week 9 - manual therapy Flashcards
What is the aim of manual therapy?
reduce pain
increase movement
increase patient confidence, reassurance or reduce fear avoidance
increase proprioception/joint position sense
some therapists use it as a ‘way in’ to allow the patient to exercise or do longer term treatment modalities
How long is the benefit of manual therapy?
short term benefit only
What structures do passive movements help?
joint or muscle
What structures do joint mobilisation (accessory) help?
joint
What structures do soft tissue massage/mobilisation/trigger points help?
soft tissues
What does hands on facilitation help with?
proprioception
How does manual therapy reduce pain?
Neuromodulation
reduced sensitivity and threshold level for pain signal
central changes within the brain, endorphins
stimulation of sympathetic nervous system
pain gate theory
psychological/placebo/therapist effect
How does manual therapy increase movement?
graded exposure to painful activity
increase neural activity/stimulus
increase confidence and self-efficacy
reduced pain = patient able to move more
How does manual therapy increase confidence/ reassurance?
reduced threat response
trust from therapist
How does manual therapy increase proprioceptive/joint position sense?
stimulation of sensory nerves
stimulation of mechanoreceptors
What is a passive movement?
a physiological movement performed at a joint by an external force, with the patient completely relaxed
What is an indication for passive movements?
increase joint ROM or muscle length if patient not able to this for themselves
What is a joint mobilisation (accessory)?
a passive movement (performed by a therapist) of one joint surface relative to another
described as slide, glide and roll
What is an indication for joint mobilisation?
a joint (reduced ROM) problem
What is a grade 1 joint mobilisation?
small amplitude of movement, not into resistance