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Clinical Pearl Details
June 2012
Brian Macks, PT, OCS, COMT, FAAOMPT -
| Overview: |
Adapted from the North American Institute of
Orthopedic Manual Therapy OMPT curriculum Level II Upper as instructed
by Kathy Berglund and as originated by Erl Pettman. |
| Technique: |
Assess the passive accessory motion of the OA joint in the Cranio-Vertebral detailed biomechanical exam. |
| Indication: |
A determination has been made that the OA joint is
restricted for left rotation. The ipsilateral flexion or contralateral
extension of the OA joint need joint glides assessment. |
| Procedure: |
The following assumes a loss of left rotation. It
has been previously determined whether ipsilateral flexion or
contralateral extension of the OA joint is at fault.
To check left OA flexion, have the patient sit in a chair. The physical
therapist should stand on the left side of the patient. Hold the head
with your left hand and take the left OA to full flexion barrier. The
right hand should hold C1 with a wide pinch grip along the lateral
masses. The right hand should rotate C1 to the right by pushing the
left transverse process anterior and superior.(Figure 1)
To check right OA extension, have the patient sit in a chair. The
physical therapist should stand on the left side of the patient. Hold
the head with your left hand and take the right OA to full extension
barrier. The left hand should stabilize C1 in a wide pinch grip along
the lateral masses. The left hand pulls the right occipital condyle
anterior and inferior.(Figure 2) |
| Instruction: |
Possible questions to be answered are:
1. Is motion available?
2. What is the endfeel?
3. Is pain produced? |
Figure 1 |
Figure 2 |
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