Physiotherapy and PROCEDURE: Manual Therapy – manipulation techniques

 Procedure : Manipulation

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.