Lecture 7 Flashcards
What is repeated motion? Who coined this term?
Taking patient through 10 reps of some EX and seeing how they respond. You’re looking for directional preference - something that makes me feel better.
The McKenzie Method is a way of helping with back and spine problems by doing certain movements over and over. The idea is to find which movement makes the pain better and focus on that. The goal is to make the pain move toward the center **(centrilization) **of the spine, and patients are taught exercises to do on their own. It’s important to work with a trained practitioner for the right guidance.
Patient led PT is what technique?
McKenzie
What is centrilization
getting the most distal symptoms to become more centrailized (this is a good thing)
What is a latearl shift? Is it good?
Patient shifting away from pain
We want to fix this (its bad)
What are the 3 positives for adverse neural dynamics?
1) Able to bring on or taking away their symptoms by changing something proximally or distally
2) Does what I’m doing bring on your synptoms (i.e., is that the pain you came in with)
3) Side to side difference of greater than 10 degrees (for upper chain normally measured at elbow, for lower is knee / hip)
What 3 terms were coined by Mulligan? (doing in lab)
SNAGs - Sustained Natural Apophyseal Glides (facet glides)
NAGs - Natural Apophyseal Glides (facet)
MWM - Movement with mobilization
Most NAGs/SNAGs follower the nautral orientation of the facet (so about 45 degrees for the cervicl spine
What is movement w/ mobilization?
I’m sustaining some type of motion while mobilizing the joint
The picture belower is a cervical SNAG
* The patient has pain / limited right rotation.
* We apply pressure form left because we are gliding them to the right
* They are actively moving into that motion (movement w/ mobilization) while you SUSTAIN that pressure (SNAG)
What is the difference between SNAGs and NAGs
SNAGs are sustained while NAGs are short oscillatory glide instead of a sustained one.
KNOW: movement with mobilization is essentially having the patient move while being mobilized think having a band pulling shoulder back while moving the shoulder
The idea is to combine patient movement with therapist-guided mobilization to improve joint function and reduce symptoms
KNOW: Maitland Apprach –> everything we do to assess symptoms turns into their treatment
Graded mobilization (on test)
Grade 1 = just deforming the table a tad (enough pressure to bend a flies knees) - As soon as you can see the indentitaion of you skin when pressing
Grade 2 = going just to the cusp of resistance (deforming maximmaly before it starts pushing back on you)
Grade 3 = starts at the start of resistance (right when it starts pushing back)
- Basically the last 50% of avalable range
Grade 4 = basically the last 25% of aviable range. - Go to the end of the aviable range then back off slightly over and over
NOTE: Once you start doing graded mobilizations we don’t come out of resistance once were in it (i.e., push down and let up over and over - but only let up slightly - we arent coming all the way out of that resistance)
- Dont come way out then way in over and over
End of avilable range = pushing all the way into table until it doesnt move anymore
Beginning of resistance = when you start to feel resistance (not just the slight deformation but when you start feeling it push back on you) - around 50% - this is when you meet resistance
What grades of graded mobilization do pain dominant patients get?
Grade 1 and 2
(these help with high pain)
Which part of graded mobilization has a larger amplitude and ends right at the start of resistance?
Grade 2
What grades of graded mobilization are for stiff dominant pts?
Grade 3 and grade 4 (it just kind of feels stuck of stiff)
NOTE: in every pt start off w/ grade 1/2 and make sure thats okay before jumping into 3/4
Which grade of graded mobilization starts at the start of resistance and goes all the way to end of motion?
grade 3
