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Conditions > Station 5/Part 2 - Techniques > Flashcards

Station 5/Part 2 - Techniques Flashcards

1
Q

Grade 1 Sustained Glide

A
  • low grade
  • joint is pushed halfway to the tissue barrier and held there
  • indication: ROM maintenance and pain management
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2
Q

Grade 1 Oscillation

A
  • low grade
  • small amplitude movement between the starting position and just before the tissue barrier
  • indication: ROM maintenance and pain management
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3
Q

Grade 2 Sustained Glide

A
  • low grade
  • the joint is pushed only to the tissue barrier and held there
  • indication: ROM maintenance and pain management
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4
Q

Grade 2 Oscillation

A
  • low grade
  • large amplitude movement between the starting position and the tissue barrier
  • indication: ROM maintenance and pain management
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5
Q

Grade 3 Sustained Glide

A
  • high grade
  • the joint is pushed past the tissue barrier to the anatomical limit and held there
  • indication: increase ROM and stretch the joint capsule
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6
Q

Grade 3 Oscillation

A
  • high grade
  • large amplitude movement that starts just before the tissue barrier and pushed just past the tissue barrier and then back again
  • indication: increase ROM and stretch the joint capsule
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7
Q

Grade 4 Sustained Glide

A

N/A

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8
Q

Grade 4 Oscillation

A
  • high grade
  • small amplitude movement that starts at the tissue barrier and pushes just past it and then back to the tissue barrier
  • indication: increase ROM and stretch the joint capsule
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9
Q

Grade 5 Sustained Glide

A

N/A

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10
Q

Grade 5 Oscillation

A

OUT OF SCOPE
- high grade
- high velocity movement performed by chiro, typically known as an adjustment gravity and resistance eliminated
- indication: adjust positional faults in bones/joints and reduce subluxations

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11
Q

Stroking ✔

A
  • WHAT: a superficial reflex technique, often used at the beginning of treatment
  • WHERE: can be done over or under sheets, with or without lotion
  • PURPOSE: can have a relaxing or stimulating effect
  • EXPECTATION: a light technique that should not cause pain or discomfort
  • HOW: for relaxing: slow/light/soothing/even strokes in the direction of hair growth, for stimulating: brisk/light/even strokes in all directions
  • not time expectation, demonstrate for min 10 seconds
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12
Q

Rocking ✔

A
  • WHAT: grouped with shaking, a passive movement technique applied to the whole body
  • WHERE: can be done over or under sheet (over best)
  • PURPOSE: create movement around joints and have a relaxing effect
  • EXPECTATION: gentle back and forth motion of the body with no pain, or sense of being out of control
  • HOW: use hands to gently push body of client away and allow to roll back , best to start at hips and shoulders, gentle and controlled, gradually slowing to a stop
  • no time expectations, demonstrate minimum 10 seconds
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13
Q

Shaking ✔

A
  • WHAT: grouped with rocking, a passive movement technique
  • WHERE: under or over sheet, best done under with proper draping
  • PURPOSE: to move and relax soft tissue
  • EXPECTATION: a light jostling in the area with loosening of the soft tissue, no pain or discomfort
  • HOW: place hand lightly over area/muscle, quickly and smoothly move hand back and forth causing muscle to shake , performed perpendicular to muscle/joint, not vigorous enough to cause pulling/stretch sensation
  • no time expectations, perform for minimum 10 seconds
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14
Q

Vibrations ✔

A
  • WHAT: a superficial reflex technique applied to a specific area of the body, can be static or running
  • PURPOSE: increase smooth muscle movement and/or loosen mucus in lungs
  • EXPECTATION: a light technique with no pain or discomfort, a vibrating or shaking that is local (static) or global (running)
  • HOW: place palm on skin and perform fast/oscillating/trembling movements, maintain continuous contact with skin, for STATIC: hand maintains vibration only in indicated area, for RUNNING: hand gently glides over indicated area maintaining vibration
  • expectation: minimum 30s, and 3 passes for running, perform minimum 10 seconds in exam
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15
Q

Effleurage ✔

A
  • WHAT: a superficial fluid technique
  • WHERE: performed on the skin with use of lotion and proper draping
  • PURPOSE: increase circulation and warm up general area to prepare for techniques, or as a transition between one technique and another to soothe and flush the area
  • EXPECTATION: a soothing glide of therapists hand, with firm but not deep pressure, should not cause pain or discomfort
  • HOW: on skin with lotion, use firm pressure towards heart and lighter strokes back to where you began, encompass entire indicated area, hand should not slip under draping
  • no time expectation, perform or a minimum 10 seconds
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16
Q

Petrissage ✔

A
  • WHAT: a neuromuscular technique to reduce muscle tone and pain, and increase circulation, 7 possible techniques
  • WHERE: primarily done directly on skin with lotion, exceptions are compressions and muscle squeezing
  • PURPOSE: decrease muscle tone and pain, increase circulation
  • EXPECTATION: a deeper technique with the possibility of some tenderness, pain should never exceed a 4/10, feels like a good pain
  • HOW: warm up the tissue, perform the technique, flush the area
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17
Q

Types of Petrissage

A
  1. Compressions: static pressure to an area
  2. Muscle Squeezing: static compression/squeezing of muscle between hands or fingers
  3. Picking Up: squeezing compression, then lifting/pulling of the muscle from underlying structures
  4. C-scoop: back and forth gliding, squeezing and lifting of the muscle alternating between hands
  5. Wringing: twisitng and torquing of muscle
  6. Kneading: rhythmic, unidirectional, circular movement along muscle
  7. Stripping: unidirectional pressure following muscle fiber
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18
Q

Myofascial Release ✔

A
  • WHAT: a technique that separates fascial tissue from adhered muscle fibers to increase pliability of the connective tissue, local circulation and improve tissue/joint mobility
  • WHERE: directly on skin, with no lotion, it stimulates sensory receptors and is a 3D mechanical load to elongate tissue
  • PURPOSE: reduce fascial restrictions by separating fascial tissue from adhered muscle fibers to increase local circulation and improve tissue/joint mobility
  • EXPECTATION : for SUPERFICIAL: a light pulling/dragging on the skin, for DEEP: a light pulling/dragging on the skin with some discomfort or pain similar to a rug burn
  • HOW: assess tissue for general direction of restriction, perform technique, reassess tissue for restriction
  • no time expectation, demonstrate for minimum 10 seconds
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19
Q

Types of MFR

A
  1. Superficial (glide, cross-hand stretch, spread/shear)
  2. Subcutaneous (skin rolling, torquing, s or c bow)
  3. Deep (cutting, j-stroke, anchor and spread)
20
Q

Superficial MFR

A
  1. Glide: palm of hand on indicated area and push in the direction of the restriction without hand sliding quickly
  2. Cross-hand stretch: cross arms and place hands on either end of effected area, attempt to move hands away from each other causing a stretch/pull in opposite directions
  3. Spread/Shear: same a cross-hand, without crossing hands
21
Q

Subcutaneous MFR

A
  1. Skin Rolling: pick up skin and roll in direction of restriction, can cbow if there is difficulty getting the tissue to roll (just be sure to communicate this)

2.Torque/C or S bow: pick up the tissue similar to skin rolling, instead of rolling, twist and torque the skin, or create and “s” or “c” shape with tissue

22
Q

Deep MFR

A
  1. Cutting: bring dorsal aspect of distal phalanges together and push fingertips into indicated tissue, “cutting” in a direction that is perpendicular to that of the fascial restriction by pronating and supinating the hand
  2. J-Stroke: sink thumb into indicated tissue, reinforcing with the opposite hand, move in a slow and downward motion opposite of restriction before doing a quick upward “J” stroke in the direction of restriction (can also use finger 2 and 3)
  3. Anchor and Spread: anchor indicated tissue at the bottom of the restriction and spread the tissue in the direction of the restriction
23
Q

Myofascial Trigger Point Release ✔

A
  • WHAT: a myofascial technique used to reduce muscle pain and referral pain to support with mobility and restrictions
  • WHERE: performed directly on the skin with the use of lotion
  • PURPOSE: to reduce muscle and referral pain, improve joint and muscle mobility, decrease H/T and restrictions
  • EXPECTATION: a painful technique that does not go above a 4/10, may recreate referral pain but should dissipate
  • HOW: warm up tissue, identify TPs, apply ischemic compressions: bring up to a 4/10 once it dissipates or up to 2 minutes release and flush (3x) then passive stretch and heat, determine pain scale, flush area
  • INDICATORS: local tenderness over palpable nodule, taut band of muscle, local twitch response or jump sign, client report of referred pain, autonomic phenomenon pattern STATE WHICH TWO YOU OBSERVE
24
Q

Percussive Techniques/Tapotement ✔

A
  • WHAT: a percussive technique that can be used to stimulate or sedate tissue
  • WHERE: can be done over or under the sheet
  • PURPOSE: to decrease pain, stimulate tissue (if less than 30s), relax tissue (if 30s-3min), increase airway clearance and stimulate/maintain atonic constipation
  • EXPECTATION: no pain or extreme discomfort, may cough
  • HOW: using quick/rhythmic movements that are smooth and without breaks, can move from light to moderate or greater
  • demonstrate minimum 10 seconds, but indicate purpose and how long you would perform
    no tapotement over kidneys for moderate or greater techniques
25
Q

Types of Tapotement

A
  1. Light (pincement, fingertip tapping)
  2. Light to moderate (point percussion, clapping)
  3. Moderate to heavy (cupping, loose hacking)
  4. Heavy (hard hacking, knuckle percussion, pounding)
26
Q

Light Tapotement

A
  1. Pincement: quick and gentle pinching with the fingertips and thumb
  2. Fingertip tapping: quick, light tapping with one finger at a time using finger pads (not nails)
27
Q

Light to Moderate Tapotement

A
  1. Point Percussion: quickly tap all fingertips from one hand at the same time, alternate hands
  2. Clapping: a slapping or patting motion using full, open, flat hand
28
Q

Moderate to Heavy Tapotement

A
  1. Cupping: cup hands an pat area, will create a light suctioning with hands on skin
  2. Loose hacking: use ulnar boarder to perform chopping motion, keep fingers loose
29
Q

Heavy Tapotement

A
  1. Hard hacking: use ulnar boarder to perform chopping motion, with closed fingers
  2. Knuckle percussion: create a loose fist and knock along area with dorsal aspect of middle/distal phalages and thenar/hypothenar eminence (not directly with knuckle)
  3. Pounding: create loose fist and pound/strike area with ulnar boarder and 5th digit
30
Q

Stretch ✔

A
  • WHAT: a muscle lengthening technique
  • PURPOSE: lengthen and relax the muscle
  • EXPECTATION: should not be painful or uncomfortable, will feel a pulling/stretch sensation that will go just beyond the tissue barrier
  • HOW: ensure optimal positioning of client, warm up tissue, slowly bring into lengthened position pushing just past the tissue barrier, holding for 30s (2-3x), demonstrate for minimum 10 seconds (2-3x)
31
Q

Frictions ✔

A
  • PURPOSE: to soften scar tissue, increase local circulation and restore/maintain tissue and joint mobility
  • EXPECTATION: an uncomfortable technique that should not exceed a 4/10 on the pain scale, will feel a quick and deep rubbing, numbness is normal
  • HOW: warm up the muscle, clean off excess oil/lotion, if in tendon sheath bring into lengthened position otherwise neutral, use pad of middle and index or thumb and reinforce, apply fast cross fiber rubbing gradually increasing pressure to pain tolerance, would normally do for up to 2 minutes however demonstrate for at least 10 seconds, following frictions flush passively stretch and ice
32
Q

Types of Joints

A

Convex: a convex surface moving on a concave surface
- examples: shoulder, wrist, hip, ankle
- joint mobilization will always occur in the opposite direction of limb movement

Concave: a concave surface moving on a convex surface
- examples: elbow, knee
- joint mobilization will always occur in the same direction as the movement of the limb

33
Q

General Joint Mobilization ✔

A
  • WHAT: a technique used to increase successive action of the joint by mobilizing joint capsule, stimulating mechanoreceptors and decreasing nociceptors, as well as stimulating joint capsule fluid production
  • PURPOSE: a LOW GRADE: maintain current level of range and mobility, HIGH GRADE: increase ROM in a restricted joint
  • EXPECTATION: no pain or discomfort, exact sensation will vary
  • HOW: warm up tissue, hands as close to the joint as possible, stabilizing proximal and distal, assess joint to determine where restrictions are, place in open packed position, perform GRADE 2 sustained glide to identify tissue barrier, perform mobilization (SUSTAINED for 5-30s, OSCILLATING 60-120/min for 5-60s), reassess joint, flush the area
34
Q

Manual Lymphatic Drainage ✔

A
  • WHAT: a light/gentle technique that compliments and supports the skeletal muscles and the diaphragm to move lymphatic fluid through capillaries, nodes and ducts
  • PURPOSE: promotes lymphatic flow, reduces edema from tissue restrictions
  • HOW: axillary pump 5-7x, pump 5-7x ducts proximal to joint if applicable, using light pressure move in unidirectional circles with overlapping strokes towards the heart, move proximal to distal
35
Q

Free Muscle Entrapment

A
  • WHAT: an adhesions/collagen technique that breaks binding in tissue through extending tissue beyond pliability to breaking point
  • PURPOSE: to free muscles adhered to deeper muscles, fascia or bones, improve joint function and decrease px
  • HOW: grab one muscle and roll it away from neighbor
36
Q

Sweeping Cross Fibre

A
  • WHAT: a tension technique that broadens and separates muscle fibres
  • PURPOSE: to encourage tissue fluid flow, enhance pliability and reduce tension in fascia
  • HOW: long gliding movement, thumb sweeps towards palm
37
Q

Compression Broadening

A
  • WHAT: an adhesion technique that mimics natural sarcomere overlapping of the whole muscle
  • PURPOSE: to loosen and reduce adhesions along parallel fibres, enhance elasticity and pliability
  • HOW: compression with broad cross fibre stroke applied
38
Q

Deep Longitudinal Stripping

A
  • WHAT: a HT/TP technique that uses ischemic compression while encouraging tissue to elongate and increase pliability
  • PURPOSE: to reduce HT, TPs and increase elongation, elasticity and pliability
  • HOW: deep stripping parallel to muscle fibres done slowly from origin to insertion
39
Q

Muscle Approximation ✔

A
  • WHAT: a HT/TP technique that activates muscle spindle reflex by reducing the stretch on muscle fibres and decreases gamma firing to reduce muscle spasm/tone- muscle spindles reside in the muscle fibres and respond to stretch by shortening the muscles (sarcomeres lengthen and muscle relaxes)
  • PURPOSE: to reduce spasm and HT
  • HOW: compress muscle against bone beneath and then grab and pull ends together and hold
40
Q

Golgi Tendon Release (GTO) ✔

A
  • WHAT: a HT/TP technique that stimulates the golgi tendon organs to inhibit alpha neuron firing, GTOs are the most concentrated in the musculotendinous interface and respond to load by relaxing the muscle (sarcomeres lengthen and muscle relaxes)
  • PURPOSE: to reduce spasm and HT on long tendons or painful sites
  • HOW: c or s bow on tendon or O&I on short tenon near the junction of the tendon and the muscle
41
Q

Origin and Insertion Technique (O&I) ✔

A
  • WHAT: a variation on GTO technique for short tendons or when site is too painful
  • PURPOSE: to reduce spasm and HT
  • HOW: work in a small plus sign (+) shape over origin and insertion with moderate to deep pressure
42
Q

Passive Engagement (PET) ✔

A
  • WHAT: a HT/TP technique that affects muscle spindles of GTO, magnifying effects by changing length
  • PURPOSE: to reduce muscle spasm and HT, and decrease neurological response
  • HOW: static compression, compression broadening or stripping with passive joint movement
43
Q

Active Engagement (AET) ✔

A
  • WHAT: recruits more muscle fibres into activating muscle spindle reflex, reduces muscle spindle activity
  • PURPOSE: reduce HT, broaden/loosen adhesions, lengthen and elongate tissue
  • HOW: like passive engagement but client movements joint actively
44
Q

Muscle Resisted Engagement (MRT)

A
  • WHAT: a HT/TP technique that recruits maximum engagement of muscle fibres into activating muscle spindle reflex, reduces muscle spindle activity
  • PURPOSE: to reduce HT, lengthen and elongate tissue and broaden/loosen adhesions
  • HOW: like passive engagement but client moves joint against therapist applied resistance
45
Q

Facilitated Shortening

A
  • WHAT: a HT/TP technique that redistributes and breaks cross linked adhesion tissues, for overstretched muscles the technique serves to retrain muscle spindle activity
  • PURPOSE: to break adhesions in retinaculum and to encourage over stretched muscles to shorten
  • HOW: client actively contracts against therapist applied resistance and pressure/stripping towards tissue shortening
46
Q

Pin & Stretch

A
  • WHAT a HT/TP technique that encourages elongation and flexibility
  • PURPOSE: to increase connective tissue mobility, broaden/loosen adhesions and elongate tissue
  • HOW: anchor spot of most tension and move joint passively into stretch, start with muscle shortened

Conditions (7 decks)

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