The argument died down pretty quickly once said individual realized I wasn't arguing against manipulation. It's just that I'm lucky if I do more than 2-4 thrust manipulations/month, not counting teaching courses regularly.
However, let's get something straight, repeated end range loading has the same neurophysiologic effects that mobilization/manipulation do. They're all just movements on the same continuum.
This study shows that a majority of those that met the thrust manipulation CPR also fit into the MDT derangement category. That's not surprising, as individuals fitting into that CPR are healthy individuals with acute pain, low fear avoidance, etc. They should be Rapid Responders.
This study shows that lumbar spine mobilization improves SLR compared to static stretching and control groups. A similar study was done as a capstone at a local DPT school in Buffalo NY showing prone pressups having the same effect, significant improvement in SLR. You know why? Prone pressups have the same effect as lumbar mobilization. The patient just has to use a little elbow grease as opposed to lying there and letting you do all the work.
In the end both thrust manipulation and joint mobilization through arthrokinematic movements, or rapid thrust fire joint mechanoreceptors that bombard the CNS with proprioceptive information. Repeated end range loading does the same thing, but with osteokinematic (large, gross movements), but the difference is... the patient can perform them without you. - Give it up, you don't have magic hands!
|Eval and Treatment of Rapid Responders is easy!|
|And by "You" I mean the patient, not your passive treaments|
A rapid response should occur in a majority of your patients, especially within the first visit. It's up to the patient, and your appropriate instruction for HEP to keep part of that improvement for the second visit. If you meet both of those variables, chances are the patient will have successful outcome sooner than later.
Keeping it Eclectic...
|Please click here to subscribe now (again)|