Thoracic I, Direct I Flashcards
Kappler’s Corollary
. Used to confirm flexion/extension component of type II somatic dysfunction
. Stand behind patient w/ hands over shoulders/scapular regions w/ thumbs over messed up vertebra
. Patient flexes head/neck and physicians rotates vertebra left and right
. Patient extends head and physicians rotates left and right
. Compare
ART final corrective force is ___
Operator induced
ART activating force
. Repetitive springing or concentric movement of joint through restrictive barrier
MFR indirect technique
. Dysfunctional tissues guided along path of least resistance until free movement is achieved
. Useful for treating acute strains and sprains or highly sensitive patients
Muscle energy
. Direct technique
. Form of OMT in which patient’s muscles are actively used on request from precisely controlled position in specific direction against physician counterforce
. 1st describes in 1948 by Fred Mitchell Sr.
Muscle energy principles
. Patient first isometrically contracting then relaxing specific muscles for joint mobilization
. Muscles targeted short, tight, restricted muscles maintaining dysfunction
. Initial position engages restrictive barrier
. Patient provides activating force
Guidelines for muscle energy treatment
. Make specific diagnosis . Engage barrrier, HOLD . Instruct patient to contract muscle against your holding force . Time of contraction 3-5 sec. . Relax 1-2 sec. . Engage new barrier (if no inc. in motion don’t continue to force tissue into new barrier) . Repeat process 3-5 times . Reassess
Common mistakes when using muscle energy
. Patient contraction too forceful
. Time for relaxation ignored
. Continued treatment when muscle doesn’t response
M99.02 ART
Thoracic articulation patient seated
Thoracic articulation patient seated dysfunction, objective, and discussion
Dysfunction: generalized motion restriction/stiffness of single or multiple spinal segments and their articulations
Objective: improve motion restriction/stiffness of single/multiple spinal segments and their articulations
Discussion: good for older patients w/ spinal arthritis and stiffness, used segmentally or regionally, choose sidebending or rotational focus
Thoracic articulation patient seated patient and physician position
. Patient seated
. Physician standing behind and to the side opposite side to treated
Thoracic articulation patient seated procedure
. Contact post. Shoulder w/ your left forearm and hand, contact left spinal region w/ your right thumb/thenar
. Simultaneously sidebend and rotate successive spinal segments by applying downward force through left arm to induce left sidebending
. Work up/down spine, repetitively complete w/ restrictive segments
. Switch sides and repeat
. Reassess
M99.02 MFR Thoracic scapulothoracic release technique dysfunction, objective, discussion
. Dysfunction: restricted motion of left scapula on thoracic cage
. Objective: improve scapular motion
. Discussion: used for evaluation and treatment
Thoracic scapulothoracic release patient and physician position
. Patient lies on side w/ affected side up, hips and knees flexed, pillow for comfort
. Physician stands on side of table facing patient
Thoracic scapulothoracic release procedure
. Drape patient’s left arm over your right shoulder
. Contact patient’s med. scapular border w/ fingertips, take 1 step back w/ back foot for stability
. Control scapula and assess full range motion
. Restrictionof motion relieved by holding against barrier w/ traction, holding in position of ease, range of motion/stretching or articulating against barrier
. Reassess
M99.02 ME Thoracic patient seated extended dysfunction, objective, and discussion
Dysfunction: thoracic type II dysfunction, T8ERSr
Objective: improve ability of T8 to rotate and sidebend left and flex
Discussion: easily performed after diagnosing in seated position
Thoracic patient seated extended muscle energy patient and physician position
Patient seated w/ left side closest to edge of table, arms folded across chest right over left
. Physician standing at left side of patient opposite the rotational component of dysfunction
ME thoracic patient seated extended procedure
. Reach across front of patient w/ left arm to place hand on patient’s right shoulder
. Monitor spinous process of T8 and T9 w/ index and middle fingers of right hand to localize flexion as left arm/hand flex patient’s torso until restriction barrier hit
. Maintain flexion while adjusting right hand so fingers monitor T8-T9 transverse processes, using right and left hands position patient’s torso to engage in edge of left sidebending and left rotation barrier
. Patient rotates torso right as left hand applies counterforce, maintain 305 seconds, relax 1-2
. Find new barriers and repeat the 3-5 times
. Reassess
M99.02 ME thoracic patient seated flexed dysfunction, objective, discussion
Dysfunction: thoracic type II dysfunction, T8FRSr
. Objective: improve T8 to rotate and sidebend left and extend
. Discussion: easily performed after diagnosing in seated position
M99.02 ME thoracic patient seated flexed patient and physician position
. Patient seated at edge of table w/ left side closest to edge, arms crossed over chest right over left
. Physicians standing left side of patient opposite rotational component of dysfunction
ME thoracic patient seated flexed procedure
. Left arm across patient and place on right shoulder
. Monitor T8-T9 spinous process to localize extension as your left arm induces extension until restrictive barrier felt
. Maintain extension and adjust right and left hands on torso to engage left sidebending and left rotation barriers
. Patient rotate torso to right as your left hand applies counterforce for 305 sec, relax 1-2 sec
. Find new barriers and repeat 3-5 times
. Reassess
