opp exam 1

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opp exam 1
2010-09-17 20:28:14
osteopathic principles ten step screening soft tissue techniques muscle energy

ten step screening, soft tissue techniques, muscle energy
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  1. general concepts of 10 step
    •Used as a general screening exam to help prioritize regions for treatment.

    –Does not yield specific somatic dysfunctions.

    • –In combination with TART changes, it gives clues on where somatic dysfunctions may
    • exist.

    • –Useful for observing the overall functional symmetry of a body region in both its
    • static and dynamic state.

    –Useful for making global connections between body regions from a tensegrity viewpoint.
  2. 10 steps:

    2.Standing Spine Sidebending Test

    3.Standing Flexion Test

    4.Seated Flexion Test

    5.Seated Upper Extremity Motion

    6.Seated Trunk Tests

    7.Seated Cervical Motion

    8.Supine Thoracic Cage Motion

    9.Lower Extremity Motion

    10.Pelvis Landmarks
  3. gait
    •Assess for


    –Heel strike and toe off

    • –Hip
    • sway (Trendelenberg)

    –Trunk rotation

    –Arm swing

    -neutral posture

  4. always remember to do what during 10 step evaluation
    reset the pelvis
  5. FABERE test
    leg in 4 shape
  6. goals of soft tissue
    1.Relax hypertonic muscles

    2.Stretch passive fascial structures

    • 3.Enhance circulation to local myofascial
    • structures

    4.Improve local tissue nutrition, O2, and removal of metabolic waste

    • 5.Identify somatic dysfunction
    • 6.Improve abnormal somato-somatic
    • and somatovisceral reflex activity

    7.Observe tissue response to OMT

    • 8.Improve local and systemic immune
    • responsiveness

    • 9.Provide general state of tonic
    • stimulation

    10.Provide general relaxation
  7. stretching
    • •forces
    • are along the longitudinal axis
  8. kneading
    • •forces
    • are perpendicular to the longitudinal axis (like a bowstring)
  9. inhibition
    • •forces
    • are directed superficial to deep ususally over a specific area of tension (tender
    • point)
  10. effleurage
    • •lymphatic
    • treatment superficially from distal to proximal and peripheral to central.
  11. petrissage and skin rolling
    • •deep
    • kneading/squeezing of muscle tissue breaking adhesive bands from the skin to
    • deeper tissue
  12. tapotement
    • •repetitively
    • striking the belly of the muscle with the hypothenar edge of the hand.
  13. goals of muscle energy treatment
    • •Decrease
    • muscle hypertonicity

    • •Lengthen
    • muscle fibers

    • •Reduce
    • the restraint of movement

    • •Produce
    • joint mobilization

    • •Improve
    • respiratory and circulatory function

    • •Strengthen
    • asymmetrically weakened muscles
  14. isotonic muscle contraction
    • –The
    • muscle is anchored only on one end and uses a consistent weight.

    • –Goal
    • is to strengthen muscle by shortening origin and insertion of muscle under
    • load.

    • –Clinically,
    • the physician uses less force than the patient.
  15. isolytic muscle contraction
    • –Contraction
    • of a muscle against resistance while forcing the muscle to lengthen.

    • –The
    • therapeutic goal is to stretch fibrotic or chronically shortened myofascial
    • tissues.

    • –Clinically
    • the physician’s force is greater than the patient’s
  16. isometric contraction
    • –Most
    • common type used in muscle energy techniques.

    • –Muscle
    • is contracted without shortening the muscle’s origin and insertion.

    • –Clinically,
    • the physician’s force matches (or is the same as) the patient’s force.
  17. theoretical basis of muscle energy
    • •Most
    • commonly used as a direct technique (a technique that is localized towards the
    • restrictive barrier).

    • •After
    • a isometric contraction, the muscle group is in a relaxed, refractory phase
    • which allows the muscle to be passively stretched to a new restrictive barrier.
  18. principles of treatment (muscle energy)
    •Accurate diagnosis

    •Position to the point of initial barrier resistance (feather edge)

    •Physician establishes appropriate counterforce

    • •Patient
    • introduces appropriate muscle energy effort

    –Direction–Duration–Amount of force

    •Patient must completely and voluntarily relax

    •Pause for neuromuscular adaptation (post-relaxation phase)

    •Reposition to the new restrictive barrier

    • •Repeat
    • until no futher change is obtained

    •Reassess for appropriate change
  19. key treatment concepts of muscle energy
    • 1.This is not a wrestling match. Only use enough muscle strength to contract
    • the muscles.

    2.Hold the isometric contraction at least 3-5 seconds.

    3.Be sure to wait for the involuntary second wave of relaxation (post relaxation phase) before repositioning.

    4.Reposition after each contraction (including the last).

    5.Remember, the correction occurs during repositioning and not during the isometric contraction.
  20. –TART
    changes in adductor muscles (inner thigh)
    restricted motion of abduction
  21. general clinical findingsd of hypertonicity
    hypertonic one way; restricted other direction/motion (move towards restrictive barrier)

    ex: hypertonic adductor... preferred position is slightly adducted thigh, restricted abduction, dr pushes to sbduct, patient pushed to adduct