Manual Physical Therapy of the Spine - E-Book

Kenneth A. Olson

• Publisher: Saunders
• Year: 2015
• ISBN:
  9780323263078
• Edition: 2
• Topic: Medicine
• Subtopic: Physiotherapy, Physical Medicine & Rehabilitation

Master the techniques and problem-solving skills needed to manage spinal and TMJ disorders! Manual Physical Therapy of the Spine, 2nd Edition provides guidelines to manipulation, manual physical therapy examination, and treatment procedures of the spine and temporomandibular joint. Informed by evidence-based research, this text offers detailed instructions for reaching an accurate diagnosis and developing a plan of care. Written by well-known spinal manipulation expert Kenneth Olson, this resource provides the complete information you need to make sound decisions during clinical interventions.

• Descriptions of manual therapy techniques include evidence-based coverage of the examination and treatment of spine and TMJ disorders, along with discussions of alternative treatment methods and potential adverse effects and contraindications to manipulation.
• Guidelines for completing a comprehensive spinal examination include medical screening, the patient interview, disability assessment, and tests and measures, along with an evaluation of the examination findings and the principles involved in arriving at a diagnosis and plan of care.
• Impairment-based manual physical therapy approach includes a review of the evidence to support its use to evaluate and treat spinal and TMJ conditions.
• Case studies demonstrate the clinical reasoning used in manual physical therapy.
• Guide to Physical Therapist Practice terminology is incorporated throughout the book, using accepted terms familiar in physical therapy settings.
• Expert author Ken Olson is a highly respected authority on the subject of spinal manipulation in physical therapy.
• A clear, consistent format for explaining techniques makes this reference easy to use in the clinical setting.

• NEW! Coverage of emerging topics includes soft tissue assessment, mobilization, dry needling, myofascial pain and trigger points, thoracic outlet syndrome, cervicogenic dizziness, and differentiation of headache types, plus expanded coverage of examination procedures and psychologically informed management strategies for chronic low back pain.
• NEW! Full-color design and photographs show essential concepts and procedures from multiple angles, illustrating hand and body placement and direction of force.
• UPDATED evidence-based research provides the latest thinking on manual therapy of the spine.

Chapter 1: Introduction

Objectives

▪ Describe the purpose of the textbook.

▪ Explain the philosophy of treatment used in orthopaedic manual physical therapy.

▪ Describe the history of manipulation.

▪ Define common terminology used in orthopaedic manual physical therapy.

▪ Explain evidence-based principles for assessment of the reliability and validity of clinical examination procedures and clinical trials.

▪ Explain how to use this textbook and video clips.

OVERVIEW

This chapter introduces the purpose of the textbook, describes the history of manipulation, defines common terminology used in the textbook, introduces evidence-based principles, and provides an explanation for use of the textbook and the accompanying video clips.

Purpose

The purpose of this textbook is to provide the necessary background information and detailed instructional materials to allow full integration of manipulation and manual physical therapy examination and treatment procedures of the spine into physical therapist professional education and clinical practice.

Physical therapy students and faculty in professional physical therapist education programs are the primary audience for this textbook. The secondary audience includes practicing physical therapists, chiropractors, and osteopathic physicians who want to keep current with professional physical therapist education programs. In addition, this textbook is a useful adjunct to other instructional materials for manual physical therapy residency, fellowship, and postprofessional degree programs in orthopaedic and manual physical therapy.

Physical therapists have been practicing manipulation since the inception of the profession, and all physical therapist professional degree programs must demonstrate full integration of both thrust and nonthrust joint manipulation in the curriculum to maintain accreditation. ^1,2 The intent of this textbook is to provide physical therapist programs detailed instructional materials for the most effective instruction of manipulation.

Prerequisites in the curriculum should include clinical tests and measures for musculoskeletal conditions, including manual muscle testing, muscle length testing, and goniometry. Knowledge of therapeutic exercise, anatomy, physiology, and functional anatomy and biomechanics should also precede instruction in manipulation. Each chapter provides a review of the evidence to support the examination and treatment techniques presented in the chapter and the kinematics and functional anatomy of the anatomic areas covered in the chapter. An impairment-based classification of common conditions treated by physical therapists is presented in each chapter to assist with clinical decision making, and patient management principles are addressed for each condition. Detailed descriptions of examination and manual therapy treatment procedures are covered in each chapter and in the video clips. Common exercises to address each diagnostic classification are also included in each chapter.

History of Manipulation

Manipulation in recorded history can be traced to the days of Hippocrates, the father of medicine (460–370 BC). Evidence is seen in ancient writings that Hippocrates used spinal traction methods. In the paper “On Setting Joints by Leverage,” Hippocrates describes the techniques used to manipulate a dislocated shoulder of a wrestler. ³ Succussion was also practiced in the days of Hippocrates. The patient was strapped in an inverted position to a rack that was attached to ropes and pulleys along the side of a building. The ropes were pulled to elevate the patient and the rack as much as 75 feet, at which time the ropes were released and the patient crashed to the ground to receive a distractive thrust as the rack hit the ground ⁴ (Figure 1-1). Six hundred years later, Galen (130–200 AD) wrote extensively on exercise and manipulation procedures in medicine. ³

Hippocrates’ methods continued to be used throughout the Middle Ages, with little advance in the practice of medicine and manipulation because of the reliance on the church for most healing throughout Europe. ³ In the Renaissance era, Ambroise Paré (1510–1590) emerged as a famous French physician and surgeon ³ who used armor to stabilize the spine in patients with tuberculosis ⁴ (Figure 1-2). His manipulation and traction techniques were similar to those of Hippocrates, but he opposed the use of succussion. ⁴

The bonesetters flourished in Europe from the 1600s through the late 1800s. In 1656, Friar Moulton published The Complete Bone-Setter. The book was later revised by Robert Turner. ⁴ No formal training was required for bonesetters; the techniques were often learned from family members and passed down from one generation to the next. The clicking sounds that occurred with manipulation were thought to be the result of bones moving back into place. ⁴

FIGURE 1-1 Falling ladder (a.k.a. succession)
(From Schoitz.)

In 1871, Wharton Hood published On Bone-Setting, the first such book by an orthodox medical practitioner. ⁵ Hood learned about bonesetting after his father had treated a bonesetter, Richard Hutton. Hutton was grateful for the medical care and offered to teach his practitioner about bonesetting. Instead, it was the practitioner’s son, Wharton Hood, who accepted the offer. Hood thought that the snapping sound with manipulation was the result of breaking joint adhesions. ⁵ Paget ⁶ believed that orthodox medicine should consider the adoption of what was good and useful about bonesetting but should avoid what was potentially dangerous and useless.

Osteopathy was founded by Andrew Still (1826–1917) in 1874. In 1896, the first school of osteopathy was formed in Kirksville, Missouri. ⁴ Still developed osteopathy based on the “rule of the artery,” with the premise that the body has an innate ability to heal and that with spinal manipulation to correct the structural alignment of the spine, the blood can flow to various regions of the body to restore the body’s homeostasis and natural healing abilities. Still’s philosophy placed an emphasis on the relationship of structure to function and used manipulation to improve the spinal structure to promote optimal health. ⁷ The osteopathic profession continues to include manipulation in the course curriculum but does not adhere to Still’s original treatment philosophy. Many osteopathic physicians ...