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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