UQ Interventions Framework

Question 1

C-spine manipulation criteria

Answer 1

• Symptoms <38 days
• Side to side rotation difference >10º
• Pain with PA spring testing mid C-spine (C3-C7)
• Positive expectation manipulation would help

Question 2

Describe the effects of a grade I-II mobilization

Answer 2

• Firing of articular mechanoreceptors & proprioceptors
• Firing of cutaneous & muscle receptors
• Altered nociception
• Synovial fluid movement

Question 3

Describe the effects of a grade III-IV mobilization

Answer 3

• Stretching of joint restrictions & adhesions
• Change positional relationships
• Diminish/eliminate barriers to normal motion

Question 4

What are the 3 categories of corrective exercise

Answer 4

• Mobility: target basic freedom movement
• Stability: targets basic motor control
• Movement pattern retraining: targets functional movement patterns utilizing both mobility & stability
• Corrective exercises are performed to provide a functional base when dysfunction, limitation, for asymmetry is noted

Question 5

What are the 2 categories of functional exercise

Answer 5

• General: exercise that complements fundamental human movement patterns
• Specific: exercises that complements specific skills or specialized activities poor athletics

Question 6

What is the progression of functional exercises

Answer 6

• Breathing
• gripping
• Head-eye tracking (Cervical)
• Limb movements
• Rolling
• Crawling
• Transitional movements
• Upright movements FE positions: non-weight bearing, quadruped, kneeling, & standing
• Supine
• Prone
• Half kneeling
• Tall kneeling
• Lunge
• Split stance
• Normal

Question 7

Describe the SFMA 4x4 Matrix

Answer 7

• Lying (prone/supine), Quadruped, kneeling, standing
• No resistance with PA (pattern assistance), No resistance, resistance with PA, resistance
• Goal is to guide you through the correction of a stability problem

Question 8

Describe Gray Cook concept of 3 R’s

Answer 8

• Reset = manual therapy techniques
• Reinforcement = protective & corrective
• Reload = corrective type exercise that changes the movement pattern for the future
• Feedback: sue of Test, Treat, Re-test

Question 9

What are the 4 resistance types of 4x4 Matrix

Answer 9

• 1) No resistance with Pattern Assist (PA)
• 2) No resistance (except gravity & body weight)
• 3) Resistance with PA
• 4) Resistance

Question 10

Where does the oblique capitis inferior/superior refer to/trigger point referral

Answer 10

• Horizontal line from back of ear to eye

Question 11

Where does sternocleidomastoid refer to/trigger post referral

Answer 11

• Posterior head on unilateral side
• C-shape from temple around to the medial eyebrow
• Top of the head, unilateral tip of chin, and unilateral area around mastoid

Question 12

Where does the upper traps refer to/trigger point referral

Answer 12

• Tip of mastoid
• Hot spot along lateral eyebrow but not at temple
• Smaller rams horn pattern

Question 13

Normal value for deep neck flexor endurance test

Answer 13

• 30 secs
• Tuck chin & lift head off table only 1 inch and hold

Question 14

What are the 3 levels of nerve compression

Answer 14

• Neuropraxia
• Axonotmesis
• Neurotmesis

Question 15

Describe neuropraxia

Answer 15

• Temporary compression
• Axon intact
• Myelin disrupted
• Conduction slows but still intact as the nerve is whole
• No Tinel’s sign

Question 16

Describe axonotmesis

Answer 16

• Axon disrupted
• Endoneurium intact & serves as a tube for the axon to re-grow
• Positive Tinel’s sign
• EMG & NCV changes
• Cause: stretch injury like humeral dislocation stretching the axillary nerve
• Expect complete recovery gif motor point its <12 inches away

Question 17

Describe neurotmesis

Answer 17

• Complete transection of the axon & the tube
• EMG & NCV changes
• Spontaneous recovery NOT possible: requires surgical repair/grafting
• Cause: traction injury, laceration injection into the nerve

Question 18

When is blood flow restricted to nerves

Answer 18

• Stretch/elongation by 10-15% takes all blood flow away
• 30mmHg externally restricts blood flow

Question 19

What do nerves need

Answer 19

• Blood flow
• Movement
• Space

Question 20

Tests for thoracic outlet syndrome

Answer 20

• Positive test for all = change in radial pulse (reduction) or complains of paresthesia
• Adson’s: shoulder ABD 15º, inhale & hold breath, C-ext. & rotation to ips side being tested
• Costoclavicular: seated with straight chest out & shoulders back
• Roos: shoulder ABD 90º+ER & 90º elbow flexion, then make a fist & open for 3 min
• Hyerabduction (Wright test): just like Adson’s but lateral flexion & rotate away contralateral to side being tested

Question 21

Describe the shoulder abduction test/sign

Answer 21

• Test for cervical radiculopathy
• Positive = relief or reduction of neural symptoms
• Implicates disc herniation or nerve root compression
• Have patient place hand on top of head and ask about changes in their symptoms