Physical Therapy Manual Techniques Quiz

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Questions and Answers

Which grade of mobilization is characterized by small amplitude oscillations performed at the beginning of the available motion?

Grade I (correct)

Grade IV

Grade III

Grade II

Which grade of mobilization is indicated for pain modulation in conditions with low symptom irritability and is performed at tissue resistance?

Grade III

Grade IV (correct)

Grade I

Grade II

According to Cyriax, what is the primary characteristic of manipulation?

A passive movement with therapeutic purpose using the hands (correct)

A small amplitude rapid movement the patient cannot prevent

A high velocity thrust

A continuum of skilled passive movements to joints and soft tissues

Maitland's definition of manipulation emphasizes which key element?

Small amplitude, rapid movement that the patient cannot prevent (A) Signup and view all the answers

According to the 'Guide to Physical Therapist Practice', mobilization and manipulation are described as existing on a:

Continuum of skilled passive movements (A) Signup and view all the answers

In the context of this class, 'mobilization' is primarily differentiated from 'manipulation' by its:

Speed of movement (D) Signup and view all the answers

While manipulation can be used on various joints, it is most frequently applied to which region?

Spine (B) Signup and view all the answers

Which of the following is stated as an objective for this class regarding manual therapy?

To understand the current evidence on mechanisms of pain relief when utilizing manual therapy (A) Signup and view all the answers

What type of motion does arthrokinematics describe?

Movements occurring at joint surfaces (A) Signup and view all the answers

Which of the following is an example of an osteokinematic movement?

Extension (D) Signup and view all the answers

How does opioid receptor activation influence neuronal activity related to pain?

Decreased temporal and spatial summation (D) Signup and view all the answers

What is the role of descending inhibitory pathways in pain modulation?

Decrease activity in the dorsal horn (A) Signup and view all the answers

What changes occur in pain processing regions as a result of opioid activity?

Decreased activation (A) Signup and view all the answers

Manual therapy is defined as:

The deliberate application of externally generated force upon body tissue, typically via the hands, with therapeutic intent. (A) Signup and view all the answers

Which of the following is NOT considered a form of touch-based intervention within manual therapy?

Exercise Therapy (B) Signup and view all the answers

Who is credited with establishing the American Osteopathic College?

Andrew Taylor Still (A) Signup and view all the answers

The role of "bone setters" in the history of manual therapy is best described as:

Individuals from Nepal and Norway and other cultures, who practiced manipulative techniques on joints prior to the 20th century. (C) Signup and view all the answers

Which historical figure is referenced for their use of manipulation and traction?

Hippocrates (B) Signup and view all the answers

When a convex surface moves on a concave surface, the direction of roll and glide is:

Opposite (D) Signup and view all the answers

If a concave surface is moving on a convex surface, how do roll and glide relate?

They are the same (C) Signup and view all the answers

What is the primary focus of joint mobilization techniques?

Enhancing the glide/slide component of joint arthrokinematics (A) Signup and view all the answers

Which of the following is NOT a contraindication for joint mobilization?

Muscle guarding/spasm (B) Signup and view all the answers

What does Grade V mobilization refer to?

Manipulation or HVLAT (A) Signup and view all the answers

Who is credited with developing chiropractic medicine?

Daniel David Palmer (A) Signup and view all the answers

What is the core principle behind chiropractic medicine?

Misaligned vertebrae disrupt nerve impulses, causing disease. (A) Signup and view all the answers

James Henry Cyriax is known for developing which diagnostic method?

Selective tissue tension testing (A) Signup and view all the answers

Maitland's primary contribution to manual therapy is:

Popularizing mobilization as an alternative to manipulation. (B) Signup and view all the answers

When was the International Federation for Orthopedic Manual Therapy (IFOMT) established?

1970 (D) Signup and view all the answers

What credential can be earned upon completing an accredited OMPT fellowship?

FAAOMPT (D) Signup and view all the answers

What is a key finding related to transient biomechanical effects of manual therapy?

Evidence supports short-term improvements in joint mobility. (C) Signup and view all the answers

The release of endogenous opioids during manual therapy primarily occurs in:

The periphery (A) Signup and view all the answers

Study Notes

Manual Therapy Overview

This presentation covers manual therapy, its definition, history, mechanisms, and techniques.
Manual therapy is the deliberate application of external force on body tissue using hands. The intent is therapeutic.
The history of manual therapy dates back thousands of years, including "bone setters" in various cultures (Nepal, Russia, Norway, etc.).
Key figures like Hippocrates are referenced in historical records.
The 16th-19th centuries saw physicians documenting manipulation in textbooks.
In 1892, Andrew Taylor Still established the American Osteopathic College, believing in the curative power of manipulation to improve function, particularly of disturbed arteries.
Daniel David Palmer developed Chiropractic Medicine, focusing on vertebral subluxations and nerve impulses.
James Henry Cyriax (1954) developed a method for logical, clinically reasoned differential diagnosis, including "selective tissue tension testing".
In 1970, the International Federation for Orthopedic Manual Therapy (IFOMT) was established.
The American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) formed in 1992. Completing an accredited OMPT fellowship leads to the FAAOMPT credential, which is recognized as an integral part of the Physical Therapy scope of practice.

Mechanisms of Manual Therapy

Manual therapy mechanisms are complex, encompassing several physiological responses to a mechanical force.
The initial stimulus is a mechanical force.
The mechanism leads to neurophysiological responses that contribute to the outcomes associated with manual therapy.
Various factors influence outcomes including transient biomechanical effects, decreased cytokines, opioid release, and neurophysiological effects.
Understanding this complex chain of neural events is crucial to comprehending the effects of manual therapy.
Transient biomechanical effects are often noticed, in terms of joint mobility changes, but lasting joint position changes are less evident. Technique choice does not seem to make a major difference in outcomes.
Decreased cytokines and endogenous opioid release in the periphery play a significant therapeutic role.
Neuron activation, spatial summation, and temporal summation are all parts of this complex response.
Opioid receptors have a significant role in pain modulation.
Decreased activity in the dorsal horn, either through descending inhibitory pathways, or by way of "gate control" theory, is also important.
Activation of pain processing regions of the brain is also reduced with manual therapy.

Joint Kinematics

Joint motion combines rolling, sliding, and spinning.
Arthrokinematics describes the movements that occur at joint surfaces.
Osteokinematics describes bone movement around a joint (e.g., flexion, extension).
The convex-concave rule governs movement. Convex surfaces moving on concave surfaces exhibit opposite glide and roll. A concave surface over a convex surface will experience the same direction of glide and roll.
The direction of glide is less important than the mechanical stimulus in achieving outcomes.

Joint Mobilization & Manipulation

Mobilization techniques are passive, skilled methods on joints and related soft tissues. Varying speeds and amplitudes are used.
Maitland developed a grading system (Grades I-V) for mobilization.
Grade V mobilization/manipulation involves high velocity, low amplitude thrust (HVLAT).
Kaltenborn also developed grading systems.
Understanding the different grades of mobilization helps describe what is occurring during the treatment.

Indications, Contraindications and Precautions

Indications for manual therapy include pain, muscle guarding/spasm, ROM limitations, and functional immobility
Contraindications include malignancy, osteopenia/osteoporosis, unhealed fractures/fusions, acute injuries with uncertain severity of damage, patient refusal.
Precautions include hyperalgesia/allodynia, hypermobility, weakened connective tissues, long-term corticosteroid use, immediate post-surgery, disuse, and rheumatoid arthritis.

Questions

The presentation concludes with a call for questions from the audience.

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Description

Test your knowledge on the principles and techniques of mobilization and manipulation in physical therapy. This quiz covers definitions, characteristics, and applications of various manual therapy methods. Perfect for students and professionals looking to refresh their understanding of these critical concepts.