Session #4: Overview of osteopathic techniques Flashcards Preview

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Flashcards in Session #4: Overview of osteopathic techniques Deck (39)
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goals of osteopathic manipulation

- relief of pain or reduction of other symptoms
- improve function
- increased movement
- improve blood supply and nutrition to affected areas
- ensure return flow of fluids
- normal nerve transmission
- decreased patient stress


goal setting in osteopathic manipulation

Goals are made on an individual basis for the patient
Need to have realistic expectations. Longer illness means longer recovery time usually. Reevaluated during each visit.


what are the difference classes of osteopathic manipulation techniques?

direct, indirect and both
passive and active


direct techniques

take the restricted joint or tissue into the barrier, sometimes gradually and sometimes quickly


indirect techniques

the restricted joint or tissue is moved away from the restriction and into the relative ease or freedom at beginning of treatment
allows neural mechanisms or fascial tensions to change to permit better movement


direct and indirect technique

the tissues or joints are placed into their barrier or freedom, then moved into the opposite position


active vs passive techniques

active means the patient is required to participate under the direction of the doctor (eg contract or deep breathing)
passive means the doctor does all the work


extensibility of soft tissue

when you place connective tissue under prolonged mild tension, it will show plastic elongation


muscle spindle reflex

if the intrafusal fibers (sensory fibers) are stretched rapidly, they cause a reflex contraction of the extrafusal fibers (muscle fibers)


golgi tendon organ reflex

when tension on a muscle's tendon becomes extreme, the reflex inhibitory effect from the golgi tendon organ may cause sudden relaxation of the entire muscle


reciprocal inhibition

when a stretch reflex excites one muscle, it simultaneously inhibits the antagonist muscle (e.g. hamstrings and quadriceps during running)


crossed extensor reflex

when one muscle contracts voluntarily, the reflex will simultaneously relax the same muscle on the contralateral side and excite the contralateral antagonist muscle (e.g. stepping on nail, opposite hip will be extended)


concentric contraction

approximation (bringing into proximity) of the muscle attachments causes contraction of a muscle


eccentric contraction

muscle becomes lengthened during contraction due to an external force


isometric contraction

change in the tension of a muscle without the approximation of the muscle origin and insertion, e.g. arm wrestling


isotonic contraction

concentric contraction where muscle shortens steadily with varying rate, e.g. curling weights


isokinetic contraction

concentric contraction where the muscle shortens under constant load at constant rate


isolytic contraction

form of eccentric contraction where muscles forced to lengthen as they contract; to try to lengthen the muscle


isokinetic resistance

a force is applied to a contracting muscle but the applied force is less than the contracting muscle's force; muscle contracts with isokinetic contraction
used to activate reciprocal inhibition and crossed extensor reflex


isometric resistance

a force is applied to the contracting muscle, and the force is equal to the contracting muscle's force, so muscle contracts with isometric contraction
used to activate golgi tendon reflex


soft tissue passive direct techniques

working to extend the connective tissue, with a longitudinal or perpendicular stretch
e.g. massage


active direct vs indirect soft tissue techniques (resistance used and reflexes triggered)

active direct soft tissue techniques use isometric resistance to trigger the golgi tendon reflex to relax the muscle
active indirect soft tissue techniques use isokinetic resistance to cause reciprocal inhibition or crossed extensor reflex


what class of technique is the muscle energy technique, which physiological principle does it target?

active direct technique
triggers golgi tendon organ reflex


how to do muscle energy technique

1. guide patient's dysfunction into their barriers of motion (e.g. if something is extended, bring it to barrier of flexion)
2. patient tries to move one freedom against an isometric resistance for 3-5 sec
3. relax
4. re-engage with barrier
5. repeat


what is the counterstrain technique used for

when one muscle becomes strained from trauma, resistance, or gravity, its antagonist hypershortens. Shortened muscle gets stretched, it contracts by reflex and this overlap leads to reflex tender points.
Counterstain treats the tender points


what kind of technique is the counterstain?

passive indirect technique


how do you do the counterstain technique?

1. patient placed in position of ease with respect to their tender point
2. position held for 90 seconds ("fold and hold")
3. slowly return patient to neutral position, don't want to reexcite muscle spindles


what kind of technique is the facilitated position release? What is it used for

passive indirect technique
wants to relax the muscle by decreasing the load on the muscle, to stop excitatory discharges from muscle


facilitated positional release technique

1. guide affected region into neutral position
2. add compression or traction to facilitate force to the point you're testing
3. area is placed into its freedoms (the movement that it does more easily) while the force is applied, held for 3-5 seconds


what kind of technique is the high velocity, low amplitude (HVLA) thrust technique? what is it used for?

passive direct
want to move a joint through its restrictive barrier, by applying a thrust to it