Manual Therapy: Knee: Difference between revisions
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== Indication<br> == | == Indication<br> == | ||
Indications for the use of manual therapy in the lower extremity, characterized by various definitions such as joint dysfunction, subluxation, or as a result of a clinical prediction rule , include (1) diagnosis of a painful neuromusculoskeletal joint disorder, (2) pain in or from palpation of bony joint surfaces, (3) pain in of from palpation of joint soft tissues, (4) decreased or altered range of quality of motion, and (5) pain on stressing and/or overstressing/provoking (in any or all planes) a joint. <ref name="jam">James W. brantighal et al., Manipulative therapy for lower extremity conditions: Expansion of literature review, National University of Health sciences 2009, 53-71 (Level of evidence: 2A)</ref> | |||
When there is pain in combination with joint restriction, it is recommended to apply manual therapy together with exercise therapy. (Grade of recommendation: B) In international multidisciplinary guidelines Manual therapy is not mentioned or classified by exercise therapy. In the Netherlands it is the habit to use exercise therapy in combination with manual therapy. There is a consensus that manual therapy can be considered as a preparation for exercise therapy, in cases of pain and limitations in movement of a joint.<br>In knee osteoarthritis, anterior-posterior mobilizations of the tibia-femoral joint and the patella can be performed but exercises for the stretching of the muscles can also be considered. <ref name="pet">Peter WF et al.,’ Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.’ Acta Reumatol Port 2011, 268-281 (Level of evidence: 1A )</ref><br> | |||
== Clinical Presentation == | == Clinical Presentation == | ||
Revision as of 21:40, 20 December 2012
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Databases Searched:
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Keyword Searches: ”Manual Therapy”, “manual therapy (knee), treatment”, “Physical therapy techniques” and “knee (joint)” or “lower extremity”, “manual therapy: knee osteoarthritis”, “Treatment osteoarthritis knee”
Search Timeline: October, 2012 - November 30, 2012
Description[edit | edit source]
The primary goals of manual therapy of the knee are:
•Modulate pain
•Increase range of motion
•Reduce or eliminate soft-tissue inflammation
•Improve contractile & non-contractile tissue repair, extensibility, or stability
•Facilitate movement [1] [2] [3]
Manual therapy is defined as the application of manual forces of the therapist, to change/improve the quality and the range of motion of joints and soft tissues. [1]
It includes many techniques. The most common are joint mobilization and manipulation. Mobilization is a manual technique with the aid of repeated passive motion at low speed and with varying amplitudes, while manipulation is defined as fast with a small force, small amplitude and high speed of movement of a joint. [3]
Manual therapy believes in the improvement of the joint function and movement chain by a combination of mechanical and neuromuscular mechanisms. In particular, some techniques are aiming at increasing the extensibility of collagen, optimizing the joint lubrication and to reduce the muscle tone which results in an improved joint function and joint mobility.[2]
The techniques used for the knee region are classified into clusters. For each cluster the goals are described in the context of methodological and systematic actions. [4]
Indication
[edit | edit source]
Indications for the use of manual therapy in the lower extremity, characterized by various definitions such as joint dysfunction, subluxation, or as a result of a clinical prediction rule , include (1) diagnosis of a painful neuromusculoskeletal joint disorder, (2) pain in or from palpation of bony joint surfaces, (3) pain in of from palpation of joint soft tissues, (4) decreased or altered range of quality of motion, and (5) pain on stressing and/or overstressing/provoking (in any or all planes) a joint. [5]
When there is pain in combination with joint restriction, it is recommended to apply manual therapy together with exercise therapy. (Grade of recommendation: B) In international multidisciplinary guidelines Manual therapy is not mentioned or classified by exercise therapy. In the Netherlands it is the habit to use exercise therapy in combination with manual therapy. There is a consensus that manual therapy can be considered as a preparation for exercise therapy, in cases of pain and limitations in movement of a joint.
In knee osteoarthritis, anterior-posterior mobilizations of the tibia-femoral joint and the patella can be performed but exercises for the stretching of the muscles can also be considered. [6]
Clinical Presentation[edit | edit source]
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- ↑ 1.0 1.1 J Haxby Abbott et Al., ’Exercise therapy, manual therapy, or both, for osteoarthritis of the hip or knee: a factorial randomized controlled trial protocol’, trial journal, February 2009 (Level of evidence: 1B )
- ↑ 2.0 2.1 Michael A. Hunt et al., ‘Effect of Anterior Tibiofemoral Glides on Knee Extension during Gait in Patients with Decreased Range of Motion after Anterior Cruciate Ligament Reconstruction’, Physiother Can. 2012, 235-241 (Level of evidence: 1B)
- ↑ 3.0 3.1 Carolyn J. et al, ‘Physiotherapy management of knee osteoarthritis.’, International Journal of Rheumatic Disease 2011, 145-151 (Level of evidence: 1A)
- ↑ Book: Medical Library VUB Jette. D.L. Egmond, R.Schuitemaker , Extremiteiten: Manuele therapie in enge en ruime zin, Houten : Bohn Stafleu Van Loghum, 2006, p. 559-630
- ↑ James W. brantighal et al., Manipulative therapy for lower extremity conditions: Expansion of literature review, National University of Health sciences 2009, 53-71 (Level of evidence: 2A)
- ↑ Peter WF et al.,’ Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.’ Acta Reumatol Port 2011, 268-281 (Level of evidence: 1A )
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