Chiropractic Skills Week 1

Manipulation Vs Adjustment - Manipulation: passive, manual, articular, directional, low or high amp, high or low velocity, controlled force. Adjustment- chiropractic, neurophysiological functions Joint Mobilization- non-thrust, within physiologic range of joint motion, passive, controlled depth and rate, singularly/repetitively, high or low velocityManipulation vs Mobilization- mobilizations occur up to PHYSIOLOGICAL BARRIER (end of passive ROM)Manipulations move joint into PARAPHYSIOLOGICAL SPACE (beyond physiological barrier)4 Phases of Joint Manipulation Active ROM Passive ROM Paraphysiological Space Limit of joint integrity 2 Barriers of Joints Negative (sub atmospheric intra articular) pressure is overcome by manipulative thrust without damaging the joint Limit of anatomical Integrity - to surpasses caused injury Adjustments may be specific or general Specific Manipulative Therapy focuses force to one articulation as much as possible utilises short levers located near to target joint specific vectors of General Manipulative Therapies use broader contacts influencing multiple segments long levers utilized intention to mobilize multiple segments Chiropractors emphasize specific manipulation. It is not possible to be ABSOLUTELY specific with manual manipulative therapy techniques. The idea behind being specific is to prevent injury to adjacent unstable segments. Patients and Chiropractic - Week 2 Primarily patients see chiropractors for MusculoSkeletal care (back, shoulder, Neck, headaches, non specific MSP pain)Evidence use high quality clinical research de-emphasizes intuition, unsystematic clinical experience spinal manipulation technique is clinically effective SMT is safe and effective Lower Back Pain evidence suggests that chiro is as effective as physio and medical care no serious adverse effects same cost limited available evidence - referrals are based on preference evidence- more short term pain relief faster recovery than commonly used physical therapy treatment strategy Chronic LBP SMT/MOB either similar or better pain outcomes than placebo similar effect to prescription, short term effective compared to GP, long term effective compared to physio Acute Neck Pain SMT/MOB superior to GP for long term SMT =similar pain relief to high tech rehab exercises (short term) MOB is equal to SMT for cervical spine evidence suggests that a multimodal approach is most effective. manual therapies alone have no effective evidence cannot guarantee positive outcome for SMT for visceral disease, there is minimal evidence.