More on Rapid and Slow Responders | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

More on Rapid and Slow Responders

Here are some points from my recent lecture on Soft Tissue Patterns on Rapid and Slow Responders.

I also wrote about this here. Also, try google image for deranged person or derangement. Some odd results in there! Anyway...

I chose those terms as classifications instead of derangement and dysfunction because MDT clinicians often call a patient deranged. Who is deranged? A patient who is responding quickly to repeated loading or the clinician for calling a patient that to their face?

1) Rapid Responders
  • will have a greater than 25% change in
    • ROM
    • pain
      • location
      • intensity
      • duration
    • function
  • are often limited in one direction and have a directional preference (DP)
  • they are acute or subacute
  • if chronic, they most likely have episodic Sx presentation, despite having it for months/years, it goes away for long periods of time
  • do not exhibit signs of central sensitization typically
  • respond to repeated end range loading, and most manual treatments, but mechanically need the right direction to start moving and feeling
  • will have greater improvements lasting between visits
2) Slow Responders
  • are usually chronic in nature
  • may or may not have central sensitization and fear avoidance for movement
  • usually have poor motor patterns developed in response to pain and/or lack of mobility
  • will have less than 25% improvement in pain, ROM, strength, etc after a treatment
  • respond better to graded exposure to movement
  • need a lot of education on the importance of movement, but end range is usually not tolerated well
  • this may be an area that is adjacent to a rapid responding one
    • i.e. Rapid Responding lumbar spine, Slow Responding Hip
  • it's not no pain, no problem - get the slower responding DNs moving better to improve the greater picture!

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