CMT1 Shaking, Rocking, Tapotement.txt

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CMT1 Shaking, Rocking, Tapotement.txt
2011-03-14 14:17:41
MSA1 shaking rocking tapotement Soma

CMT1, shaking, rocking, tapotement, Soma
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  1. Shaking
    Tissue is moved back and forth at an even rhythm. Pace can vary from gentle to vigorous
  2. Direct shaking
    • Therapist grasps muscle belly. Can take the place of stroking back.
    • Don't do distal to knee
  3. Indirect shaking
    Therapist grasps distal limb
  4. Rocking
    • Therapist moves body region in rhythmic manner and allows it to return to original position & continues to adjacent jt.
    • Can be gentle or vigorous
  5. Effects of shaking and rocking
    • Reflexively relaxes muscles (affects proprioceptors)
    • Mobilize jt capsule
    • Promotes jt action
  6. Therapeutic uses/ indications of rocking and shaking
    • Relax hypertonic muscles
    • Mobilize jts
    • Relax ct
    • Reduce guarding
    • Transitions
  7. Contraindications of rocking and shaking
    Acute injuries to bones, jts, muscles and nerves
  8. Classification of tapotement
    Various parts of the hand striking tissues at a fairly rapid rate. Generally using both hands, but can be performed with one.
  9. Movement of tapotement
    Light and springy
  10. Tapotement is stimulating to the tissue how
    By direct mechanical action and reflexively by activating the sympathetic nervous system
  11. Cupping/ clapping
    Cupped hands strike skin alternatively, compressing the air, causing a vibratikn wave to penetrate the tissues
  12. Benefit of cupping/ clapping
    Can be used over lungs to loosen secretions
  13. Technique of cupping/ clapping
    Alternate flexion & extension of wrists, rest of arm used as little as possible. Performed rapidly but lightly
  14. Beating
    Loosely clenched fist strikes tissue with dorsal part of middle & distal phalanges & heal of hand. More stimulating than cupping.
  15. Technique of beating
    Remember Tarzan "beating" of chest. Alternately flexing & extending the wrists, rest of arm as relaxed as possible. Pressure is more than cupping
  16. Hacking
    Lateral & dorsal surface of 3rd, 4th, & 5th fingers strike tissue in rapid succession to create strong stimulating effect.
  17. Technique of hacking
    Therapist is at right angles to muscle direction, elbows flexed and a ducted, wrists in extension (prayer position). Rapid alternation between pronation & supination, with some radial & ulnar deviation, hands and fingers relaxed.
  18. Movement of hacking should not come from...
    flexion & extension of elbows as this can produce too much pressure
  19. Ulnar hacking
    Using only ulnar border of hand and fingers, used on large fleshy areas for deeper effect.
  20. Point hacking
    For the face and smaller areas, using tye finger tips & flexing & extending the wrists
  21. Pounding
    Similar technique to hacking, but with lightly clenched fists, which creates deeper effect as ulnar borders strike the tissues. Suitable for large deep muscle masses
  22. Effects of tapotement
    • Stretching effect reflexively facilitates muscle contraction
    • Vasoconstriction followed by vasodilation
    • Sensory nerve endings are stimulated, may give rise to pain by spinal gating mechanism
    • Applied over thorax, cupping ca. Loosen adherant mucus to enable it to be coughed up
  23. Therapeutic uses of Tapotement
    • Provudes general stimulating effect in massage sequence
    • To relieve neuralgia after amputation, trauma or other pathologies
    • Treatment of chronic chest conditions
  24. Contraindications of Tapotement
    • Untreated hypertension
    • Hyperesthesia- (sensitive areas) may be painful or uncomfortable
    • Flaccid muscles- may be overstretched
    • Spasticity- may be significantly increased
    • Newly formed scar tissue- may interfere with healing or stimulate overproductikn
    • Cancer or tuberculosis- risk of spreading
    • Vigorous clapping over severe rib fracture
    • Acute heart failure esp when associated with coronary thrombosis
    • Acute pulmonary embolism
  25. Vibration
    • Fine shaki g movement or tremor into tissues using therapist hand or fingertips with one or both hands
    • Can apply fine or course vibrations
    • Techniques can be static or moving during application
  26. How to vibrate
    • Muscles of forearm contract and relax fast enough to create a vibration
    • Upper arms and shoulders are kept relaxed
  27. Effects of vibration
    • Loosens lung secretions when applied ovee thorax as ct exhales
    • Fine vibrations are more soothing; coarse more stimulating
    • Stimulates nerve activity
    • When used in painful areas or areas needing sensory re-education, creates a different sensory input
    • Decreases muscle tone when applied to tendon for up to 30 seconds
  28. Therapeutic uses/ indications for vibration
    • Chronic chest congestion
    • Bring awareness of a limb after cast removal
    • Pain relief
    • Relax or stimulate muscles
  29. Contraindications of vibration
    • Open or contagiius skin lesions
    • Spasticity
    • Acute chest conditions (over thorax)