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Practice Topics Exam 4 > Thrust Manipulation > Flashcards

Thrust Manipulation Flashcards

1
Q

What does US physical therapy history say about manipulation

A

Mary McMillan - 1st president of APTA (1921)
4 branches of PT:
Manipulation, thre ex, electrotherapy, hydrotherapy

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2
Q

McMillan’s 1921/1925 book - states that (massage/manip vs. exercise)

A

Massage (manipulation) = movements done upon the body

Exercise = movements done with a part of the body

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3
Q

Current history and the future - Evidence based practice

A

Evidence shows that manipulation and exercise are PTs most useful tools

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4
Q

Historical summary

A

No one profession invented or owns manipulation
Multiple practioners doing it
Manipulation has been a vital part of the scope of PT practice since the inception of the profession!

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5
Q

Manipulation definition

A

The skilled passive movement to a joint and/or the related soft tissues at varying speeds and amplitudes including a small amplitude, high velocity therapeutic movement

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6
Q

Thrust manipulation =

A

High velocity, low amplitude therapeutic movement within or at the end of range

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7
Q

Non-Thrust manipulation =

A

Manipulation that does not involve a thrust

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8
Q

Grade 1

A

Small amp, does not touch resistance

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9
Q

Grade 2

A

Large amp, does not touch resistance

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10
Q

Grade 3

A

Large amp, touches resistance

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11
Q

Grade 4

A

Small amp, touches resistance

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12
Q

Grade 5

A

High velocity, low amp

Performed at end range!

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13
Q

Indications - Mechanical

A 
Hypomobility
Joint fixation/acute joint lock
Somatic dysfunction
Restore bony alignment
Meniscoid entrapment/displaced disc fragment
Adhesions
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14
Q

Indications - Physiological

A 
Pain modulation
Reflex relaxation of mm
Reprogramming the CNS
Mm facilitation
Release of endorphins
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15
Q

Absolute contraindications

A 
Bone pathology
Neurological
Vascular
Lack of diagnosis
Lack of pt consent
Pt positioning
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16
Q

Absolute contraindications - Bone pathology

A 
Tumor
Infection
Metabolic
Congenital
Inflammatory
Iatrogenic
Traumatic
17
Q

Absolute contraindications - Neurological

A

Cervical myelopathy
Cord compression
Cauda equina
CNS disorder

18
Q

Absolute contraindications - Vascular

A

Aortic aneurysm
Vertebral artery insuf
Carotid artery dysfunction
Bleeding/clotting disorder

19
Q

Relative contraindications

A 
Adverse rxn to previous MT
Disc herniation
Inflammatory arthritides
Pregnancy
Spondylosis, listhesis, DJD
OP
Anticoagulant or steroid use
Psych dependence
Vertigo
Lig laxity, joint instability, preg
Arterial calcification
Worsening condition
20
Q

Evidence regarding safety - Acute LBP - risk of cauda equina

A

1 in 100 million manips

21
Q

Evidence regarding safety - cervical spine

A

1/400,000 to 3/10 million

Very rare, but when it does happen - it is very serious

22
Q

Principles of application - Joint gliding

A

Knowledge of anatomy/kinesiology

Plane of the joint, right angles, or with distraction

23
Q

Principles of application - Localization

A

Limits procedure to joint being treated

above and below

24
Q

Principles of application - Locking

A

Apply leverages to lock uninvolved segments
Never lock the segment you wish to manipulate
Apposition locking/Ligamentous myofascial

25
Q

Principles of application - Levers

A

Short = one vert is held while force is applied to adjacent vert and resultant force is sufficient to move one segment on the other - one segment moving directly against the other

Long = use of an extremity or multiple spinal segments in a locking maneuver - pulling on the leg to manipulate the spine

26
Q

Principles of application - Velocity

A

High

Applied after the slack is removed

27
Q

Principles of application - Amplitude

A

Force is applied quickly over a short distance

Smaller amp with a short lever

28
Q

Principles of application - Balance/control

A

Pt and therapist safety and comfort

29
Q

Principles of application - Cavitation

A

Audible pop - may or may not happen
Sudden dec in intracapsular pressure
Dissolved gasses in the synovial fluid release into joint cavity
Followed by elastic recoil of synovial capsule

30
Q

Validation of clinical practice by research

A

Patient classification
Clinical guidelines
Measuring outcomes

Practice Topics Exam 4 (9 decks)

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