Wk1 Masterclass + Prep Work Flashcards
(18 cards)
When should Grade 1-2 joint manipulations be performed?
when the pt is in pain
When should Grade 3-4 joint manipulations be performed
when the pt is complaining of a stiff joint
Example of a long lever joint maniplation
Moving many joints simultaneously. Low velocity high amplitude
e.g Rotation of cervical spine
Example of short lever joint manipulation
High velocity thrust at a specific segment, often creating a ‘pop’ due to cavitation
e.g manipulation of sacroiliac joint
Why is the biopsychosocial approach so important
Focuses on the individual rather than just the injury
What is the envelope of function
What an individual is able to tolerate based on load and freq without losing tissue homeostasis
What happens if an individual performs high frequency of activities in the zone of supraphysiological overload
Increase likelihood of injury, reducing the zone of homeostasis
By using the envelope of function, how should rehab be performed
Stop performing activities which are within the zone of supraphysiological overload temporarily to reduce irritation
Advise against rest to prevent the envelope of function to decrease further
Encourage pt to keep doing activities which are still within the envelope of function
Performing activities under the min. effective dose will do nothing
Instead of completely avoiding an aggravating activity, pt’s such reduce the volume of the activity (e.g if a footballer is used to playing 90mins but it is too painful to play for that long, they should instead condition themselves by playing shorter amounts (e.g 10mins)
How to assess envelope of function
Subjective and objective assessments
Assess current strength capacity
How to minimise pain impairment
Ice, Panadol
How to minimise swelling impairment
Compression, Elevation, Tape
How to minimise decreased ROM/stiffness impairment
Manual therapy, Mobility exercises
How to minimise instability impairment
Tape, Strengthen, Proprioception
How to minimise proprioception reduction impairment
Balance exercises
Questions to assess pt using biopsychosocial model
What do you think is happening?
Why do you think this is happening?
What makes it better/worse?
What are you worried about ?
How does exercise improve tendon stiffness
The tendon recognises that it is under load, causing cells to distribute the message that the tendon has been loaded. This then creates an up regulation of of IGF-1 creating tendon remodelling
What can manual therapy do
Alter pain sensation
Change muscle activation
Improve joint ROM
How does manual therapy work
Complex neurophysiological response from the peripheral and CNS
Mechanical stimulation (e.g pushing on joints) triggers afferent neurons located in skin/joints/muscle
This stimulation can have a number of responses e.g. pain inhibition, neuromuscular inhibition or facilitation
