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 velocity
Manipulation 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.

	Created by Sarah Nguyen over 8 years ago

Chiropractic Skills (Manual Theory Concepts) Note on Chiropractic Skills Week 1, created by Sarah Nguyen on 23/03/2017.

Chiropractic Skills Week 1