the pelvis, until monitoring hand detects motion. Pt pushes top SHOULDER forward against doc’s resistance x3-5s, then relaxes as doc rotates to new RB. Pt then pulls HIP posteriorly and cephalad against resistance. Repeat
MET Lumbar Type 2 SD, Lateral recumbent long restrictor technique
Pt lateral recumbent, PTP down, doc facing pt
Caudad hand or thigh flexes pts knees and hips while cephalad hand monitors dysfunctional segment. Fine tube F/E until segment is in neutral.
Place pts top foot behind bottom knee in popliteal fossa. Switch monitoring hands. Use cephalad hand to move pt’s top shoulder posteriorly until caudad hand detects motion. Pt pushes SHOULDER forward against doc’s resistance x3-5s, relaxes, doc moves to new RB, then pt pulls HIP posteriorly against doc’s resistance
MET: Left unilaterally extended sacrum
Monitor SI joint
Abduct the leg until motion is palpated at the left SI joint; instruct pt to assume prone TV watching position
Externally rotate left leg to gap anterior aspect of left SI joint; place heel of hand on the left sacral base
Apply anterior/inferior force to engage RB; have the pt breath deeply and encourage the anterior/inferior motion associated with exhalation and resist posterior/superior motion with inhalation
MET: Left unilaterally flexed sacrum
Monitor left SI joint, then ABduct the leg until motion is palpated
Internally rotate the left leg to gap posterior SI joint; place heel of hand on left ILA
Apply anterior/superior force to engage RB. Have pt breath deeply and encourage anterior/superior motion with inhalation and resist posterior/inferior motion with exhalation
MET: bilateral sacral flexion
Setup each SI joint individually as when performing unilateral treatment
Monitor SI joint, then ABduct the leg until motion is palpated; internally rotate the lower extremities to gap posterior SI joint
Place heel of hand across apex of sacrumand apply anterior superior force, encourage anterior/superior motion with inhalation and resist exhalation
MET: bilateral sacral extension
Setup each SI joint individually as when performing unilateral tx
Monitor SI joint, then ABduct the leg until motion is palpated at SI joint; instruct pt to assume prone TV watching position
Externally rotate pts legs
Place heel of hand on sacral base and apply anterior/inferior force to engage RB. Have pt breath deeply and encourge the anterior/inferior motion with exhalation; resist inhalation
MET: L/L sacral torsion
Pt in modified sims with axis side down
Flex hips and knees while monitoring L5/S1 interspace
Lower pts ankles towards floor by pushing until reaching sidebending RB
Instruct pt to lift their feet towards the ceiling for 3-5s
MET: L/R Sacral torsion
Pt lateral recumbent with axis side down
Flex top hip and knee to 90, pull pts lower arm toward physician to produce posterior rotation so that pts back gets closer to table and front faces ceiling
Instruct pt to take 2-3 deep breaths, after each exhalation have pt reach back with top arm
Place pt’s top foot on doc’s thigh and induce further flexion of top hip and knee untilmotion is felt at monitoring hand; apply gentle force on pt’s knee towards the floor (adducting top hip). instruct pt to lift knee up against your hand for 3-5s
