Mechanisms of Action of Manipulative Therapy

105 Pages·2011·3.96 MB·English

by  Bill Vicenzino

Mechanisms of Action
of Manipulative

Therapy
Bill Vicenzino
Professor in Sports Physiotherapy
Head of Division of Physiotherapy
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Manipulation

1.  Low Velocity Techniques (cid:2) (cid:3)
Passive Mob
–  Under control of client
–  Passive ± active or functional components*
–  Includes soft tissue, joints, nerual …

2.  High Velocity Thrust Techniques
–  Beyond control of client

–  Small amplitude (ie, HVLA)
What is the major
difference
between
mobilisation and

HVT?
Indicates successfu l
manipulation!

Significance to
mechanism of action?
Brodeur R 1995 The audible release associated with
joint manipulation JMPT 18: 155-64

Audible release caused through
cavitation mechanism that is
responsible for:

Initiating reflex effects

Producing forces in target tissues
without damaging muscle
Does it work?
Or
What is its clinical efficacy?
Gross et al (2010) Manipulation or Mobilization for Neck
Pain: Cochrane Database of Systematic Reviews. DOI:
10.1002/14651858.CD004249.pub3
Gross et al (2010) Manipulation or Mobilization for Neck
Pain: Cochrane Database of Systematic Reviews. DOI:
10.1002/14651858.CD004249.pub3
Hall T, Chan HT, Christensen L, Odenthal B, Wells C, Robinson K.
Efficacy of a C1-C2 self-sustained natural apophyseal glide (SNAG) in
the management of cervicogenic headache. Journal of
Orthopaedic & Sports Physical Therapy. 2007 Mar;37(3):100-7.
Spinal manual therapy appears efficacious
…in short to mid term