Lumbopelvic Manipulation technique

Original Editor - Jun Cesar Atienza, PT

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Purpose

To describe and demonstrate the supine lumbopelvic manipulation technique used in the Flynn et al study in developing a clinical prediction rule for the use of this technique in low back patients.

Technique

1. Patient lies relaxed in a supine position.
2. Therapist stands on opposite of the side to be manipulated.
3. Patient’s legs are crossed over each other, opposite leg over the other.
4. The therapist faces towards the patient’s feet and stabilizes along opposite hip with elbow while side bending legs away from therapist.
5. Patient is asked to clasp fingers together and place hands behind neck.
6. The therapist then faces patient’s face and stabilizes along opposite (same as step 4) hip with elbow and places hands behind patient’s back by the shoulder blades.
7. The therapist sidebends patient’s upper body away, while simultaneously rotates towards.
8. Therapist then places opposite palmar hand along opposite ASIS to keep pelvis stabilized and locks elbow.
9. Therapist places other hand along shoulder blade and continues to rotate patient’s upper body towards to engage restrictive barrier.
10. As end-range barrier is sensed, therapist applies a high velocity low amplitude through the ASIS towards treatment table.

Illustrations

Figure 1 is taken directly from the Flynn et al study and illustrates the manipulation technique as described above.

Figure 2 is taken from the Cleland et al case report illustrating the same manipulation technique used for satisfying clinical prediction rule by Flynn et al.