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ECOS I Exam 1 > ST, MFR & INR > Flashcards

ST, MFR & INR Flashcards

1
Q

What is an indirect technique?

A

A technique that takes tissues away from the restrictive barrier

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2
Q

What is a direct technique?

A

A technique that takes tissues toward the restrictive barrier

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3
Q

Which types of technique are commonly a direct technique?

A

Soft tissue, muscle energy and HVLA

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4
Q

Which types of techniques are mostly an indirect technique?

A

Balanced ligamentous tension, facilitated positional release and counter strain

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5
Q

Which two techniques are both an indirect and direct technique?

A

Myofascial release and Still’s technique

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6
Q

What are the components of soft tissue?

A

Fascia, muscles, organs, nerves, vasculature, lymph vessels, tendons, ligaments and aponeuroses

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7
Q

What are the components of fascia?

A

Fascia, muscles, organs, nerves, vasculature and lymph vessels

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8
Q

Which components of soft tissue are NOT in fascia?

A

Tendons, ligaments and aponeuroses

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9
Q

Soft tissue is

A

All the tissue in the body that is not hardened by the processes of ossification or calcification such as bones and teeth

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10
Q

What is soft tissue technique?

A

A direct technique that usually involves local stretching, linear stretching, deep pressure or traction

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11
Q

History of soft tissue technique

A

Used by AT Still especially deep inhibitory pressure

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12
Q

Soft tissue proposed mechanism of action

A

Relaxes hypertonic muscles and reduces spasm by decreasing alpha motor neuron activity
Stretches and increases the elasticity of shortened fascial structures
Improves local tissue nutrition, oxygenation and removal of metabolic wastes
Identifies areas of restricted motion, tissue texture abnormalities and sensitivity
Improves local systemic immune system
Provides a general state of relaxation
Provides a general state of tonic stimulation by stimulating the stretch reflex in hypotonic muscles

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13
Q

What are the indications of soft tissue technique?

A

Somatic dysfunction (TART findings)
Clinical conditions present that would benefit from soft tissue techniques
In adjunct to other OMT

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14
Q

What are some clinical conditions that would benefit from soft tissue?

A

Hypertonic muscles, excessive tension in fascial structures and abnormal somato-somatic or somato-visceral reflexes

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15
Q

When using ST in adjunct to other OMT you

A

Identify areas of somatic dysfunction
Observe tissue response to application of manipulative technique
Provide a general state of relaxation
Provide a general state of tonic stimulation
Prepare tissues for other types of manipulation

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16
Q

What are the most serious reactions to ST?

A

Ecchymosis (bruising), acute muscle spasm or post procedure muscle soreness

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17
Q

What are some absolute contraindications for ST?

A

Lack of consent
Skin or soft tissue is not intact (traumatized, friable, easily torn)
Absence of somatic dysfunction

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18
Q

What are some relative contraindications of ST that can be observed on the skin?

A

Contagious skin diseases, acute burns, painful rashes, abscesses or cellulitis and skin cancers

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19
Q

What are some relative contraindications of ST that can be observed on fascia?

A

Acute fasciitis or acute fascial tears

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20
Q

What are some relative contraindications of ST that can be observed on muscle?

A

Acute muscular strains, myositis or muscle neoplasms

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21
Q

What are some relative contraindications of ST that can be observed on ligaments?

A

Acute ligamentous strain or acute ligamentous inflammatory disorders

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22
Q

What are some relative contraindications of ST that can be observed on bone?

A

Acute fracture, osteomyelitis, primary or secondary bone tumors and osteoporosis

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23
Q

What are some relative contraindications of ST that can be observed in vasculature?

A

Hematoma, deep venous thrombosis and coagulopathy

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24
Q

What are some relative contraindications of ST that can be observed on the viscera?

A

Infection, neoplasm, organomegaly of the liver or spleen, gastric or bowel obstruction or distention, acute or undiagnosed abdominal pain, and pelvic pain

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25
Q

What are some relative contraindications of ST that can be observed on joints?

A

Septic joint or instability/collagen disorders

26
Q

What are the three principals of ST treatment?

A

Traction/stretching, kneading and inhibition

27
Q

Traction/stretching in reference to ST means

A

Origin and insertion of the myofascial structures being treated are longitudinally separated

28
Q

Kneading during ST tx

A

Rhythmic, lateral stretching of the myofascial structure

Origin and insertion are held stationary, the central portion is stretched like a bowstring

29
Q

Inhibition during ST tx

A

Sustained deep pressure over a hypertonic myofascial structure

30
Q

ST basic treatment

A

Pt should be comfortable and relaxed
Physician should be in a comfortable position and able to minimize energy expenditure and able to use body weight to affect the
Initially forces are gentle and of a low amplitude (1-2 secs stretching with 1-2 sec rest)
After response is evaluated force & amplitude may be increased
Forces should be comfortable for the pt and pt may experience discomfort as in a good stretch
Physician hands should NOT slide over skin or create friction
Technique continued until desired effect is achieved and the soft tissue’s amplitude and extension has reached a maximum

31
Q

What is myofascial release (MFR)?

A

A system of diagnosis and tx first described by AT Still and his early students which engages continual palpatory feedback to achieve release of myofascial tissues
Can be applied as direct, indirect or combined technique

32
Q

History of MFR

A

AT Still was fascinated by fascia
1980’s Drs Peckham, Chila and Ward created the biomechanical (focused on anatomy) and fascial continuum model (focused on fascia)
1990s Dr O Connel created the bioenergetic model (focused on cells)

33
Q

What is fascia?

A

A thin sheath of fibrous tissue enclosing a muscle or other organ

34
Q

What does fascia do?

A

Surrounds, protects, provides structure to organs, blood vessels, bone, nerve fiber, muscles (to the tiniest myofibril)
It has nerve cells to sense stress or injury and has the ability to contract in reaction

35
Q

What does MFR do?

A

Interacts with the fascia and the tissue it surrounds to improve homeostasis and innate healing

36
Q

What are the different force effects?

A

Stress, viscosity, plastic deformation, elastic deformation, strain, creep and hysteresis or stress strain

37
Q

What is stress (force effect)?

A

The effect of a force normalized over an area

38
Q

What is viscosity (force effect)?

A

Capability of a solid to continually yield under stress with a measurable rate of deformation

39
Q

What is plastic deformation (force effect)?

A

A stressed, formed or molded tissue preserves its new shape

40
Q

What is elastic deformation (force effect)?

A

A stressed, formed or molded tissue recovers its original shape

41
Q

What is strain (force effect)?

A

A change in shape as a result of stress

42
Q

What is creep (force effect)?

A

The continued deformation of a viscoelastic material under constant load over time

43
Q

What is hysteresis or stress-strain (force effect)?

A

A CT response to loading and unloading where the restoration of the final length of the tissue occurs at a rate and to an extent less than during deformation (loading) representing energy loss in the CT

44
Q

MFR techniques address somatic dysfunction by (MFR indications)

A

Normalizing motion, relieving edema, re-establishing symmetry, relieving pain, aiding circulatory and lymph function, normalizing neuroreflexive activity, supporting visceral fxn, restoring bioenergetic balance and supporting homeostatic fxn

45
Q

What are the absolute contraindications of MFR?

A

Lack of consent and absence of somatic dysfunction

46
Q

What are the relative contraindications of MFR?

A

Extreme caution should be exercised in pts with fractures, open wounds, soft tissue or bony infections, abscesses, deep venous thrombosis (threat of embolism), anticoagulation, disseminated or focal neoplasm, recent post-operative conditions over the site of proposed tx (wound dehiscence) and aortic aneurysm

47
Q

There have been no reports of complications from MFR however,

A

Overly aggressive interventions are counterproductive

48
Q

After receiving MFR tx pts commonly experience

A

Post tx soreness similar to post exercise soreness especially in the first 1-2 treatments

49
Q

Those with what disorders may experience flare ups in association with MFR tx?

A

Autoimmune, inflammatory and rheumatic disorders

50
Q

What are the principles of diagnosis when using MFR?

A

The area of somatic dysfunction is evaluated in multiple planes of motion, determining position of ease and restrictive barrier (somatic dysfunction is named for the position of ease)

51
Q

During MFR if your hands move superiorly on the thoracolumbar fasica (as an example) then what motion will occur?

A

Flexion

52
Q

During MFR if your hands move inferiorly on the thoracolumbar fasica (as an example) then what motion will occur?

A

Extension

53
Q

During MFR if your hands move to the left on the thoracolumbar fasica (as an example) then what motion will occur?

A

Right rotation

54
Q

During MFR if your hands move to the right on the thoracolumbar fasica (as an example) then what motion will occur?

A

Left rotation

55
Q

During MFR if your R hand moves inferior and L superior on the thoracolumbar fasica (as an example) then what motion will occur?

A

Side bending right

56
Q

During MFR if your L hand moves inferior and R superior on the thoracolumbar fasica (as an example) then what motion will occur?

A

Side bending left

57
Q

MFR principles of treatment

A

Pt should be comfortable and relaxed
Physician should be in a comfortable position (same as ST)
Engage tissues by adding light compression
Once a diagnosis is made a decision is made to tx in an indirect or direct manner
Continue to hold tissue until relaxation or creep of underlying tissues is sensed
Consider using a release enhancing mechanism such as breathing
Once relaxation is noted release the tissues and re-evaluate TART findings

58
Q

Integrated neuromuscular release

A

Release enhancing maneuver
Activating the musculature below where the hands are treating the myofascia can untether the dysfunction
Used with direct myofascial release as a release enhancing maneuver

59
Q

Summary of ST technique

A

Direct and repetitive technique

Low force and amplitude which progressively increases

60
Q

Summary of MFR technique

A

Direct or indirect non-repetitive technique
3 dimensional diagnosis and treatment
May use release enhancing maneuvers such as breathing

ECOS I Exam 1 (26 decks)

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