Physiotherapy and PROCEDURE: Manual Therapy – manipulation techniques



DEFINITION/DESCRIPTION:
Manipulation may be specifically defined as a high velocity technique performed at speed outside the models control

Grades of Movement:
Grade I       is a small amplitude movement in resistance free range
Grade II      is a large amplitude movement in resistance free range
Grade III     is a large amplitude movement into resistance
Grade IV     is a small amplitude movement into resistance
Grade V     small amplitude high velocity thrust technique into resistance

CONTRAINDICATIONS:
-           clinical features of cord compression
-           clinical features of cauda equine compression e.g. disturbances of bladder or bowel function, perineal anesthesia
-           clinical features associated with disturbances of reflexes, muscle power or sensation due to nerve root compression
-           hypermobility syndromes involving spine
-           fixed spinal deformities
-           spinal surgery
-           trauma e.g. fractures, open wounds, dislocations, spondylolysis and spondylolisthesis
-           congenital anomalies
-           infections
-           inflammatory arthropathies
-           metabolic bone disease and endocrine disorders
-           tumors
-           vascular disorders
-           some medications e.g. anti-coagulants, steroids
-           pregnancy
-           patients judged to be unsuitable for manipulation

HAZARDS/COMPLICATIONS/PERCAUTIONS:
-           development and/or exacerbation of symptoms including protective muscle spasm or guarding during attempts to position model would contra-indicate continuation of the technique

INFECTION CONTROL:
-           appropriate hand hygiene

-           appropriate hygiene of plinth, pillows, all surfaces in direct contact with subject.





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