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SMT-1 (Part 1) Flashcards

1
Q

MSK Diagnosis:

What article discuss that:

PT undergone more training in MSK management & treatment

A

Flynn 2003 in JOSPT

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2
Q

MSK Diagnosis:

What article discuss that:

Out of 85 physician resident, 82% failed a MSK competency exam

A

Freeman, K in 1992 in the journal of Bone and Joint Surgery

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3
Q

What did Josef More in 2005 study of Risk Determination For Patient With Direct Access To PT In The Military Healthcare Facilities concluded after review visits of 95 PT’s at 25 clinics for 40 months showed:

A

There were no adverse events, litigation, no license suspension

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4
Q

What was the result from the article A Description Of Physical Therapist’s Knowledge In Managing Musculoskeletal Conditions from the Journal of BMC MSK disorders, Childs et al in 2005

A

94% physicians Orthopedic
81% PT’s with OCS and SCS,
74% PT w/o OCS and SCS
68% DPT students

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5
Q

Geneen. Cochrane database. 2017. An overview of cochrane reviews. What does it say:

A

“There were some favorable effects in reduction of pain severity and improved physical function, though these were mostly of small to moderate effect, and were not consistent across the reviews.” The available evidence suggests that physical activity and exercise is an intervention with few adverse events that may improve pain severity and physical function.”

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6
Q

What does the evidence tells us about PNE for Chronic MSK Pain.

Article by Watson. Journal of Pain. 2019

A
  1. PNE does not produce clinically significant decreases in pain or disability
  2. PNE does produce clinically significant decreases in kinesiophobia and catastrophizing
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7
Q

What does the evidence tells us about PNE for Chronic MSK Pain.

Article by Watson. Journal of Pain. 2019

A
  1. PNE does not produce clinically significant decreases in pain or disability
  2. PNE does produce clinically significant decreases in kinesiophobia and catastrophizing
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8
Q

What does the evidence tells us about PNE for Chronic MSK Pain.

Article by Watson. Journal of Pain. 2019

A
  1. PNE does not produce clinically significant decreases in pain or disability
  2. PNE does produce clinically significant decreases in kinesiophobia and catastrophizing
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9
Q

What is the Kumar et al. (JEMDS, 2016) study about?

A

They got 90 patient with MusculoSkeletal Pain Syndrome who Failed traditional physical therapy:

• After 1 DN treatment:
>65 patients had excellent results (VAS 0-1)
>18 good results (VAS 2-3)
>5 fair reults (4-5)
>2 showed VAS of 6

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10
Q

Main Results and author for this study:

  • In patients that failed physical therapy treatment with eccentric exercise protocol
    *Patients randomized to received DN or PRP for patellar tendinopathy
A

Results:
1. Both groups improved
2. PRP was better at 12 weeks, DN was better at 26 (long term follow up)

Author:
1. Dragoo. AJSM. 2014

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11
Q

Main Results and author for this study:

In Women with PFPS. They Compare Exercise vs Exercise plus QL and Glut med DN

A

Results:
1.Both groups reached statistical significance for improvement and treatment success
2. DN group significantly better than exercise alone

Author:
1. Zarei et al. Arch Med Rehabil. 2020

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12
Q

Main Results and author for this study:

Dry needling vs sham in hip OA

A

Author:
1. Ceballos- Laita. 2020

Results:
1. DN group showed statistically significant benefits for:
-Pain intensity
-Pain pressure threshold (Increased, meaning patient could tolerate more activity with no pain or less pain)
-Psychological distress

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13
Q

Main Results and author for this study:
-Dry needling, acupuncture, SMT for chronic pain in the military

A

Results:
1. Those military patients with non-pharm treatments had less
– Alcohol/drug disorders
– Accidental poisoning from opioids/sedatives/barbituates/narcotics
– Less self inflicted harm

Author:
1. Meerwijk et al. Journal of General Internal Med. 2019

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14
Q

Main Results and author for this study:
-Dry needling, acupuncture, SMT for chronic pain in the military

A

Results:
1. Those military patients with non-pharm treatments had less
– Alcohol/drug disorders
– Accidental poisoning from opioids/sedatives/barbituates/narcotics
– Less self inflicted harm

Author:
1. Meerwijk et al. Journal of General Internal Med. 2019

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15
Q

Main Results and author for this study:
-Dry needling, acupuncture, SMT for chronic pain in the military

A

Results:
1. Those military patients with non-pharm treatments had less
– Alcohol/drug disorders
– Accidental poisoning from opioids/sedatives/barbituates/narcotics
– Less self inflicted harm

Author:
1. Meerwijk et al. Journal of General Internal Med. 2019

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16
Q
  1. Who was B.J. Palmer?
  2. What did her wrote about on The Philosophy of Chiropractic.
    Palmer School of Chiropractic; 1909
A
  1. Father of Chiropractic studies: Palmer School of Chiropractic; 1909
  2. “Chiropractors have found in every disease that is supposed to be contagious, a cause in the spine. In the spinal column we will find a subluxation that corresponds to every type of disease.
17
Q

What did Mirtz et al. (2009) mentioned of his Results from the Subluxation concept:

A
  1. No evidence of incidence rate of subluxation- Subluxation would have to be found in subjects and not found in other subjects.
  2. No evidence of subluxation in one population compare to another (Gender, race, ethnicity, age).
  3. No evidence of subluxation that is consistently evident in one condition vs. another
  4. No evidence that subluxations impair nerve to visceral organs and impedes health
  5. No evidence to suggest that manipulation of subluxations removes nerve interference, restores nerve flow to the organ or eliminates nerve interference as to affect organ health
18
Q

What did Mirtz et al. (2009) mentioned of his Results from the Subluxation concept:

A
  1. No evidence of incidence rate of subluxation- Subluxation would have to be found in subjects and not found in other subjects.
  2. No evidence of subluxation in one population compare to another (Gender, race, ethnicity, age).
  3. No evidence of subluxation that is consistently evident in one condition vs. another
  4. No evidence that subluxations impair nerve to visceral organs and impedes health
  5. No evidence to suggest that manipulation of subluxations removes nerve interference, restores nerve flow to the organ or eliminates nerve interference as to affect organ health
19
Q

What did Mirtz et al. (2009) mentioned of his Results from the Subluxation concept:

A
  1. No evidence of incidence rate of subluxation- Subluxation would have to be found in subjects and not found in other subjects.
  2. No evidence of subluxation in one population compare to another (Gender, race, ethnicity, age).
  3. No evidence of subluxation that is consistently evident in one condition vs. another
  4. No evidence that subluxations impair nerve to visceral organs and impedes health
  5. No evidence to suggest that manipulation of subluxations removes nerve interference, restores nerve flow to the organ or eliminates nerve interference as to affect organ health
20
Q

What are the characteristic of Grade V Mobilization or manipulation:

A

– High-velocity, low amplitude, single thrust

– Cannot be stopped by patient

– Results in audible pop / cavitation

– Duration: 90-130 ms for cervical; < 200 ms all other regions

– Elicits neurophysiological effects that may be exclusive

• Immediate reduction in paravertebral muscle tone

• Immediate increases in cervical flexor strength (Metcalfe et al., 2006)

• Immediate improvement in LM and TrA contraction (Gill et al., 2007; Brenner et al., 2007)

21
Q

What are the characteristic of Grade V Mobilization or manipulation:

A

– High-velocity, low amplitude, single thrust

– Cannot be stopped by patient

– Results in audible pop / cavitation

– Duration: 90-130 ms for cervical; < 200 ms all other regions

– Elicits neurophysiological effects that may be exclusive

• Immediate reduction in paravertebral muscle tone

• Immediate increases in cervical flexor strength (Metcalfe et al., 2006)

• Immediate improvement in LM and TrA contraction (Gill et al., 2007; Brenner et al., 2007)

22
Q

What is the DURATION of CS manipulation in compare to other regions?

A
  1. Duration for a CS manipulation: 90-130 ms (mili sec)
  2. Duration for other regions (TS/LS): < 200 ms all other regions
23
Q

When manipulating the CS vs TS/LS you want more:

A
  1. More Speed for CS Manipulations
  2. More Amplitude for TS and LS manipulations
24
Q

What are the characteristic of Grade I-IV Mobilizations:

A

– Multiple, slow, repetitive oscillations

– Can be stopped by patient

– Force restricted to specific aspects of joint ROM

– Does not result in an audible sound or cavitation

– 3 sets of 30 reps, etc.

25
Q

Grades of Oscillations (Maitland)

A

• Grade I – small amplitude movement at the beginning of the range (pain and spasm)

• Grade II – large amplitude movement within the midrange of the movement (pain and spasm)

• Grade III – large amplitude movement at the end of the range (into restriction)

• Grade IV – small amplitude movement at end range when tissue resistance (not pain) is limiting

• Grade V – small amplitude, quick thrust manipulation at end range—only w/ training!

26
Q

Based on Ngan et al. (2005) Medical Engineering & Physics, 27, 395-401

What are the kinematics and kinetics of cervical manipulation:

  1. Mean cervical thrust duration?
A

CS Mean Thrust Duration is 158 ms, but it can range from 117 ms to 250 ms

27
Q

Based on Ngan et al. (2005) Medical Engineering & Physics, 27, 395-401

What are the kinematics and kinetics of cervical manipulation:

How much pre-thrust rotation?

A

For C5/6 chin hold rotatory thrust:
– Mean pre-thrust rotation position was 54 degrees
– Mean pre-thrust flexion was 30 degrees—used Maitland chin hold technique over edge of bed!)
– Mean pre-thrust Side Bending (SB) was 6 degrees

28
Q

Based on Ngan et al. (2005) Medical Engineering & Physics, 27, 395-401

What are the kinematics and kinetics of cervical manipulation:

How much do you de-rotation (“come off”) the barrier before thrusting?

A

Mean de-rotation displacement: 4.8 degrees, range 0.5 to 16.0 degrees

29
Q

Based on Ngan et al. (2005) Medical Engineering & Physics, 27, 395-401

What are the kinematics and kinetics of cervical manipulation:

-How far into the range do you thrust? i.e. what is the amplitude of the actual thrust?

A

Ngan et al. (2005)

– Mean thrust displacement/angle: 11.4 degrees

– Mean thrust displacement range: 6.0 to 22.5 degrees

30
Q

Based on Ngan et al. (2005) Medical Engineering & Physics, 27, 395-401

What are the kinematics and kinetics of cervical manipulation:

How fast do you thrust? Velocity of the thrust?

A

– Average PEAK thrust VELOCITY: 127 deg/second

– MEAN thrust velocity: 72 degrees/second

– Mean PEAK ACCELERATION of thrust phase: 2183 degrees/second squared

31
Q

Based on Ngan et al. (2005) Medical Engineering & Physics, 27, 395-401

What are the kinematics and kinetics of cervical manipulation:

-Summary of thrusting kinematic and kinetic parameters (Ngan et al., 2005)

A

The DE-ROTATION DISPLACEMENT significantly correlates to
-THRUST DISPLACEMENT
-THRUST VELOCITY
-PEAK THRUST ACCELERATION

*i.e. the more de-rotation displacement you put on, the more thrust displacement, velocity and acceleration occurs

SMT (5 decks)

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