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More Specialized Complementary Therapies
Published in W. John Diamond, The Clinical Practice of Complementary, Alternative, and Western Medicine, 2017
Direct — The dysfunctional anatomy is placed into the position of obstruction, and a direct force is applied to remove that obstruction. The force is high velocity, with a low amplitude, just enough to go beyond the obstruction. This is a passive treatment with the osteopath supplying the force. Another technique is the muscle energy technique, where the patient will supply the force into the direction of obstruction.
Treatment of Myofascial Pain Syndromes
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Robert D. Gerwin, Jan Dommerholt
Lewit (1991) suggests using the stretch technique for short or taut muscles and fascia while promoting postisometric relaxation for treatment of trigger points. Postisometric relaxation is also known as muscle energy technique (Mitchell, 1993) or hold–relax technique (Knott & Voss, 1968) and can easily be combined with stretch-and-spray techniques either in the clinic or as part of the patient’s home program. The muscle is gently lengthened, taking up the slack until a barrier is reached. The patient is then asked to contract the muscle isometrically against resistance for about 10 s at approximately 10% of maximal effort. Because it is difficult for patients to gauge a level of effort, the clinician presents a force against which the patient pushes. The patient is instructed, “Meet my force, but do not exceed it.” Thus, the clinician is in complete control of the effort exerted by the patient, and an appropriately slight contraction of muscle is achieved. Then the patient relaxes the muscle. Once total relaxation is achieved, the slack is taken up again and the process is repeated three to five times (Lewit, 1991; Lewit & Simons, 1984; Simons & Simons, 1994). Respiratory facilitation of muscle relaxation utilizes the contraction of nonrespiratory muscles that occurs with inspiration and the relaxation of the same muscles during expiration. During the relaxation phase, the patient is asked to exhale and look down to facilitate muscular relaxation (Lewit, 1988). A variation on Lewit’s approach combines isometric contractions, reciprocal inhibition, and stretch (Fischer, 1995).
Telerehabilitation for pelvic girdle dysfunction in pregnancy during COVID-19 pandemic crisis: A case report
Published in Physiotherapy Theory and Practice, 2022
The patient performed muscle energy techniques in a sitting position for the correction of posterior innominate (Stephenson and O’Connor, 2000). The patient did not report aggravation of symptoms while performing the technique. She reported a reduction in pain at the left SI joint while performing sit-to-stand activity after a session of muscle energy technique. To further facilitate the force closure of the SI joint, stabilization exercises were taught to the patient. The prescribed exercises focused on the activation of both local and global muscles such as transverse abdominis, pelvic floor muscles, diaphragm, multifidus, hip abductors and hip extensors. The stabilizing exercises develop strength and endurance in these muscles to manage the physical demands of the patient’s daily activities (Stuge, 2012). A previous systematic review reported that functional stabilization could be obtained through the synchronization of both local and global muscles to achieve efficient motor control (Stuge, Lærum, Kirkesola, and Vøllestad, 2004).
The reliability of palpatory examinations for pelvic landmarks to determine pelvic asymmetry: a systematic review and meta-analysis
Published in Physical Therapy Reviews, 2022
Koya Mine, Kenta Ono, Nobuhito Tanpo
Traditionally, palpatory examinations for pelvic bony landmarks to determine pelvic asymmetry have been often taught and used by various health professions, such as osteopaths, chiropractors and physiotherapists [3–6]. Pelvic asymmetry has been described in a variety of terms, such as anterior rotation of ilium or sacral torsion [7, 8]. The bony landmarks to be palpated typically include anterior superior iliac spine (ASIS), posterior superior iliac spine (PSIS), inferior lateral angle (ILA) and sacral sulcus (SS). Some health professionals believe that the existence of pelvic asymmetry can contribute to pain disorders and physical impairments, and thus should be corrected by the use of specific manual techniques, such as joint manipulation or muscle energy technique [7, 9]. To the best of the authors’ knowledge, however, the validity of the concept of ‘pelvic malalignment’ as a contributing factor to pain disorders has not been established.
Efficacy of proprioceptive neuromuscular facilitation compared to other stretching modalities in range of motion gain in young healthy adults: A systematic review
Published in Physiotherapy Theory and Practice, 2019
Débora Wanderley, Andrea Lemos, Eduarda Moretti, Manuella Moraes Monteiro Barbosa Barros, Marcelo Moraes Valença, Daniella Araújo de Oliveira
For this reason, some studies (Azevedo, Melo, Corrêa, and Chalmers, 2011; Alcântara, Firmino, and Lage, 2010; Beltrão, Ritti-Dias, Pitangui, and De Araújo, 2014; Bonnar, Deivert, and Gould, 2004; Morcelli, Oliveira, and Navega, 2013) have tried to elucidate the efficacy of different modalities for muscle stretching exercises on ROM gain. The most mentioned techniques are: static and ballistic stretching (Decoster, Cleland, Altieri, and Russell, 2005; Khodayari and Dehghani, 2012; Puentedura et al, 2011; Zakaria, Melam, and Buragadda, 2012); kinesiostretching (Mallmann et al, 2011; Moesch et al, 2014); proprioceptive neuromuscular facilitation (PNF) (Khodayari and Dehghani, 2012; Puentedura et al, 2011; Zakaria, Melam, and Buragadda, 2012); and muscle energy technique (Alcântara, Firmino, and Lage, 2010). Despite the wide variety of stretching, many studies (Fasen et al, 2009; Funk et al, 2003; Khodayari and Dehghani, 2012; Puentedura et al, 2011; Schuback, Hooper, and Salisbury, 2004; Sharman, Cresswell, and Riek, 2006; Wallin, Ekblom, Grahn, and Nordenborg, 1985) suggest that PNF is more effective on the gain of ROM than other modalities (Sharman, Cresswell, and Riek, 2006).