basics

Question 1

what are the benefits of manipulation?

Answer 1

1. symptom relief
2. release of adhesions
3. restore joint motion
4. reduction of postural faults
5. normalization of muscle tone
6. normalization of neural tone
7. improved posture or locomotion
8. enhancement of well being
9. psycological benefits

Question 2

what are some common mistakes that make a manipulation ineffective?

Answer 2

1. loss of contact point pressure
2. poor bimanual skills
3. incorrect direction of thrust
4. incorrect velocity of thrust
5. incrorrect force of thrust
6. loss of leverage at time of thrust
7. poor practitioner posture
8. patient or practitioner not relaxed
9. pre-loading is reproducing pain

Question 3

What are some common factors associated with manipulation injuries?

Answer 3

1. poor screening/evaluation/poor patient selection
2. poor manipulation choice/direction
3. poor manipulative technique

Question 4

What are IFOMPT cervical manipulation clearing recommendations?

Answer 4

1. use of sustained pre-manipulative position
2. performance of craniovertebral ligament stress tests
3. dizziness differentiation to rule out vertebral artery, internal carotids, upper cervical instability
4. Hautant’s test: arms out, eyes closed, extend cervical spine and rotate

Question 5

How would you differentiate dizziness in the early stages of vertebral artery disease?

Answer 5

Vertebrobasilar artery disease- mid and upper cervical pain, occipital headache, acute onset of pain “unlike any other.”

Question 6

How would you differentiate dizziness in the early stages carotid artery disease?

Answer 6

internal carotid- mid and upper cervical pain, pain around the ear and jaw, head pain in the frontal-temproal-pratial region, ptosis, lower cranial dysfunction (VIII-XII), acute onset of pain “unlike any other.”

Question 7

How would you differentiate dizziness with upper cervical instability?

Answer 7

Upper cervical instability- neck and head pain, feeling of instability, cervical muscle hyperactivity, constant need for head support, worsening of symptoms

Question 8

what are the contraindications to manipulation?

Answer 8

1. multi-level nerve root pathology
2. worsening of neurologic symptoms
3. unremitting, severe, non-mechanical pain
4. unremitting night pain (preventing patient from falling asleep)
5. relevant recent trauma
6. upper motor neuron lesion
7. spinal cord damage

Question 9

what are some precautions to manipulation?

Answer 9

1. local infection
2. active cancer
3. osteoporosis
4. inflammatory disease
5. history f cancer
6. prolonged steroid use
7. hypermobility syndromes
8. connective tissue disease
9. systemic pathologies
10. recent manipulation by another health care practitioner
11. cervical anomalies

Question 10

what desease processes have medications associated with them that can weaken bones?

Answer 10

1. heart burn
2. breat cancer
3. organ transplants
4. RA and asthma
5. GURD
6. depression and anxiety disorders
7. DM II

Question 11

what medications are known to weaken bone?

Answer 11

1.aluminum containing antacids- gaviscon, maalox, mylanta- heart burn indigestion
anticonvulsants- phenytoin (dilantin), phenobarbital- seizure disorder, epilepsy
comatase inhibitors- anastrozole (arimidex), exemestane (aromasin), letrozole (fermara)- breast cancer
2.immunosuppressants- cyclosporine A, tacrolimus (fk506)- organ transplant
glucocorticoids- cortisone, prednisone- RA and asthma
3.proton pump inhibitors- esomepraaole (nexium), oeprezole (prilosec), lansoprasole (prevacid)- GURD
4.active seratonin reuptake inhibitors- excitalopram oxalate (lexapro), fluoxetine (prozac), sertraline (zoloft)- depression and anxiety disorders
5.azolidenediones- pioglitasone (actos), rosigilitazone (avandia)- DM II