Manipulation

What is the manipulation clinical prediction rule?

-symptoms < 16 days -no symptoms past the knee -stiffness to lumbar spring (PA) -low FABQ work score (<19) ->35 deg internal hip rotation on one side

What is the Maitland system?

-uses accessory motions for the spine, physiological motions for extremities -positioning is dependent on severity and irritability

What is the general consensus of manipulation?

Better than no treatment, similar effects to other treatments, short-term relief

According to Maitland, how should central or bilateral symptoms be treated?

Central PA Rotation with each side up or worse side up Longitudinal mobilization (manual or traction)

What are the outcome measurements for LBP?

Fear Avoidance Beliefs Questionnaire Oswestry Disability Index Roland-Morris Disability Questionnaire Patient Specific Functional Scale

According to the Maitland system, how should radicular symptoms (canal signs) be treated?

Longitudinal motion Rotation

According to the Maitland system, if the symptoms are severe/irritable, what should you do?

Position AWAY from the direction or painful posture Grades I or II

According to the Maitland system, if the symptoms are NOT severe/irritable, what should you do?

Position towards the restricted motion or stiffness Grades III or IV

According to Maitland, how should unilateral symptoms be treated?

Unilateral PA Rotation- symptomatic side off table Transverse oscillations, SP towards symptomatic side

What is manipulation?

controlled, skillful passive movement -high velocity, low amplitude thrust (HVLA -grade V