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DISEASE EVAL MANUAL TX EXERCISE

Idiopathic Scoliosis Postural eval, <20 deg PT, 20-40 Elongation -Monkey
Forward bend test deg (PT + bracing), bar hang
(check for hump), >40-50 deg 30 ecs)
cobb angle (surgery) Step down with one
measurement arm reach, klapp’s
Manipulation exercise
(rotation), grade 1 (https://www.youtub
or 2 manip, prayer e.com/watch?v=C4
stretch with lateral msAilfjw0)
shift, METs for (for S curves, treat
concave side, pain the major curve
mx first)

Functional Scoliosis Postural eval, <20 deg PT, 20-40 (+) LLD treat first,
ROM, mmt, LLD, deg (PT + bracing), Flexion maneuver
march test, cobb >40-50 deg for the thorax (pt
angle measurement (surgery) who lose thoracic
kyphosis & lumbar
Manipulation lordosis)
(rotation), METs for Prayer stretch- 30
concave side, secs
prayer stretch with
lateral shift,

Adult Degenerative Postural eval, SLR, Grade 1&2 mob, Reaching overhead
Scoliosis mmt, ROM, DTR, METs for concave (higher on concave,
cobb angle shoulder level on
measurement convex) 30 secs

Cervicogenic PAIVMs, PPVIMs, Manual distraction, C1-C2 SNAG, short

Headache Upper segmental Cervical suboccipital muscle
mobility testing, manipulation or stretch, scalene
cervical flexion mobilization muscle stretch
rotation test,
vertebrobasilar
instab testing,
Sharp purser

Cervical Vertebrobasilar Manual distraction, Chin tucks,

Spondylosis instab testing, Thoracic Isometrics
manipulation,
isometrics, cervical
manip or mob
Cervical Vertebrobasilar Thoracic/cervical Isometrics, Neck
Spondylolysis instab testing, manip or mob and shoulder girdle
Spurling’s test, endurance
cervical distraction exercises
test, ULTTs

Cervical Cervical ROM Distraction sometrics

Degenerative Disc PAIVMs, PIVMs SNAGs Cervical herni…
Disease Spurlings Thoracic mob
ULTT DNF strengthening
https://www.ncbi.nl Lhermitte’s Sign (chin tucks,
m.nih.gov/books/N Distraction biofeedback
BK560772/ Shoulder abduction training)
test
Ext bias DTR Neck mm stretchin
PA (focus on neck
and shoulders; will
have decreased
cervical lordosis)

Cervical Disc Cervical ROM Distraction Isometrics

Herniation PAIVMs, PIVMs SNAGs Cervical herni…
Spurlings Thoracic mob
Ext bias ULTT DNF strengthening
Lhermitte’s Sign (chin tucks,
Neck pain with Distraction biofeedback
radiating pain (CPG Shoulder abduction training)
#4) test
DTR Neck mm stretching
PA (focus on neck
and shoulders)

Thoracic Outlet First rib First rib manip scalene stretch

Syndrome Adsons
Roos Pec Minor stretch
ULTT
MMT Strengthen lev
PA (focus on neck scap, SCM and
and shoulders) traps (e.g. rowing)

Nerve mob

Endurance training
for posture

Tietze Syndrome Pain Assessment Rib manipulation to Pectoralis major

(Costocondritis) - (PQRST) usually at improve inspiration manual stretch
skim through this the 2nd and 3rd rib, and expiration (Figure 17.30)
research aching, localized at (Week 4 & 5) - TheraEx Kisner
(https://www.resear the anterior chest Thoracolumbar 6th edition
chgate.net/publicati wall and radiating pdf file*
on/272654627_Tiet to the back Pectoralis major
ze%27s_Syndrome (ipsilateral), page Pistol Thrust to self-stretch
_in_the_emergency 513 chapter 8 of Increase Thoracic (preferably for
_department_A_rar Magee for site of Spine Mobility* V-position for
e_etiology_of_atrau referred pain for (Fig. 16.24 - Kisner) sternal portion
matic_chest_pain) Costochondritis- stretch)
SUBJECTIVE Cross-Arm Thrust (Figure 17.31)
to Increase TheraEx Kisner
Palpation Thoracic Spine 6th edition
(Anterior Chest Mobility*
Wall - usually at (Fig. 16.25 - Kisner) Pectoralis minor
the 2nd and 3rd manual stretch
Costocartilage for Fall Thrust to (Figure 17.33)
TS) = (+) swelling Increase Thoracic TheraEx Kisner
at the 2nd and 3rd Spine Mobility* 6th edition
rib - firm, tender, (Fig. 16.26 - Kisner)
spontaneous, (-) Increase Thoracic
discoloration Extension
PROM & AROM - Self-stretching
limited ROM of (Figure 16.2)
ribs (chest TheraEx Kisner
expansion - 6th edition
figure 8-27 of
Magee), (+)
pectoralis major
and minor
tightness (Figure
5-138) of Magee
- OBJECTIVE

Neck Sprain Cervical Screening To increase general Neck rotation,

- AROM, PROM, facet mobility of C7 flexion and
etc. on T1 (easiest to do extension -
and VERY effective maintain neck
Cranial Cervical in relieving neck flexibility!
Flexion Test pain) - (WEEK 3 -
Synchronous Isometric
Cranial Cervical Cervical Part 2 pdf strengthening,
Endurance Test file) sitting, neutral
position
Cervical
mobilization (Upper, See this link:
Mid, or Lower) - https://www.rickysin
depending on the ghmd.com/wp-cont
specific level given ent/themes/ypo-the
 (WEEK 3 - me/pdf/neck-strain.
Synchronous pdf
Cervical Part 2 pdf
file)

Neck Strain Cervical Screening To increase general Neck rotation,

- AROM, PROM, facet mobility of C7 flexion and
etc. on T1 (easiest to do extension -
and VERY effective maintain neck
Cranial Cervical in relieving neck flexibility!
Flexion Test pain) - (WEEK 3 -
Synchronous Isometric
Cranial Cervical Cervical Part 2 pdf strengthening,
Endurance Test file) sitting, neutral
position
Cervical
mobilization (Upper, See this link:
Mid, or Lower) - https://www.rickysin
depending on the ghmd.com/wp-cont
specific level given ent/themes/ypo-the
(WEEK 3 - me/pdf/neck-strain.
Synchronous pdf
Cervical Part 2 pdf
file)

Cervical Facet - PAIVM - C1-C2 self - biofeedback

Syndrome - PPIVM sustained glide stabilizer device
(neck pain c HA) - upper segment (Self-SNAG) (exercise)
Unilateral neck pain (cervical) mobility - cervical manip -
pt’s most severe testing and mobilization
HA experienced - ROM

Cervical - inclinometer ROM - thoracic manip - neck stretching

Torticollis - determine passive - geste antagoniste (SCM & scalene)
(neck pain c mob intervertebral mob - - biofeedback
deficits) - cervical flexion stabilizer device
rotation test (exercise)
- neck rotation
(rotate and hold for
15-30 sec with 2-4
reps)
- neck lateral
flexion (15-30 sec)
- lateral flexion
 self-strengthening
(6s x 8-12 reps)

RA, atlas -Cranial cervical - Thoracic Mob - biofeedback

subluxation flexion test - stabilizer device
(neck pain c - Cervical flexion (exercise)
coordination endurance test - cervical isoms
impairment) - algometric (15.58)
assessment - periscapular
- palpation (MF strengthening
trigger point & - basic stabilizaion
tenderness) c limb loading
- sharp purser test (16.44-16.45)
- shear test - cervical flexion
- Alar ligament (16.59)
(Kaltenborn) test -figures 17.46 and
- Tectorial 17.47
Membrane test - unstable surfaces
16.46

Thoracic Co Physical Positional traction (Extension bias)

mpression Fracture examination by placing a towel - Spinal stab
(+) pain upon at the middle back ex.
palpation How to Tracti… - Scapular
(+) spasms on stab ex.
vertebral mm Fall thrust - Stretch
Ataya parehas (+) warm and techniques to antagonist
raman ni silang 3 swollen on increase thoracic mm.
ka condition HAHA vertebral area spine mobility - Sho
-kim Kyphosis Ass… (secretong ulder
malupet kamo na hor.
- ROM thoracic pangita asa ni sya add,
(passive and dapit) int
active) rot,
(+) decrease - Hip
ROM/stiffness flexo
rs,
int
Posteroanterior rot.
central vertebral - Reference:K
pressure (PACVP) isner
page:469
Posteroanterior
unilateral vertebral
pressure (PAUVP)

Transverse
vertebral pressure
 Fireman’s
technique
(+) test relieves
symptoms
Thoracic tract…

Reference:

Magee(5th ed)
Chapter 8 page 502
Thoracic tract…

Thoracic Exa…

Thoracic Physical Positional traction (Extension bias)

Osteoporosis examination by placing a towel - Wall/floor
(+) pain upon at the middle back angels
Ataya parehas palpation How to Tracti… - Y lifts
raman ni silang 3 (+) spasms on - Prone
ka condition HAHA vertebral mm overhead
-kim (+) warm and Fall thrust press
swollen on techniques to - Thora…
vertebral area increase thoracic
Thoracic Exa… spine mobility
(secretong
malupet kamo na
ROM thoracic pangita asa ni sya
(passive and dapit)
active)
(+) decrease
ROM/stiffness

MMT on thoracic
and scapular mm

Posteroanterior
central vertebral
pressure (PACVP)

Posteroanterior
unilateral vertebral
pressure (PAUVP)

Transverse
vertebral pressure

Fireman’s
 technique
(+) test relieves
symptoms
Thoracic tract…

Reference:
Magee(5th ed)
Chapter 8 page 502
Kyphosis Ass…

Thoracic Kyphosis Physical Positional traction (Extension bias)

examination by placing a towel - Thoracic
Ataya parehas (+) pain upon at the middle back extension
raman ni silang 3 palpation How to Tracti… mobilization
ka condition HAHA (+) spasms on c foam roller
-kim vertebral mm - Dynamic
(+) warm and Fall thrust thoracic
swollen on techniques to mobilization
vertebral area increase thoracic extension c
Kyphosis Ass… spine mobility therapy ball
(secretong - Angel
ROM thoracic malupet kamo na exercise c
(passive and pangita asa ni sya foam roller
active) dapit) - Ext. rot,
(+) decrease scapular
ROM/stiffness retraction,
along with
MMT on thoracic chin tucks c
and scapular mm a resistance
tube
Posteroanterior - Reference:
central vertebral - Thora…
pressure (PACVP)

Posteroanterior
unilateral vertebral
pressure (PAUVP)

Transverse
vertebral pressure

Fireman’s
technique
(+) test relieves
symptoms
Thoracic tract…

Reference:
 Magee(5th ed)
Chapter 8 page 502

Thoracic Exa…

Lumbar Step off sign - Flexion Bias Williams Flexion

Spondylolisthesis Palpation of the Approach exercises
lumbar vertebrae
https://www.physio- reveals a slippage, Gentle Stabilization
pedia.com/Spondyl May be tender due manipulation (grade exercises,
olisthesis to traumatic origin 1 and 2) for pain segmental and
modulation. AVOID global stabilization
Kisner HVT will
Lumbar Rom - exacerbate Stretch Hip Flexors,
Flexion and symptoms Hip Extensors
Extension LOM
Endurance training
Pain in Lumbar of muscles,
extension ( pain effective for chronic
with single-limb low back pain
standing lumbar
extension. This Movement in
maneuver is usually closed kinetic,
painful on the antilordotic
affected side ) movement patterns
of the spine, elastic
Positive SLR test band exercises in
the lying position
Scotty dog collar

ROM
MMT
DTR
Myotomes
Dermatomes

LBP

Degenerative ^^ ^^ ^^
Spondylolisthesis Still looking for Stop looking na eh Goodnight bro
sources May malapit pero untag maka kita
naghahanap ka pa kag mga sources
rin ng iba ( KINSA sa degenerative
ANI ASA MANANG spondyshitesis
DUOL DIBA WALA hahahaha
 NIEXIT JKJK ) -mykel

HAHAHAHA

Lumbar Stenosis Shopping cart sign Flexion Bias Williams Flexion

- leaning forward Approach - widens exercises
relieves pressure, the IV foramina.
lumbar extension Extension causes Stabilization
causes back pain pain due to exercises,
foraminal opening segmental and
dysfunction, bone global stabilization
spurs lipping. DO
NOT DO IF IF Patient education -
SYMPTOMS Move within pain
PERIPHERALIZED free ranges and
maintain ADLs that
May present bowel Gentle intermittent do not exacerbate
or bladder joint distraction and the symptoms.
dysfunction, saddle joint gliding. ( Avoid
anesthesia, Grade 1 and 2 ) If a Hyperextension
bilateral lower patient has no
extremity weakness signs of acute joint
and also cauda inflammation but
equina. does not have sign
of nerve root
Pain is relieved by irritation a stronger
forward flexion and traction force may
rest be beneficial to
cause opening of
ROM the IV foramina,
MMT which helps relieve
DTR the pressure.
Myotome
Dermatome Traction - widen the
IV foramina.
LBP Positioning the
spine in flexion
prior to the
application of
traction provides
the increased
space.

Positional traction,
in which the patient
is placed in
side bending away
from the side of
pain and
rotation toward the
 pain, may also be
beneficial to
increase the
diameter of the
lateral foramen.

Sacroiliac Joint Palpation: Look at • To increase Shotgun Technique

Dysfunction alignment, position forward rotation
of the iliac crests, (OGI) ME technique of
PSIS, ASIS o Prone. Stabilize the gluteus
the sacrum with maximus to correct
SI Joint special test one hand, with an anteriorly
clusters: Thigh fingers pointed rotated innominate
thrust, sacral thrust, caudally bone.
SI compression, SI o The to other hand
distraction applies an anterior ME technique of
and lateral force, the rectus femoris
parallel to the joint to correct a
(For surface posteriorly rotated
Anterior/Posterior innominate bone.
Innominate)Supine • To increase
to Long sit test (to backward rotation
check for apparent (OGI)
leg length) o Prone. Stabilize
• Do a DKTC, then the sacrum with
bridging while one hand, with
grasping both fingers pointed
ankles (this will cranially
clear tight o The to other hand
structures and applies a posterior,
allow better medial force,
movement) parallel to the joint
surface
Additional Special **Alternate position:
Tests: Gaenslen’s sidelying
Test & FABER
SIJ Manipulation to
Postural Analysis: increase nutation
● Anterior and counternutation
rotation:
PSIS higher For Upslip involved
and ASIS LE in close pack
lower on either prone or
involved supine apply
side HVLAT
● Posterior
rotation:
 PSIS lower
and ASIS
higher on
involved
side
● Upsliip: all
landmarks
higher on
the affect
side

Forward Bend Test

Gillet (March Test)

Low Back Sprains Prone Instability Grade 1 & 2 Non Trunk Muscle
Test (?) thrust oscillation Activation (Drawing
PAIVM (?) technique In Maneuver &
ROM Abdominal Bracing)

Low Back Strains MMT Grade 1 & 2 Non Trunk Muscle

ROM thrust oscillation Activation (Drawing
technique In Maneuver &
Abdominal Bracing)

Mild stretching:
Single Knee and
double knee to
chest x 10 SH x 5
reps

Lumbar - Directional - Lumbar - TRa

Degenerative Disc preference Traction Activation
Disease testing - Multifidus
- DTR activation
- Myotome - Stretching
- Dermatome (Single and
- ROM double
- MMT KTC)
- Straight leg
raise test

Lumbar Disc - Directional - Mckenzie

Herniation preference (directional
testing approach)
- Lasègue’s - Motor
Test control
- MMT exercises
 - Straight leg (ex. glute
raise test bridge,
- DTR plank with
- Myotome arm lift)
- Dermatome - Sciatic
- ROM nerve
flossing

Lumbar - Palpation - Mckenzie

Spondylosis - DTR exercises
- Myotome
- Dermatome - Same2
- ROM treatment
- MMT rani sila sa
disc
herniation

MPS -postural analysis -MET on muscle -stretching and

(may be -trigger points (pain with trigger points strengthening
perpetuated by on compression; -cross friction according to
scoliosis, LLD and snapping palpation massage muscle with trigger
other mechanical elicits twitch point
factors so also use response) -if accompanying
other assessments -ROM (there is tension HA:
and tx according to restricted range of >cervical manip
the case) stretch) (PAINFUL) >SNAG
-MMT (muscle with >thoracic manip
trigger point may be >DNF biofeedback
weak but no
atrophy)
-(+) jump sign

-can accompany
tension headaches
so assessment of
neckpain with HA:
>PAIVM
>PPVIM
>Cervical flexion
rotation test

Decreased Cervical -look if na affected -↑ craniocervical -SNAG

Lordosis and cerebral artery extension -rhomboid stretch
(Could be from disc >vertebrobasilar -↑ lower cervical
degeneration, insufficiency (head flexion
spondylosis, flat hang, thinker test) -thoracic manip
upper back and -trigger points
neck posture -postural analysis
(military posture), -ROM (look for
etc) stretch and tight
weakness)
>tight: anterior neck
muscles
>stretch: posterior
neck muscles
-ligament testing
since ligaments
hold the cervical
vertebrae in place:
>sharp purser
>alar ligament test
>tectorial
membrane test

Increased Cervical -postural analysis -thoracic manip -DNF strengthening

Lordosis (forward head) -cervical manip -rhomboid, lower
(neck pain with -ROM (pt >↑ craniocervical trap, serratus
mobility deficits) commonly have flexion (dont do anterior
stiffness) craniocervical strengthening
>tight: posterior extension since -pec and SCM
neck muscles extension na daan) stretch
>stretch: anterior -↑ lower cervical -upper trap and lev
neck muscles extension scap stretch
-cranial cervical -chin tucks
flexion test
-cervical flexion
endurance test
-MMT
-trigger points