03 Thoracic and Lumbar 3 (Manual Therapy) Flashcards Preview

7232 Ortho > 03 Thoracic and Lumbar 3 (Manual Therapy) > Flashcards

Flashcards in 03 Thoracic and Lumbar 3 (Manual Therapy) Deck (30):
1

What is a manipulation?

- high velocity, low amplitude movement
- takes up available amount of movement or pushes past end range

2

cavitation

- air pop
- release of air from the joint capsule
- this is NOT realignment of the spine

3

indications for manual therapy

- loss of ROM
- hypomobility with spring test

4

spring test

same as joint mobility testing

5

When do you do joint mobility testing or spring testing?

as part of the objective exam

6

contraindications for manual therapy of the spine

- osteoporosis
- chronic corticosteroid use (more than 1 month)
- recent fracture
- spinal cord compression
- cauda equina compression
- active degeneration
- positional dizziness
- malignancy
- active inflammatory condition

7

contraindications to manual therapy
- What is an example of active degeneration?

RA

8

contraindications to manual therapy
- What do they mean by "positional dizziness"

dizziness brought on by c-spine movements

9

contraindications to manual therapy
- What are examples of an active inflammatory condition?

- osteomyelitis
- ankylosing spondylysis

10

precautions for manual therapy of the spine

- undiagnosed, unexplained, non-incident related pain
- hx of cancer
- gross psychological overlay
- suspected osteoporosis
- spondylolisthesis
- instability
- pregnancy
- spinal fusions
- gross foraminal encroachment
- acute nerve compression/irritation
- children/teenager
- acute whiplash
- vertebral artery issues

11

Why could undiagnosed, unexplained, or non-incident related pain be a precaution for manual therapy?

if you can't figure out why they have back pain, you shouldn't manipulate it

12

What is meant by gross psychological overlay?

- if things they are saying don't add up or make sense
- if they say things that indicate psychological issues
- "seem a little crazy"

13

pregnancy precautions for manual therapy

- specific precaution is for 3rd trimester and 1-2 months postpartum
- she doesn't manipulate anyone who is pregnant, just to be on the safe side

14

Why are spinal fusions a precaution?

- if something is fused, you really don't want to mobilize it
- regions above and below are more likely to have instability

15

How do you determine level to mobilize or do treatment on?

- go through and assess each level
- see if there is hypomobility, pain, or comparable signs

16

What should you do after treatment?

assess ROM and pain

17

How would you document a manipulation for a right sided UPA mob grade 3 for 30 seconds?

R UPA grade 3 x 30"

18

What in the thoracic spine often relates to cervical pain and ROM?

thoracic hypomobility

19

When is it thoracic manipulation indicated for patients with neck pain?

- when cervical patients aren't improving with treatment only in the neck
- thoracic hypomobility is related to cervical pain and ROM

20

What are the manual therapy techniques for t-spine?

- CPA
- UPA
- transverse pressure
- long-finger transverse
- rotary PA (screw)

21

CPA mob for t-spine
What part of the hand are you using?

hypothenar eminence

22

UPA mob for t-spine
What part of the hand are you using?

thumbs

23

Which patients need UPA mob for t-spine?

- one sided pain
- usually have limitations in rotation

24

When would you use transverse pressure on a patient?

- unilateral pain
- can't tolerate a UPA

25

What grades can you do with long finger transverse pressure?

1 and 2

26

Who would you use long finger transverse pressure with?

patients with a lot of pain

27

goal of long finger transverse pressure

relieve pain so that PT can do something more with treatment session

28

What grade is the rotary PA?

5

29

What does the research say about manipulation vs. mobilization?

- both have similar effects
- manipulation is quicker and low risk in the thoracic spine

30

Why would you not do manipulations every time with a patient?

Eventually, you want to move them to exercises because that's what they'll do at home