Regional Interdependence In Treatment Of The Elbow: Difference between revisions
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Cervical Thrust Manip Video | Cervical Thrust Manip Video | ||
== | == Cervico-Thoracic Manipulation Technique == | ||
*Non-thrust grade III and IV PPIVM and PAVM directed at impaired segment | |||
Done in combination the following: | |||
*Stretching wrist extensors strengthening wrist and forearm and mobilizations of elbow/wrist | |||
CT Manip Video | |||
== D. Thoracic Manipulation For Treatment of Lateral Epicondylitis<br>1. Intervention Strategy <br>A. Although cervical has been shown to be superior to thoracic manipulations, clinicians have attempted to treat the thoracic spine in order to make gains in lateral epicondylitis. This technique involves targeting the middle thoracic spine (T5-T8). To perform the manipulation, the stabilizing hand is placed at a level immediately distal to the restricted segment using a “pistol grip.” The subject is supine with their arms cross over their chest and hands grasping their opposite shoulder. The therapist’s other hand is used to stabilize the neck, head, and upper thoracic. Gentle flexion of the thoracic spine is introduced until tension is palpated under the therapist’s hand on the transverse process. The therapist then performs a high-velocity, low thrust manipulation in a downward, cephalad direction. <br> Outcomes of Intervention<br>1. Both thoracic and cervical spinal manipulation increases pain-free grip strength on affected side with lateral epicondylitis.<br>2. Cervical spinal manipulation produces an immediate bilateral increase in pressure pain threshold in patients with lateral epicondylitis, but thoracic spinal manipulation does not 2. == | == D. Thoracic Manipulation For Treatment of Lateral Epicondylitis<br>1. Intervention Strategy <br>A. Although cervical has been shown to be superior to thoracic manipulations, clinicians have attempted to treat the thoracic spine in order to make gains in lateral epicondylitis. This technique involves targeting the middle thoracic spine (T5-T8). To perform the manipulation, the stabilizing hand is placed at a level immediately distal to the restricted segment using a “pistol grip.” The subject is supine with their arms cross over their chest and hands grasping their opposite shoulder. The therapist’s other hand is used to stabilize the neck, head, and upper thoracic. Gentle flexion of the thoracic spine is introduced until tension is palpated under the therapist’s hand on the transverse process. The therapist then performs a high-velocity, low thrust manipulation in a downward, cephalad direction. <br> Outcomes of Intervention<br>1. Both thoracic and cervical spinal manipulation increases pain-free grip strength on affected side with lateral epicondylitis.<br>2. Cervical spinal manipulation produces an immediate bilateral increase in pressure pain threshold in patients with lateral epicondylitis, but thoracic spinal manipulation does not 2. == |
Revision as of 21:48, 2 November 2012
Regional Interdependence of manipulation on elbow pain[edit | edit source]
Definition: Treatment directed at one area of the body to ellicit changes in another[edit | edit source]
-in addition to treatment directed at the elbow, patients with elbow pain may benefit from treatment directed at the cervical or thoracic spine, elbow, and/or wrist.[edit | edit source]
I.Treatment techniques[edit | edit source]
- Lateral epicondylitis
Cervical (link to spot within this page) (Patients - Treatments - Video - References)
CT (Patients - Treaments - Video - References)
Thoracic (Patients - Treatments - Video - References)
Wrist (Patients - Treatments - Video - References)
- Cubital tunnel
Carpal Mobilization (Patients - Treatments - Video - References)
- Radial Nerve entrapment
Median and Radial Nerve mobilization (Patients - Treatments - Video - References)
II. Outcomes
[edit | edit source]
Pain |
Pain free Grip strength |
Pressure pain threshold | Disability | Perception of change | Global improvement | Max grip force | Carpal mobility | Elbow flexion test | |
Cervical | X | X | |||||||
CT | X | X | X | X | |||||
Throacic | X | ||||||||
Wrist |
X | X | X | X | X | ||||
Carpal mobilization | X | X | X | ||||||
Medain/Radial Nerve Mob | X | X |
Cervical Thrust manipulation technique[edit | edit source]
- Patient supine with neck in nuetral
- Physical therapist positions neck into rotation and contralateral flexion
- High velocity low amplitude (HVLA) thrust manipulation directed superior and medial towards contralateral eye
Cervical Thrust Manip Video
Cervico-Thoracic Manipulation Technique[edit | edit source]
- Non-thrust grade III and IV PPIVM and PAVM directed at impaired segment
Done in combination the following:
- Stretching wrist extensors strengthening wrist and forearm and mobilizations of elbow/wrist
CT Manip Video