Exam 1: Manual Therapy

Question 1

What are the earliest accounts of manual therapy?

Answer 1

Hippocrates and Galen

Question 2

What are bonesetters?

Answer 2

lay people without formal training; some religious orders; use manipulation to set fx, reduce dislocation, increase jt mobility, and treat disease

Question 3

17-19th centuries and manual therapy

Answer 3

bonesetters, separated from main stream medicine-considered quacks

Question 4

Who is the father of ostepathy?

Answer 4

Andrew Taylor Still

Question 5

What was AT Still’s big revelation?

Answer 5

Law of the artery: any interference with circulation can affect health; vertebral alignment

Question 6

more modern osteopaths

Answer 6

have incorporated more traditional medical thought, more like allopaths now

Question 7

Father of chiropracty

Answer 7

Daniel David Palmer

Question 8

DD Palmer’s big event

Answer 8

manipulated Henry Lillard’s neck and restored his hearing

developed laying on of hands (magnetic healing)

Question 9

DD Palmer’s law of the nerve

Answer 9

vital life forces blocked as a result of vertebral positional faults; diseases are caused by impinged nerves

Question 10

20th century manual therapy important people

Answer 10

James Mennell (taught PT's manipulation)
John Mennell (orthopedist, linked CT and arthrokinematics, taught PTs and surgeons)
James Cyriax (diff. dx, end feel, advocated for PTs and man therapy)
Freddy Kaltenborn (concave/convex rule)
Geoffrey Maitland (mob grading, co-founder of IFOMT)
Stanley Paris (first APTA ortho section president)

Question 11

Guide to PT practice definitions of mob/manip

Answer 11

A manual therapy technique comprised of a continuum of skilled passive movements to joints and/or related soft tissues that are applied at varying speeds and amplitudes, including a small amplitude/high velocity therapeutic movement

Question 12

Mobilization and speed

Answer 12

slow speed so the patient can stop the movement; non-thrust techniques

Question 13

Manipulation and speed

Answer 13

high velocity, low amplitude-pt can’t stop it

Question 14

manipulation and range

Answer 14

within ROM or at end range

Question 15

Chiropracty definition

Answer 15

direct thrust to a joint past physiologic ROM, without exceeding joint limit

Question 16

ovoid joint

Answer 16

surfaces entirely convex or concave in all directions

Question 17

sellar joint

Answer 17

each surface is both convex and concave at right angle to each other
ex-CMC, sternoclavicular joint

Question 18

planar joint

Answer 18

both surfaces are flat

Question 19

treatment plane

Answer 19

plane perpendicular to a line extending from axis of rotation in the convex to the middle of the concave articular surface
-2D plane imposed over the concave articular surface

Question 20

tx plane and gliding, traction, compression

Answer 20

gliding is parallel to tx plane

traction/compression perpendicular

Question 21

anatomic ROM

Answer 21

absolute end of range, injury if you move past this barrier

Question 22

physiologic ROM

Answer 22

ROM actively available to pt

Question 23

pathologic ROM

Answer 23

restricts motion before normal physiologic barrier

Question 24

indications for manual therapy

Answer 24

MS pain that has a mechanical nature; passive mobility impairment; muscle guarding/spasm; non-irritable condition

Question 25

BRAIN BREAK

Answer 25

go look at page 7 of the handout for contraindications & precautions

Question 26

oscillatory mobilization grading

Answer 26

``` I-small amplitude, beginning of range II-larger amp into mid-range III-large amp, mid to end range IV-small amplitude at end range V: high velocity thrust (manipulation) ```

Question 27

sustained translation grading

Answer 27

I-very small movement into range II-movement into available range without going to end range III-end range hold

Question 28

traction

Answer 28

movement at right angle to treatment plane

Question 29

traction grading

Answer 29

I=small movement, no appreciable jt separation; nullifies compressive forces on joint II-into available range w/o going to end range III-end range hold, significant joint separation

Question 30

suggested mobilization dosage for painful joint

Answer 30

- grade I-II oscillatory or sustained - loose-packed position - if they can't tolerate at the joint, do a joint around it - hold sustained or oscillate 30-90 sec, 2-3 times

Question 31

suggested mobilization dosage for hypomobile joint

Answer 31

- III-IV oscillatory - III sustained - jt at or near restricted range - hold 30 sec, 3-5x

Question 32

mobilization and pain

Answer 32

grades I and II oscillatory and sustained activate I/II pain receptors

Question 33

mechanical effects of mobilization

Answer 33

- increased collagen (Type 3>1) - scar formation (collagen organization & cross-links) - elastic/plastic tissue deformation on collagenous tissues (capsule, ligaments, fascia, tendons) - III/IV os and III sus are necessary