- California Physical Therapy Association
- ISBN 13: 9780702031304
- Manipulation of the Spine, Thorax and Pelvis: An Osteopathic Perspective [With DVD ROM]
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California Physical Therapy Association
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- Manipulation of the Spine, Thorax and Pelvis: An Osteopathic Perspective / Edition 2;
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Back to home page. Listed in category:. Free postage Opens image gallery Image not available Photos not available for this variation. Watch this item Watching Watch list is full. Very Good: A book that has been read and does not look new, but is in excellent condition. Provides a step-by-step illustrated guide to spinal manipulation techniques within the context of osteopathic medicine.
This book, divided in four main parts, describes the principles and theory of spinal manipulation, its use in clinical practice, and instructions for 35 different techniques covering all levels of the spine, thorax and pelvis. Book Details Title:. Lateral border, proximal or middle phalanx. Supine with the neck in a neutral relaxed position. Head of couch, feet spread slightly.
Ensure your left forearm is over or slightly anterior to the ear. Step to the right and stand across the right corner of the couch. Optimal alignment for the thrust is in a curved plane. Relax and adjust your balance. The thrust must be applied, using both hands, along a curved plane that follows the shape of the occipto-atlantal articulation Fig. Lateral border, proximal or middle phalanx of operator's right index finger. If necessary, remove pillow or adjust pillow height.
Adjust couch height so that the operator can stand as erect as possible and avoid crouching over the patient as this will limit the technique and restrict delivery of the thrust. Remove your right hand from occiput and palpate the contact point on the right posterior arch of the atlas with the tip of your index or middle finger. Slowly but firmly slide your right index finger, in close approximation to the suboccipital musculature, downward towards the couch along the posterior arch of the atlas until it approximates the middle or proximal phalanx.
Vertex contact is essential in this technique. It is important that your applicator has a firm contact on the atlas so that you do not slip when applying the thrust along a curved facet plane. Keep your right elbow close to the couch in order to keep the contact point on the atlas Fig. Maintaining all holds, make to achieve any necessary minor changes in flexion, extension, sidebending or appropriate rotation until you can sense a state of appropriate tension and pre-thrust leverage at the contact point.
The patient should not be aware of tension any pain or discomfort.
ISBN 13: 9780702031304
An effective HVLA technique is best achieved if the operator and patient are relaxed and not holding themselves rigid. Apply a HVLA thrust to the posterior arch of the atlas in an anterior and superior direction along a curved plane which follows the shape of the occipto-atlantal articulation. Apply no simultaneous rapid increase of cervical rotation, extension or sidebending with the left hand Fig. Right posterior arch of atlas. Essential in this technique. The thrust must be applied along a curved plane, which follows the shape of the occipto-atlantal articulation Fig.
Lift the head slightly and gently rotate it to the left, taking the weight o[ the head in your left hand. Remove your right hand from the occiput and palpate the region of the right posterior arch of the atlas with the tip of your index or middle finger.
Slowly but firmly slide your right index finger downwards towards the couch along the posterior arch of the atlas until it approximates the middle or proximal phalanx. Ensure that your left forearm is over, or slightly anterior to, the ear. Gently introduce rotation of the head to the left, to the point at which the posterior arch becomes more obvious under your contact point. While maintaining firm applicator pressure, allow the right index finger to roll slightly on the contact point as you move your right elbow towards the patient's right shoulder to reach that point when your line of thrust is directed towards the corner of the patient's mouth.
The thrust plane is into rotation. Ensure that you maintain a firm contact point on the posterior arch of the atlas and that your applicator is in line with your forearm. Maintaining all holds and contact points, complete full rotation of the head and neck to the left until slight tension is palpated in the tissues at your contact point Fig. Maintain firm pressure against the contact point. A common mistake is to use insufficient head and neck rotation. This technique uses minimal secondary leverage. Introduce any sidebending, flexion or extension by pivoting slightly via the legs and trunk.
Do not attempt to introduce these leverages by moving the hands or arms as this will lead to loss of contact and inaccurate technique. Simultaneously, apply a rapid low-amplitude increase of head rotation to the left by supinating the left forearm Fig. This rotation movement of the head is very small but of high velocity.
Manipulation of the Spine, Thorax and Pelvis: An Osteopathic Perspective [With DVD ROM]
This ensures that the occiput and atlas move as one unit during the thrust. The atlas rotates about the odontoid peg of the axis and cavitation occurs at the right Cl-2 articulation. A very rapid contraction of the flexors and adductors of the right shoulder induces the thrust. The thrust, although very rapid, must never be excessively forcible. Use primary leverage of rotation with minimal secondary leverage. Your direction of thrust is towards the patient's mouth and into rotation Fig.
Delivering the thrust.
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The thrust is directed towards the corner of the patient's mouth. Simultaneously, apply a rapid low-amplitude increase of head rotation to the left. The occiput and atlas move as one unit during the thrust Fig. Patient Supine with the neck in a neutral relaxed position. Palpation of Place fingers of both hands gently under the occiput.