Indications/Contradictions in the Usage of OMT Flashcards Preview

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Flashcards in Indications/Contradictions in the Usage of OMT Deck (32):
1

What are the different aspects of manipulative treatment

Risks,
Absolute Contraindications
Relative contraindications

2

What are the indications of using counterstrain?

- acute or chronic somatic dysfunctions
- somatic dysfunctions with a neural component like a hyper-shortened muscle
- Use as primary treatment or in conjunction with other approaches
- Somatic dysfunctions in any area of the body

3

What are the indications of using HVLA?

- articular somatic dysfunction (TART)
- firm distinct articular barrier.

4

What are the indications of lymphatic techniques?

- Edema, tissue congestion, or lymphatic stasis
- Infection
- Inflammation

5

What are the indications of muscle energy techniques?

Clinically relevant somatic dysfunction

6

What are the indications of myofascial release techniques?

Treat somatic dysfunctions involving myofascial or other connective tissues.

7

What are indications for using osteopathy in the cranial field? What are some examples?

treat Somatic Dysfunction.

Examples:
Cranial Neuropathy-nerve
entrapment Bell’s palsy
Trigeminal neuralgia
Atypical facial pain
Headache Sinusitis
Orofacial pain

8

What non-somatic dysfunction areas are osteopathy in the cranial field useful for?

Vertigo
Visual disturbances
Tinnitus
Temporomandibular Joint Dysfunction
Malocclusions
Strabismus
Strain patterns of the sacrum
Strain patterns of the axial and appendicular skeleton

9

True or false: The counterstrain model is an indirect technique.

True

10

For counterstrain techniques, what are absolute contraindications vs. relative contraindications?

Absolute:
- Absence of somatic dysfunction
- lack of patient consent/cooperation

Relative:
- patient cannot voluntarily relax
- severely ill patient
- Vertebral artery disease
- Sever osteoporosis.

11

What safety and efficacy considerations needed to be made for counterstrain?

- Complications and precautions
- Post-treatment reaction
- Pain, most often in antagonist muscles, several hours after treatment, usually self limited and well-tolerated by patients
- Reactions associated with patient position
- Avoid positions that do not relieve pain
- Avoid positions that cause discomfort, dizziness, panic and/or neurogenic pain such as upper cervical hyper rotation and hyperextension
- Avoid extreme forward bending of the thoracolumbar spine in osteoporotic patients
- Use caution when treating the cervical spine in a patient with rheumatoid arthritis or any other rheumatological conditions, segmental or ligamentous instability.

12

What are some special considerations when using a counterstrain technique?

- Use indirect positioning to shorten the tissues/muscles associated with the tender point
- The tissues being treated may or may not be located directly beneath the tender point being treated.
- Normalize neurophysiologic functioning.
- Correct a somatic dysfunction
- Reduce/minimize pain

13

What is a counterstrain model?

An osteopathic system of diagnosis and indirect treatment in which the patient’s somatic dysfunction, diagnosed by an associated myofascial tender point, is treated by using a position of spontaneous tissue release while simultaneously monitoring the tender point

14

What is a High Velocity/Low Amplitude Model?

An osteopathic technique employing a rapid, therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint, and that engages the restrictive barrier in one or more planes of motion to elicit release of restriction. Also known as thrust technique.

15

What are absolute contraindications for HVLA?

- Regionally or segmentally specific: Surgical fusion, Klippel-Feil syndrome, Vertebrobasilar insufficiency, Inflammatory joint disease, Joint infection, Bony malignancy, Lack of patient consent and/or cooperation
- Upper cervical: Rheumatoid arthritis. Down syndrome. Achondroplastic. dwarfism. Chiari malformation.
Fracture / dislocation / spinal or joint instability Ankylosis / Spondylosis with fusion

16

What are some relative contraindications use of HVLA?

Regionally or segmentally specific"
- Acute herniated nucleus pulposus
- Acute radiculopathy
- Acute whiplash / severe muscle spasm / strain/sprain
- Osteopenia / Osteoporosis
- Spondylolisthesis
- Metabolic bone disease
- Hypermobility syndromes

17

What safety and efficacy considerations needed to be made for HVLA?

Cervical spine consensus/position paper research

18

What special considerations needed to be made for HVLA?

No special considerations

19

What are some absolute vs. relative contraindications for lymphatic OMM techniques?

Absolute:
- Anueresis (if not on dialysis)
- Necrotizing fascitis (in area involved)
- Lack of patient consent and/or cooperation.

Relative:
- Cancer
- Osseous fracture/crushed tissue
- Bacterial infections
- Chronic infections with risk of reactivation
- Diseased organ
- Pregnancy
- Circulatory disorders (embolism, venous obstructions,hemorrhage)
- Unstable Cardiac conditions
- CHF
- COPD

20

What safety and efficacy considerations needed to be made for lymphatic techniques?

Safety: None
Efficacy: dependent on clinical judgement

21

What special considerations needed to be made for lymphatic techniques?

All manipulative treatments can influence the lymphatic system through change in myofascial tension, neural reflexes and effect on respiration.

22

What is the muscle energy model?

OMM treatment in which the patient’s muscles are actively used on request, from a precisely controlled position, in a specific direction, and against a distinctly executed physician counterforce.

23

What are some absolute vs. relative contraindications for muscle energy OMM techniques?

Absolute Contraindications:
- Absence of somatic dysfunction
- Lack of patient consent and/or cooperation

Relative Contraindications:
- Infection, hematoma, or tear in involved muscle
- Fracture or dislocation of involved joint
- Rheumatologic conditions causing instability of the cervical spine
- Undiagnosed joint swelling of involved joint
- Positioning that compromises vasculature

24

What safety and efficacy considerations needed to be made for muscle energy techniques?

Be aware of contractive force. Too vigorous a contraction on the part of the patient can render the technique less effective and result in post treatment soreness or muscle spasm. Only need a gentle contraction.

25

What special considerations needed to be made for muscle energy techniques?

- Prototypical active, direct osteopathic manipulative technique.

- Can be used to treat any joint that is crossed by voluntary muscles.

- Muscle contraction is a principle mechanism for promoting lymphatic and venous circulation, thereby an important in the treatment of edema/congestion.

- May result in secondary reduction of inflammation

26

What are some absolute vs. relative contraindications for myofacscial release OMM techniques?

Absolute Contraindications:
- Absence of somatic dysfunction
- Lack of patient consent and/or cooperation

Relative Contraindications (Extreme caution):
- Abscesses
- Acute thermal injury
- Anticoagulation
- Aortic aneurysm
- Deep Venous thrombosis (or threat of embolism)
- Disseminated or focal neoplasm
- Fractures
- Open Wounds
- Recent Post-operative states over proposed treatment (wound dehiscence)
- Soft tissue or bony infections

27

What safety and efficacy considerations needed to be made for myofacscial release techniques?

Safety:
MFR is very safe w/ no known reports of complication.

Efficacy:
- Can treat carpal tunnel syndrome
- Comparable to counterstrain orMuscle energy

28

What special considerations needed to be made for myofascial release techniques?

- MFR may be performed on various tissues including fascia, tendons, cicatrices (scars), internal organs, or visceral suspensory ligaments.

- MFR decreases myofascial tone at a segmental level in treating spinal somatic dysfunction

29

What is Osteopathy in the Cranial Field?

A system of diagnosis and treatment by an osteopathic physician using the primary respiratory mechanism and balanced membranous tension.

30

What are some absolute vs. relative contraindications for osteopathy in the cranial field?

Absolute Contraindications:
- Increased intracranial pressure
- Acute intracranial bleeding
- Skull fracture
- Acute cerebrovascular accident

Relative Contraindications:
- coagulopathies
- space occupying lesion in cranium

31

What safety and efficacy considerations needed to be made for myofacsial release techniques?

OCF is very safe and effective for indicated areas.

32

What special considerations needed to be made for Osteopathy in the Cranial Field techniques?

in Newborn/Pediatrics:
Plagiocephaly
Torticollis
Feeding difficulties
Colic
Genetic disorders (e.g. Down syndrome)
Attention deficit hyperactivity disorder (ADHD)
Developmental delays
Dyslexia
Otitis media
Strain patterns of the sacrum
Strain patterns of the axial and appendicular skeleton