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NAGS involves a mid to end-range facet joint mobilisation applied anterocranially along the plane of treatment within the desired joint, combined with a small amount of manual traction. The purpose of this treatment is to increase movement within the spine, and decrease symptomatic pain.
PPIVM assessments test the movement available at a specific spinal level through the application of a passive physiological movement. [ 1 ] [ 2 ] Cervical PPIVMs can be performed in cervical lateral flexion or rotation, with the therapist restricting movement beyond a certain cervical level by blocking with the hand; this allows the ...
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
For example, the facet joint between T1 and T2 is innervated by C8 and T1 medial branch nerves. Facet joint between L1 and L2; the T12 and L1 medial branch nerves. However, the L5 and S1 facet joint is innervated by the L4 medial branch nerve and the L5 dorsal ramus. In this case, there is no L5 medial branch to innervate the facet joint.
Facet joints also prevent each vertebra from slipping over the one below. A small capsule surrounds each facet joint providing a nourishing lubricant for the joint. Also, each joint has a rich supply of tiny nerve fibers that provide a painful stimulus when the joint is injured or irritated. Inflamed facets can cause a powerful muscle spasm.
Joint mobilization using muscle force: Use muscle contraction to restore range of motion in a joint. Oculocephalogyric reflex: Treat cervical/truncal muscles by using extraocular muscle contraction. Respiratory assistance: Use the patient's voluntary respiratory motions to treat a somatic dysfunction.
Many definitions of joint manipulation have been proposed. [1] The most rigorous definition, based on available empirical research is that of Evans and Lucas: [2] "Separation (gapping) of opposing articular surfaces of a synovial joint, caused by a force applied perpendicularly to those articular surfaces, that results in cavitation within the synovial fluid of that joint."
There are many grading systems for degeneration of intervertebral discs and facet joints in the cervical and lumbar vertebrae, of which the following radiographic systems can be recommended in terms of interobserver reliability: [1] Kellgren grading of cervical disc degeneration; Kellgren grading of cervical facet joint degeneration