Manual Therapy: Difference between revisions

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== Description  ==


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According the the American Academy of Orthopaedic Manual Physical Therapists ([http://www.aaompt.org/ AAOMPT]) Description of Advanced Specialty Practice ([http://www.aaompt.org/publications/AAOMPT_2008_MT_DASP_FINAL.doc DASP]), orthopaedic manual physical therapy (OMPT) is defined as: "OMPT is any “hands-on” treatment provided by the physical therapist. Treatment may include moving joints in specific directions and at different speeds to regain movement (joint mobilization and manipulation), muscle stretching, passive movements of the affected body part, or having the patient move the body part against the therapist’s resistance to improve muscle activation and timing. Selected specific soft tissue techniques may also be used to improve the mobility and function of tissue and muscles."
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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  &nbsp;  
The International Federation of Orthopaedic Manipulative Physical Therapists ([http://www.ifompt.com/ IFOMPT]) defines manual therapy&nbsp;techniques as: "Skilled hand movements intended to produce any or all of the following effects: improve tissue extensibility; increase range of motion of the joint complex; mobilize or manipulate soft tissues and joints; induce relaxation; change muscle function; modulate pain; and reduce soft tissue swelling, inflammation or movement restriction."
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== Description<br>  ==


add text here to describe the intervention here<br>
== Terminology  ==
(The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT)&nbsp;has offered&nbsp;the following definitions:)


== Indication<br>  ==
'''Manipulation''': A passive, high velocity, low amplitude thrust applied to a joint complex within its anatomical limit* with the intent to restore optimal motion, function, and/ or to reduce pain.


add text here relating to the indication for the intervention<br>
'''Mobilization:&nbsp;'''A manual therapy technique comprising a continuum of skilled passive movements to the joint complex that are applied at varying speeds and amplitudes, that may include a small-amplitude/ high velocity therapeutic movement (manipulation) with the intent to restore optimal motion, function, and/ or to reduce pain.&nbsp;


== Clinical Presentation  ==
The terms "'''Thrust Manipulation'''" and "'''Non-Thrust Manipulation'''" have been used in the literature.&nbsp;&nbsp;"Thrust&nbsp;Manipulation" is used&nbsp;to describe interventions&nbsp;described as Manipulation&nbsp;by IFOMPT, and "Non-Thrust Manipulation"&nbsp;would be&nbsp;synonymous with the term Mobilization as&nbsp;proposed by IFOMPT.&nbsp;&nbsp;


add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures.&nbsp;
The American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) has proposed the following framework for describing manipulative interventions<ref name="Mintken">Mintken PE, et al. A Model for Standardizing Manipulation Terminology in Physical Therapy Practice. J Orthop Sports Phys Ther 2008;38(3):A1-A6.</ref>:
== Indication  ==
==  Grading Scales  ==


== Resources  ==
=== Maitland Joint Mobilization Grading Scale: ===
{{#ev:youtube|G_QI7bVrHN0}}<ref>Physiotutors. Maitland Mobilization Grades. Available from: https://www.youtube.com/watch?v=G_QI7bVrHN0</ref>


add appropriate resources here, including text links or content demonstrating the intervention or technique
'''Grade I - '''Small amplitude rhythmic oscillating mobilization in early range of movement


== References  ==
'''Grade II - '''Large amplitude rhythmic oscillating mobilization in midrange of movement


<references />
'''Grade III - '''Large amplitude rhythmic oscillating mobilization to point of limitation in range of movement


== Definition  ==
'''Grade IV - '''Small amplitude rhythmic oscillating mobilization at endrange of movement


According the the American Academy of Orthopaedic Manual Physical Therapists ([http://www.aaompt.org/ AAOMPT]) Description of Advanced Specialty Practice ([http://www.aaompt.org/publications/AAOMPT_2008_MT_DASP_FINAL.doc DASP]), orthopaedic manual physical therapy (OMPT) is defined as:
'''Grade V (Thrust Manipulation) - '''Small amplitude, quick thrust at endrange of movement
<blockquote>"OMPT is any “hands-on” treatment provided by the physical therapist. Treatment may include moving joints in specific directions and at different speeds to regain movement (joint mobilization and manipulation), muscle stretching, passive movements of the affected body part, or having the patient move the body part against the therapist’s resistance to improve muscle activation and timing. Selected specific soft tissue techniques may also be used to improve the mobility and function of tissue and muscles." </blockquote>
The International Federation of Orthopaedic Manipulative Physical Therapists ([http://www.ifompt.com/ IFOMPT]) defines manual therapy&nbsp;techniques as:
<blockquote>"Skilled hand movements intended to produce any or all of the following effects: improve tissue extensibility; increase range of motion of the joint complex; mobilize or manipulate soft tissues and joints; induce relaxation; change muscle function; modulate pain; and reduce soft tissue swelling, inflammation or movement restriction."<br></blockquote>
== Terminology  ==


The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT)&nbsp;has offered&nbsp;the following definitions:  
=== Kaltenborn Traction Grading Scale: ===
<blockquote>'''Manipulation''': A passive, high velocity, low amplitude thrust applied to a joint complex within its anatomical limit* with the intent to restore optimal motion, function, and/ or to reduce pain. </blockquote><blockquote>'''Mobilization:&nbsp;'''A manual therapy technique comprising a continuum of skilled passive movements to the joint complex that are applied at varying speeds and amplitudes, that may include a small-amplitude/ high velocity therapeutic movement (manipulation) with the intent to restore optimal motion, function, and/ or to reduce pain.&nbsp;</blockquote><blockquote></blockquote>
'''Grade I - '''Neutralizes joint pressure without separation of joint surfaces
The terms "'''Thrust Manipulation'''" and "'''Non-Thrust Manipulation'''" have been used in the literature.&nbsp;&nbsp;"Thrust&nbsp;Manipulation" is used&nbsp;to describe interventions&nbsp;described as Manipulation&nbsp;by IFOMPT, and "Non-Thrust Manipulation"&nbsp;would be&nbsp;synonymous with the term Mobilization as&nbsp;proposed by IFOMPT.&nbsp;&nbsp;


The American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) has proposed the following framework for describing manipulative interventions<ref name="Mintken">Mintken PE, et al. A Model for Standardizing Manipulation Terminology in Physical Therapy Practice. J Orthop Sports Phys Ther 2008;38(3):A1-A6.</ref>:
'''Grade II - '''Separates articulating surfaces, taking up slack or eliminating play within joint capsule
<blockquote>1. '''Rate of force application''': Describe the rate at which the force was applied.&nbsp; </blockquote><blockquote>
2. '''Location in range of available movement''': Describe whether motion was intended to occur only at the beginning, towards the middle, or at the end point of the available range of movement. The term available range of movement is intended to describe the available movement as perceived by the therapist after the patient has been positioned and at the time the technique is applied. The available movement may or may not be the same as the range of motion available at a particular joint or region under other circumstances. The use of the terms beginning, mid, and end point of available movement are only relevant in the context of describing the particular technique at the time it is applied. The term end point should not be associated with any particular anatomic structures, as many&nbsp;structures have the potential to limit motion depending on the individual patient and technique.


3. '''Direction of force''': Describe the direction in which the therapist imparts the force. This description should be devoid of the “intent” of the technique and, instead, should follow standard anatomical and biomechanical conventions.
'''Grade III -''' Stretching of soft tissue surrounding joint 


4. '''Target of force''': Describe the location where the therapist intended to apply the force. In the case of the spine, force may be directed at a specific level, or more generally across a particular region such as mid lumbar or lower thoracic. The task force suggests that replication of techniques among therapists will be more easily achieved if clearly palpable structures are used as reference points. For most peripheral joints associated with the appendicular skeleton, the target of force may be appropriately described using a specific joint as a reference. It is important to note that the use of a joint, or a particular spinal level, for reference as to where the force is applied is not intended to imply any particular theoretical assumption as to structures affected by a manipulation, but only to provide information about where the force was applied.
== Clinical Presentation  ==


5. '''Relative structural movement''': Describe which structure or region was intended to remain stable and which structure or region was intended to move, naming the moving structure or region first and the stable segment second, separated by the word “on.” For example, a “lower lumbar on upper lumbar” technique implies that the clinician intended to move the lower lumbar region while stabilizing the upper lumbar region. Techniques associated with the peripheral joints would be described utilizing the same convention (eg, tibia on femur, humerus on scapular glenoid).
add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures.&nbsp;
 
6. '''Patient position''': Describe the position of the patient (eg, supine, prone, recumbent). This would include any premanipulative positioning of a region of the body, such as being positioned in rotation or side bending.  


''For example,&nbsp;a lumbar technique might be described as, “A high-velocity, end-range, right-rotational force to the lower lumbar spine on the upper lumbar spine in a right side-lying, left lower thoracic lumbar side-bent position.”''
== Resources (Mobilization and Manipulation Techniques) ==
 
<br>
</blockquote>
== Grading Scales  ==
 
Maitland Joint Mobilization Grading Scale
{{#ev:youtube|G_QI7bVrHN0}}<ref>Physiotutors. Maitland Mobilization Grades. Available from: https://www.youtube.com/watch?v=G_QI7bVrHN0</ref>
<blockquote>'''Grade I - '''Small amplitude rhythmic oscillating mobilization in early range of movement'''<br>'''</blockquote><blockquote>'''Grade II - '''Large amplitude rhythmic oscillating mobilization in midrange of movement'''<br>'''</blockquote><blockquote>'''Grade III - '''Large amplitude rhythmic oscillating mobilization to point of limitation in range of movement </blockquote><blockquote>'''Grade IV - '''Small amplitude rhythmic oscillating mobilization at endrange of movement </blockquote><blockquote>'''Grade V (Thrust Manipulation) - '''Small amplitude, quick thrust at endrange of movement </blockquote>
Kaltenborn Traction Grading Scale
<blockquote>'''Grade I - '''Neutralizes joint pressure without separation of joint surfaces'''<br>'''</blockquote><blockquote>'''Grade II - '''Separates articulating surfaces, taking up slack or eliminating play within joint capsule<br></blockquote><blockquote>'''Grade III -''' Stretching of soft tissue surrounding joint</blockquote>
== Mobilization and Manipulation Techniques  ==


[[Elbow Mobilizations|Elbow Mobilizations]]  
[[Elbow Mobilizations|Elbow Mobilizations]]  
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[[Manual techniques for the cervicothoracic spine|Cervicothoracic Manipulation]]
[[Manual techniques for the cervicothoracic spine|Cervicothoracic Manipulation]]
== References  ==
== References  ==
References will automatically be added here, see [[Adding References|adding references tutorial]].


<references />  
<references />  

Revision as of 10:52, 25 June 2019

Original Editor - Finn Gerstell

Top Contributors - Finn Gerstell, Jess Bell, Admin, Kim Jackson, Lucinda hampton, Dana Tew, Samuel Winter, Carin Hunter, Rachael Lowe, Elaine Lonnemann, David Drinkard, Hanz Tao, Mande Jooste, Matt Huey, WikiSysop, Shaimaa Eldib, Scott Buxton, Kai A. Sigel and Rucha Gadgil  

Description[edit | edit source]

According the the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) Description of Advanced Specialty Practice (DASP), orthopaedic manual physical therapy (OMPT) is defined as: "OMPT is any “hands-on” treatment provided by the physical therapist. Treatment may include moving joints in specific directions and at different speeds to regain movement (joint mobilization and manipulation), muscle stretching, passive movements of the affected body part, or having the patient move the body part against the therapist’s resistance to improve muscle activation and timing. Selected specific soft tissue techniques may also be used to improve the mobility and function of tissue and muscles."

The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) defines manual therapy techniques as: "Skilled hand movements intended to produce any or all of the following effects: improve tissue extensibility; increase range of motion of the joint complex; mobilize or manipulate soft tissues and joints; induce relaxation; change muscle function; modulate pain; and reduce soft tissue swelling, inflammation or movement restriction."

Terminology[edit | edit source]

(The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) has offered the following definitions:)

Manipulation: A passive, high velocity, low amplitude thrust applied to a joint complex within its anatomical limit* with the intent to restore optimal motion, function, and/ or to reduce pain.

Mobilization: A manual therapy technique comprising a continuum of skilled passive movements to the joint complex that are applied at varying speeds and amplitudes, that may include a small-amplitude/ high velocity therapeutic movement (manipulation) with the intent to restore optimal motion, function, and/ or to reduce pain. 

The terms "Thrust Manipulation" and "Non-Thrust Manipulation" have been used in the literature.  "Thrust Manipulation" is used to describe interventions described as Manipulation by IFOMPT, and "Non-Thrust Manipulation" would be synonymous with the term Mobilization as proposed by IFOMPT.  

The American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) has proposed the following framework for describing manipulative interventions[1]:

Indication[edit | edit source]

Grading Scales[edit | edit source]

Maitland Joint Mobilization Grading Scale:[edit | edit source]

[2]

Grade I - Small amplitude rhythmic oscillating mobilization in early range of movement

Grade II - Large amplitude rhythmic oscillating mobilization in midrange of movement

Grade III - Large amplitude rhythmic oscillating mobilization to point of limitation in range of movement

Grade IV - Small amplitude rhythmic oscillating mobilization at endrange of movement

Grade V (Thrust Manipulation) - Small amplitude, quick thrust at endrange of movement

Kaltenborn Traction Grading Scale:[edit | edit source]

Grade I - Neutralizes joint pressure without separation of joint surfaces

Grade II - Separates articulating surfaces, taking up slack or eliminating play within joint capsule

Grade III - Stretching of soft tissue surrounding joint

Clinical Presentation[edit | edit source]

add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures. 

Resources (Mobilization and Manipulation Techniques)[edit | edit source]

Elbow Mobilizations

Wrist/Hand Mobilizations

Hip Mobilizations

Knee Mobilizations

Ankle/Foot Mobilizations

Spinal_Manipulation

Shoulder Mobilizations and  Manipulation

Cervicothoracic Manipulation

References[edit | edit source]

  1. ↑ Mintken PE, et al. A Model for Standardizing Manipulation Terminology in Physical Therapy Practice. J Orthop Sports Phys Ther 2008;38(3):A1-A6.
  2. ↑ Physiotutors. Maitland Mobilization Grades. Available from: https://www.youtube.com/watch?v=G_QI7bVrHN0
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