Spinal Manipulation Flashcards
What are the characteristic of a joint manipulative procedure?
Passive - past normal passive range Manual Articular Sudden thrust (Low amplitude/high velocity) Controlled force (patient size) Directional (articulations) Cracking noise
Define joint manipulation.
A passive manual maneuver in which a synovial joint is carried beyond its normal physiological range without exceeding the boundaries of anatomical integrity.
Define adjustment.
Specific form of joint manipulation using long or short lever techniques with specific anatomic contacts.
What are the characteristics of adjustment?
Low amplitude dynamic thrust Controlled velocity Controlled amplitude Controlled direction Audible articular crack ( cavitation)
Define joint mobilization
Non-thrust joint manipulation applied within the physiologic range of joint motion.
What are the key features of joint mobilization?
Passive rhythmic graded movements
Describe Sandoz’s arc of joint manipulation and ROM
Physiological zone consisting of active and passive ROM Physiological barrier (end range) limiting further motion into para physiological space -point at which mobilisation occurs (up to grade 4) Passing this barrier is due to manipulation (grade 5) The barrier of anatomical integrity provides the final limitation of movement
What causes the physiological barrier between passive ROM and the para physiological space?
The negative pressure of synovial fluid in joint
What prevents further movement after the para physiological space?
The structures surrounding the joint
What is the difference between specific and general adjustments?
Specific:
Specific contact point
Short levers
Specific vector of correction
General: Broader contacts Influence multiple segments Longer levers More commonly used amongst older patients
Is it possible to get a specific contact point during an adjustment/manipulation? Why?
No, the adjacent segments (above and below) are both influenced when attempting to make a ‘specific’ adjustment.
It is important to note when there is an unstable segment
What are the effects of adjusting therapy?
Treatment of neuromusculoskeletal pain disorders
High levels of satisfaction (instantaneous relief)
Non invasive approach of mechanical spinal pain
What is a cavitation?
Formation of vapour and gas bubbles within fluid (synovial) through local reduction of pressure.
Application of a pre-load force - taking visoelastic synovial fluid to a well defined elastic physiological barrier (solid-like)
Additional thrust creates high velocity movement between articulation surfaces
Articular surfaces are separated through elastic recoil of SF above a critical velocity
Inception of cavity (gas bubbles) - popping sound
Can a second cavitation occur immediately after the first one?
No, there is a refractory period therefore a second cavitation cannot be produced until approx. 20 min after the first
Is an audible release necessary?
No, it is not always possible to hear
