MANIPULATION THERAPY

INTRODUCTION
 The International Federation of Manual Medicine
Manipulation : “the use of the hands in the patient management process
using instructions and maneuvers to maintain maximal, painless movement
of the musculoskeletal system in postural balance.”
 Goal :
• Enhancing maximal movement
• Pain-free movement in a balanced posture
• Optimizing function

 Kisner :
Joint mobilization, also known as manipulation, refers to manual therapy
techniques that are used to modulate pain and treat joint impairments that
limit range of motion (ROM) by specifically addressing the altered
mechanics of the joint
 INDIKASI

 Gangguan muskuloskeletal yg memperlihatkan disfungsi somatik :

 Nyeri akut & kronis pd cervical
 Nyeri thoracal
 Nyeri iga
 LBP fungsional / mekanikal
 Penonjolan diskus
 Piriformis syndrome
 Sciatica
 Nyeri kepala
 Sacroiliac syndrome
 KOMPLIKASI & EFEK SAMPING
 Efek samping paling sering: adanya discomfort selama 6 – 72 jam
setelah treatment
 Komplikasi manipulasi :
- Cervical manipulation : vascular complication (vertebrobasilar
artery system), myelopathy
- Lumbosacral manipulation : cauda equina syndrome – estimation 1
in many millions.
General Contraindication For Manipulation

 Vertebral malignancy
 Infection or inflammation
 Cauda equina syndrome
 Myelopathy
 Multiple adjacent radiculopathies
 Joint instability (fracture, dislocation)
 Cervical rheumatoid disease
 Stenosis