BLT, Stills FPR OMT

Question 1

_____ Techniques method of action engage the restrictive barrier directly.

Answer 1

Direct

Question 2

Direct techniques (6)

Answer 2

MFR

INR

ST

MET

HVLA

Visceral

Question 3

Comination techniques (direct and indirect)

Answer 3

MFR

Stills

Question 4

Indirect techniques

Answer 4

1. MFR
2. INR
3. BLT/LAS
4. FPR

Question 5

BLT definition

Answer 5

Load tissue of the affected ligaments in a position so where tension is equal in all planes, so the bodies inherent forces can fix the SD

Question 6

BLT is described as a _____ _________ tx method

Answer 6

indirect passive

Question 7

BLT says that since it is the ________ that are involved in maintaining a lesion, it is they, not muscles that are the main agency for reduction… point of balanced tension

Answer 7

ligaments

Question 8

BLT indications (2)

Answer 8

SDs that involve

1. ligamentous articular strains

2. Lymphatic congestion/ edema

Question 9

BLT relative contraindications

Answer 9

1. fxs
2. open wounds
3. soft tissue or bony infections
4. absesses
5. DVT
6. anticoagulation, disseminated or focal neoplasm
7. post-op on site of tx
8. aortic aneurisms

Question 10

What does BLT/LAS say about direct techniques

Answer 10

if you articulate back and away from the lesion, it can strain the ligaments that are normal.

If force is used, you can seperate fibers from the ligaments and bony attachments

Question 11

BLT says that the type of motion that occurs at any given articulation is determined by what?

Answer 11

• shape of joint surfaces
• position of ligaments
• forces of muscle on that joint

Question 12

BLT says that the differences between ligaments and muscles

Answer 12

L do not stretch and contract like muscles do.

thus, tension in Ligaments has little varioation

Question 13

BLT says that tension t/o the ligament of any joint is _____.

When moving, as you move your joint, the relationship between the ligament changes, but total tension in the ligamentous articular mechanism _________

Answer 13

BALANCED.

DOES NOT.

Question 14

what biochemical changes occur before immobilization ,according to BLT

Answer 14

Fibrofatty infiltrates were found in capsular folds.

The longer the joint was immobilized, the more infiltration. Ground substance lost water and glycoaminoglycans.

Maintaing the interfiber distance for smooth movement requires collagen fiber lubrication. Whe not, microadhesions are form and collegen is deposited in a bad manner.

Question 15

• Immobilization for >12 weeks resulted in an ___________

Answer 15

overall loss of collagen since rate of degradiation > rate of synthesis

Question 16

Physiologic Changes Secondary to Immobilization, occording to BLT

Answer 16

moving an immobilized joint requires 10x more force. afteer several attempts, it is reduced to 3x more. OVertime, joint will regain normal mobility.

Question 17

steps in BLT

Answer 17

in BLT, you dx a joint SD in all planes of motion

1. Shift neutral (indirect positioning)- you want to move the distal structure of an extremity (superior segment) over the inferior segment to acheive BLT in all planes
2. Activating force: breathing pahse assx with greatest east
3. Reevaulate

Question 18

Object of BLT is to do what?

Answer 18

Balance the articular surface or tissue in the directions of physiologic motion common to articulation.

Doc doesnt CAUSE the change, but helps the body help itself.

Question 19

How much pressure should be put into BLT?

Answer 19

Not alot; you should not go to elastic limit and the doc should not make it so uncomfortable that the patient guards

Question 20

Central principle of BLT

Answer 20

Make something you palpate hard–> soft.

When flow comes through dysfunctional area, your tx is complete.

Question 21

FRP Def

Answer 21

Tx body with neutral positioning, activating force (torsion, compression or distraction) and put in position of ease

made by Stanley schiowitze

Question 22

FPR is primary described as a _________ treatment method

Answer 22

indirect passive

w/ shifted neutral

Question 23

adcantages of FPR

Answer 23

easy, effective, time effcient

patient satisfaction d/t immediate relied

thorough

Question 24

FPR indications

Answer 24

myosfasial or articular SD

Question 25

FPR absoluate contraindications

Answer 25

1. Unstable fx
2. Neurological sx
3. Life- threatining symptomatology

Question 26

FPR Relative Contraindications

Answer 26

1. tx not tolerated
2. osteoporosis/cancer
3. moderate to severe joint instability
4. spinal stenosis/nerve root impingment

Question 27

FPR Proposed Mechanism

Answer 27

Gamma motor neurons cause somatic dysfunction/tension by stimulating muscle spindles.

Puting the muscles in neutral will inverse spindle output, reducing afferent excitatory input and resetting tension and hypertonisity and unloading the joint,

Question 28

FPR steps

Answer 28

Diagnose SD in every plane

1. setup by monitoring and put in neutral sagittal plane position (mechanically unloading)
2. Add activating force: compression, torsion, distraction
3. Indirect position, 3 plane positioning (neutral) and hold for 3-5 seconds
4. return and reevaulate

Question 29

Stills technique def

Answer 29

combined techique that uses both indirect and direct tx: first put in indirect position, add axial force (compression, traction, torsion) to carry through RB

-p

Question 30

Still

Start at ________ then move to ___

Answer 30

shifted neutral–> anatomical barrier

Question 31

same advantages as FPR

Question 32

Still indications

Answer 32

1. Any SD
2. Efficacy is limited ONLY BY docs knowledge of anaomty
3. safe 4 all agez

Question 33

Still contraindications

Answer 33

dont use across wounds or fx < 6 weeks old

Question 34

Why does Still technique go from indirect–> direct?

Answer 34

Still thinks that all dislocations should be loosened from other tissue–> bring back to original place

Question 35

Steps in Still

Answer 35

1. Indirect positioning (ease)
2. Add localizing force (5 lbs of compression or traction)
3. Move through barrier while maintaing cmopression (u may hear a click)
4. go to final tx position at the anatomic barrier
5. return to neutral
6. Reassess