THER3020 midterm major points

what is the preferred positioning for a client with CCHF

semi seated

what positions should be avoided with CCHF

prone, left side-lying, placing limbs above heart

what are the indications for massage with CCHF

MD approval; relaxation & stress reduction; treat HNS and limbs, avoid cardiovascular strain

what treatment mods are used with CCHF

short segmental strokes, treat extremities and HNS, avoid trunk, monitor tolerance

what is C/I’d with CCHF

full body lymph drainage, vigorous tapotement, prolonged deep painful work, prolonged neck rotation, excessive heat near heart

what is the preferred positioning for chronic bronchitis

semi seated, side lying on unaffected side

what positioning is generally avoided with chronic bronchitis

full prone / supine

what are the indications for treatment with chronic bronchitis

mobilize secretions, improve ventilation, reduce accessory muscle tension

what techniques may be indicated for chronic bronchitis

DDB, postural drainage & tapotement, huffing, productive cough, segmental breathing

what hydrotherapy is appropriate for chronic bronchitis

facial steam, heat before fascial work

what treatment approaches should be avoided with chronic bronchitis

exhausting, vigorous, or prolonged painful treatment

what is a major precaution before postural drainage

ask when client last ate

what is the preferred positioning for emphysema

semi seated, supported side lying

indications for massage with emphysema

relaxation, reduce SOB, improve thoracic mobility, reduce respiratory muscle tension

what techniques are commonly indicated with emphysema

DDB, fascial work to respiratory muscles, TrP therapy, pursed lip breathing

what techniques are contraindicated with emphysema

prolonged painful treatment, full prone / supine positioning, aggressive joint play, heat applications

what are the indications for massage with cancer

relaxation, stress reduction, scar management, maintain ROM and joint health

what breathing technique is commonly integrated with cancer treatment

DDB

C/I’s with cancer treatment

tumor → X deep tissue techniques

untreated neoplasm → X lymph drainage

lymphedema → X heat

what are the treatment indications for OA

reduce pain, stiffness, spasm, edema, and increase ROM

what hydrotherapy is indicated for chronic OA

deep moist heat before stretch / mobilization

what hydro is indicated during acute inflammatory OA flare-ups

cold applications

positioning considerations with OA

position for comfort, support painful joints

what tissues should commonly be addressed in OA treatment

contracted muscles, fascia, periarticular tissues, affected joints

what are the indications for DDB

stress, pain, respiratory conditions / muscle imbalances

side effect of DDB

hyperventilation

risk of DDB

hyperventilation

C/I to DDB

severe CV/pulmonary disease, lymphatic insufficiency, long-term diabetes, severe kidney disease

indications for lymphatic drainage

edema, post-surgical swelling, scar tissue, post-lymph node removal

what is the complete cardiovascular contraindication to lymph drainage

chronic congestive heart failure

side effect of lymph drainage

increased urine output, lightheadedness w/BP changes

risks of lymphatic drainage

fainting, significant BP changes

indications for cold hydro

acute injury, inflammation, edema, pain, spasm, post-friction work

side effect of cold hydro

cold → burning → aching → numbness (desired effect)

risks with cold hydro

frostbite

side effect of fascial work

burning / itching sensation, redness, mild discomfort

risk of fascial techniques

bruising

C/I direct fascial techniques

acute injury, painful conditions, anticoagulants, hemophilia, hypotonic tissue

what C/I’s indirect fascial techs

acute inflammation, undiagnosed lumps, recent head trauma / neurosurgery

cross fiber frictions indications

chronic adhesions, late sub/chronic collagen remodeling

side effect of cross fiber frictions

discomfort during treatment

risk of cross fiber frictions

bruising

C/I cross fiber frictions

acute injury, RA, infective arthritis, PVD, anticoagulants, steroids, peripheral nerves

what are the indications for traction

decrease tone, assess restrictions, Improve succussive action, prepare for mobilizations

what conditions contraindicate traction

acute injury, hypermobility, RA, ruptured ligaments, fractures, nerve lesions

how is huffing performed

client takes a slow breath in then exhales forcefully through an open mouth as if fogging a mirror (“haaa”) → repeat 1-2x before returning to normal breathing

what is the purpose of huffing

to move mucus from smaller airways into larger airways with less airway collapse and less fatigue than coughing

when is huffing more appropriate than productive coughing

when secretions are deeper in the lungs, when the client fatigues easily, when repeated coughing causes bronchospasm

how is a productive cough performed

client performs DDB → takes a deep breath → calls forcefully from the diaphragm to expectorate mucus

what is the key difference between huffing and productive coughing

huffing mobilizes mucus, productive coughing removes mucus

treatment indications for joint play

pain free joint stiffness, capsular restriction, decrease accessory motion, reduced range of motion

when should joint play be performed during treatment

after tissue warming and relaxation, before stretching a range of motion

contraindications for joint play

hypermobility, acute injury, instability, RA, severe inflammation

risks of joint play

hypermobility, increased joint damage

indications for passive range of motion

joint stiffness, decreased mobility, pain limiting active movement, maintenance of joint nutrition and range of motion

one is pursed lip breathing most appropriate

emphysema, COPD, dyspnea, during DDB when the goal is to improve expiration and decrease airway collapse

when is huffing most appropriate

chronic bronchitis, excessive mucus production, after postural drainage

What are the stages of DDD

Dysfunction (annular tearing, spasm, irritation) → Instability (capsular laxity, hypermobility) → Stabilization (osteophytes, ↓ ROM, stenosis)

What are the treatment indications for DDD?

Decrease pain, spasm, fascial restrictions, and TrPs; improve mobility with heat, joint mobs (if appropriate), stretching, PROM/AROM, and strengthening

What is appropriate positioning for DDD

Position for comfort and symptom reduction. Use supportive pillows as needed

appropriate hydro for degenerative disc disease

Apply heat to the affected area before treatment to reduce pain and spasm and prepare tissues for mobilization