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Lab Demo Paper

This document discusses the history and development of manual therapy in physical therapy practice in the United States. It highlights three main contributors - Stanley Paris, Freddy Kaltenborn, and Geoffrey Maitland - who helped introduce and advance the use of mobilizations and manipulations. The document then describes a specific thoracic spinal manipulation technique called the thoracic segmental anterior glide high velocity thrust that can help address mobility restrictions, pain, and tightness in the thoracic region.

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115 views

Lab Demo Paper

This document discusses the history and development of manual therapy in physical therapy practice in the United States. It highlights three main contributors - Stanley Paris, Freddy Kaltenborn, and Geoffrey Maitland - who helped introduce and advance the use of mobilizations and manipulations. The document then describes a specific thoracic spinal manipulation technique called the thoracic segmental anterior glide high velocity thrust that can help address mobility restrictions, pain, and tightness in the thoracic region.

Uploaded by

api-512380531
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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PTH 662 - Manual Therapy

Lab Demonstration Paper


Darie Kirschling
02/18/20

There were several individuals who contributed to introducing the relevance of using

mobilizations and manipulations in physical therapy practice in the United States. Stanley Paris,

Freddy Kaltenborn and Geoffrey Maitland are three main contributors. Paris immigrated to the

United States from New Zealand and mainstreamed the use of manual therapy by teaching fellow

physical therapists his manual techniques he learned in New Zealand. Kaltenborn contributed to

the development of manual therapy in the United States by discussing the importance of

considering arthrokinematics when performing joint manipulations. Maitland introduced oscillatory

mobilizations to treat painful joints within the body. Each of these individuals plus many others

progressed the understanding of manual therapy, which eventually led to the development of the

American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) in 1991.

The manual technique I chose to demonstrate is called the thoracic segmental anterior

glide high velocity thrust with “pistol grip” hand positioning. This is an osteopathic manual therapy

technique that results in manipulation of the thoracic spine. Patients with segmental mobility

restrictions, pain due to tightness in thoracic spine, and muscular tightness in the thoracic region

would benefit from this technique. The patient begins in supine with their hands clasped behind

their neck and their elbows protruding anteriorly from their chest region. Standing to the side of

the patient, the physical therapist gently rolls the patient towards them to palpate the vertebral

segments and thoracic musculature for mobility restrictions. Once the physical therapist finds a

mobility restriction they place their third middle phalanx and their thenar eminence on the inferior

transverse processes with the patients spinous processes in between. The physical therapist will

then flex the patient down to the level they are manipulating, have the patient take a deep breath,

and upon exhalation the physical therapist will apply a high velocity, low amplitude thrust
posteriorly through the patients humeri using the therapists own hands/chest. This technique will

likely manipulate bilateral facet joints and can be continued down the spine until all mobility

restrictions are treated. If the physical therapist wants to treat one facet joint they will flex the

patient down to the level they want to manipulate, side bend the patient away and rotate them

towards the side the therapist wants to manipulate. If this technique doesn’t relieve pain and

improve mobility restrictions then it is important to try different techniques in order to figure out

what works best for the patient.

References

Wise C, Beattie P, Carp S, Dommerholt J, et al. Orthopaedic Manual Physical Therapy.


Philadelphia, PA: F.A. Davis Company; 2015. 8-14; 794-795.

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