nmt200 physical medicine wk1

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Questions and Answers

Which test is used to assess for scoliosis?

Adam’s Sign (correct)

Straight Leg Raising Test

Neer Impingement Sign

Ober's Test

What is the purpose of the Valsalva test?

To test the integrity of the ulnar nerve

To detect potential space-occupying lesions (correct)

To evaluate ligament stability in the knee

To assess for shoulder impingement

Which test is utilized to assess for Ulnar Nerve instability?

Speed’s Test

Tinel’s Sign (correct)

Wright’s Hyperabduction Test

Phalen’s Test

Which of the following is NOT a test for the shoulder?

Trendelenburg Test Signup and view all the answers

Which test assesses the integrity of the rotator cuff?

Drop-Arm Test Signup and view all the answers

What is the focus of the Halstead’s Test?

Thoracic outlet syndrome Signup and view all the answers

Which condition does the Thompson (Squeeze) Test primarily evaluate?

Achilles tendon rupture Signup and view all the answers

The Crank Test is primarily used to diagnose which condition?

Labral tears Signup and view all the answers

What historical factors contributed to the rise in popularity of bone setters in the 19th century?

The indiscriminate use and dangers of spine manipulation Signup and view all the answers

Which professionals are currently known to practice manipulation of bones?

Osteopaths, physiotherapists, chiropractors, and others Signup and view all the answers

What does biomechanics specifically apply mechanical laws to?

The locomotor system of the human body Signup and view all the answers

What is the purpose of joint mobilization?

To restore range of motion within the elastic barrier without imparting a thrust Signup and view all the answers

Which of the following is NOT a goal or benefit of joint mobilizations?

Completely eliminate joint pain Signup and view all the answers

In the context of joint mobilizations, what does 'Grades 1-4' refer to?

Levels of joint movement depth and rate Signup and view all the answers

What is the primary focus of mechanics as a branch of applied mathematics?

The effects of forces in producing motion Signup and view all the answers

Which component of the musculoskeletal system is NOT identified as providing forces during movement?

Ligaments Signup and view all the answers

What is the primary purpose of the OHIPMNRS model in musculoskeletal assessment?

To provide a framework for developing a clinical impression Signup and view all the answers

Which aspect is NOT included in the clinical encounter flow under the OHIPMNRS model?

Detailed genetic history of the patient Signup and view all the answers

In manual therapy, what is the significance of understanding contraindications?

It helps to prevent adverse effects from inappropriate techniques Signup and view all the answers

What is an aim of mobilization techniques in clinical settings?

To facilitate movement and improve function Signup and view all the answers

Which of the following best describes joint cavitation?

A rapid decrease in joint pressure that causes gas bubbles to form and collapse Signup and view all the answers

What is one of the beneficial effects of manual mobilization?

Reduction of inflammation and swelling Signup and view all the answers

What aspect of physical assessment is popularly reviewed during this manual mobilization and manipulation course?

Understanding joint play, end feel, and capsular patterns Signup and view all the answers

Which of the following clinical goals aligns with mobilization techniques?

To enhance flexibility and range of motion in joints Signup and view all the answers

What is the correct procedure for performing a gastrocnemius stretch?

Relaxing and inhaling deeply while maintaining the foot in the starting position, then exhaling and easing into the stretch. Signup and view all the answers

Which position corrects the tibialis anterior during its stretch?

Supine, cupping the right heel and holding the top of the right foot. Signup and view all the answers

During a soleus stretch, what position should the knee be in?

Flexed to 90 degrees. Signup and view all the answers

What is an essential step in performing the peroneal stretch?

Inverting the ankle while it’s stabilized. Signup and view all the answers

How long should the stretches typically be held during any of the described techniques?

30-60 seconds. Signup and view all the answers

What occurs during a glide motion in joints?

One bone's articular surface slides on another. Signup and view all the answers

What best describes a rotational motion in joints?

One bone moves while the mechanical axis remains stationary. Signup and view all the answers

Which mobilization technique involves the direction from posterior to anterior?

Posterior-Anterior Glide Signup and view all the answers

What characterizes a Grade 5 mobilization?

A high-velocity, low-amplitude thrust. Signup and view all the answers

What is required to perform manipulations as a controlled act?

Membership in a regulated health college. Signup and view all the answers

What is the intent of the Naturopath's Standard of Practice regarding manipulation?

To perform manipulation safely, effectively, and competently. Signup and view all the answers

What must a member do before conducting manipulation?

Conduct a thorough assessment and formulate a diagnosis. Signup and view all the answers

What happens during a roll motion at a joint?

One bone's surface rolls over another bone. Signup and view all the answers

Study Notes

OHIPMNRS Model

A musculoskeletal assessment approach that guides treatment for a presenting musculoskeletal concern.
Used to help determine if a mobilization is needed, and which to perform.

History and Evidence for Manual Therapy

Hippocrates, 400 BCE, described using gravity to manipulate the spine to help treat scoliosis.
Friar Thomas, 1656, wrote "The Complete Bone Setter", describing manipulation in the treatment of spinal curvatures.
Manual therapy fell out of favor in the 18th century, possibly due to indiscriminate use and dangers involved.
By the 19th century, "Bone Setters" gained popularity again, but physicians dismissed their success as luck.
By the late 19th century, manipulation became more mainstream, with papers and books explaining the procedure and benefits.
Now, manipulation of bones is practiced by Osteopaths, Physiotherapists, Chiropractors, Naturopaths, and Registered Massage Therapists.
It is a CONTROLLED ACT under the RHPA 1991.

Fundamental Concepts

Mechanics: The study of forces and their effects on motion.
Biomechanics: The application of mechanical laws to living structures, especially the human body's locomotor system.
- Considers the interaction of the skeleton, muscles, and joints.
- Bones act as levers, ligaments act as hinges, and muscles provide the forces.
- Manipulative forces take into account joint mechanics and structure, analyzing the effects of forces on the body.

Joint Mobilization

A non-thrust technique applied within the physiological range of joint motion, but not exceeding the elastic barrier.
Passive rhythmic graded movements with controlled depth and rate.
May be applied with fast or slow repetitions (Oscillations) and various depths (Grades 1-4), but always low velocity.
Movement applied singularly or repetitively, without imparting a thrust or impulse.

Goals/Benefits of Mobilizations

Restore range of motion (ROM) of a joint.
Reduce pain.
Reduce muscle spasms by stretching hypertonic muscles.
Stimulate synovial fluid production.
Increase local blood flow.
Relieve nerve compression and irritated sympathetic chain ganglia.

Types of Mobilizations

Antero-Posterior Glide (AP Glide)
Posterior-Anterior Glide (PA Glide)
Inferior Glide
Superior Glide
Medial Glide
Lateral Glide

Joint Manipulation (Grade 5 Mobilization)

Thrust technique that takes the joint PAST its physiological ROM without exceeding the anatomical limit.
Characterized by a low-amplitude, high-velocity thrust, typically producing an audible crack or pop (cavitation).
A CONTROLLED ACT under the RHPA.

Controlled Act: Manipulation under RHPA 1991

Moving the joints of the spine beyond the individual's usual physiological range of motion using a FAST, LOW amplitude thrust is a CONTROLLED ACT.
To perform manipulation as treatment, one must be a member in good standing of a REGULATED HEALTH PROFESSION that has manipulation within its scope of practice.

Naturopaths and Manipulation

CONO Standard of Practice: Manipulation.
Naturopaths must perform manipulation safely effectively, and competently.
Members must conduct an assessment and formulate a diagnosis before performing manipulation, and reassess the patient's progress and response to treatment regularly.

Stretch Techniques

Gastrocnemius Stretch:
- Patient stands facing a wall with their feet shoulder width apart.
- One leg is straight behind the other, with their heel in contact with the floor and the toes pointing straight ahead.
- Patient leans forward, keeping their back straight, until they feel a stretch in the calf.
- Hold for 30-60 seconds.
Soleus Stretch:
- Patient lies prone on the treatment table with one knee flexed to 90 degrees.
- The clinician dorsiflexes the foot as far as possible.
- The clinician supports the bent leg with one hand and wraps the other around the heel with the forearm resting against the sole of the foot.
- Patient relaxes and inhales deeply while maintaining the foot in the starting position.
- On exhale, the clinician eases into the soleus stretch.
- Hold for 30-60 seconds.
Tibialis Anterior Stretch:
- Patient lies supine on the table with the ankle plantarflexed.
- The clinician cups the heel with one hand and holds the top of the foot with the other hand.
- Patient relaxes and inhales deeply while maintaining the foot in the starting position.
- On exhale, the clinician eases into the tibialis anterior stretch.
- Hold for 30-60 seconds.
Peroneal Stretch (Evertors):
- Patient lies supine on the table with the ankle inverted, keeping the ankle in neutral relative to dorsiflexion or plantarflexion.
- Clinician grasps the lower leg with one hand to stabilize it, and places the other hand against the lateral side of the foot.
- Patient relaxes and inhales deeply while maintaining the foot in the starting position.
- On exhale, the clinician eases into the peroneal stretch.
- Hold for 30-60 seconds.
Tibialis Posterior Stretch (Invertor):
- Patient lies supine on the table with the ankle everted, keeping the ankle in neutral relative to dorsiflexion or plantarflexion.
- Clinician grasps the lower leg with one hand to stabilize it, and places the other hand against the medial side of the foot.
- Patient relaxes and inhales deeply while maintaining the foot in the starting position.
- On exhale, the clinician eases into the tibialis posterior stretch.
- Hold for 30-60 seconds.

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Description

Explore the historical context and evolution of manual therapy techniques, focusing on notable figures and their contributions. This quiz covers the OHIPMNRS model and the changing perceptions of manipulation through the ages.