Manip/mob Contraindications (absolute and relative) Flashcards

Question

irritable disorder Absolute Manip/Mob Absolute Manip (probably relative mob) Relative Manip/Mob

Answer 1

Relative Manip/Mob

Answer 2

Absolute Manip (probably relative mob)

Answer 3

5 D's * Dizziness (vertigo, light headedness) * Driop Attacks (sudden numbness/weakness) * Diploplia (double vision or other vision problems) * Disarthria (difficulty speaking) * Dysphagia (difficulty swallowing) Or the book: 1. drop attacks 2. blackouts 3. loss of consciousness, 4. nausea 5. vomiting 6. poor general health 7. dizziness 8. vertigo 9. disturbance of vision including diplopia 10. unstady gait 11. general feeling of weakness 12. dysarthria or swallowing difficulty 13. hearing disturbances, 14. headache of undetermined origin 15. facial numbness or tingling VBI = vertebrobasilar insufficency Commentary from Journal of Manual and Manipulative Therapy article: Manual Therapy and Cervical Arterial Dysfunction, Directions for the Future: A Clinical Perspective: "Traditionally, VBI was said to result in transient episodes of hindbrain ischemia manifesting in a number of cardinal signs conventionally referred to as Coman's 5 Ds19. However, clinical presentations of transient hindbrain ischemia are more diverse than these classically quoted cardinal signs." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565074/

Answer 4

Absolute Manip/Mob

Answer 5

Absolute Manip/Mob

Answer 6

Absolute Manip (probably relative mob)

Answer 7

Absolute Manip/Mob

Answer 8

Relative Manip/Mob

Answer 9

Absolute Manip/Mob

Answer 10

Absolute Manip (probably relative mob)

Answer 11

Absolute Manip/Mob

Answer 12

Relative Manip/Mob

Answer 13

1. frank spinal deformity due to old pathology such as adolescent osteochondrosis 2. congenital hypomobility 3. advance diabetes 4. advanced degenerative changes such as severe foraminal encroachment 5. severe nerve root pain, acute radiculopathy 6. irritable disorder and protective guarding 7. pregnancy and immediate post-partum 8. children/teenagers

Answer 14

1. malignancy of region of interest- rule out metastasis 2. person presenting with red flags such as cancer, fracture, systemic dz 3. rheumatoid collagen necrosis 4. unstable upper c-spine 5. vertebrobasilar insufficiency 6. bone disease such as osteoporosis, osteomyelitis, TB, paget’s disease 7. inflammatory arthritis such as RA, gout, AS 8. CES, transverse myelitis, demyelinating conditions 9. myelopathy with s/s of SC involvement 10. radiculopathy involving more than one nerve root ipsilaterally 11. spinal fusion 12. spondylolisthesis or other segmental instability 13. medically unstable 14. deteriorating CNS pathology 15. undiagnosed pain 16. anticoagulant meds, vascular disorders in the region, blood clotting disorders\* 17. clinician lack of ability

Answer 15

1. active acute inflammatory condition 2. significant segmental stiffness 3. systemic disease 4. RA w/ no acute inflammation (C-spine is an absolute contraindication) 5. neurological deterioration 6. irritable disorder (I think my kids have this) 7. osteoporosis depending on intent and direction of movement 8. condition is worsening with present treatment 9. acute nerve root irritation or irritability 10. when history and exam finding don’t make sense 11. oral contraceptives if c-spine is area of interest 12. long term corticosteroid use if c-sine is area of interest 13. immediate post-partum for lumbar, t-spine, and pelvic girdle

Manip/mob Contraindications (absolute and relative) Flashcards

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