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Passive Physiological Intervertebral Movements
Passive physiological intervertebral movements (PPIVM) refers to a spinal physical therapy assessment and treatment technique developed by Geoff Maitland used to assess intervertebral movement at a single joint, and to mobilise neck stiffness.Geoffrey Douglas Maitland, Elly Hengeveld, Kevin Banks, Kay English, (2005). ''Maitland's Vertebral Manipulation, Volume 1.'' Elsevier Butterworth-Heinemann. . Technique PPIVM is used as an assessment technique to assist with identifying the location, nature, severity and irritability of vertebral symptoms. They can be used to test for cervical or lumbar joint hypermobility or instability, or whether a joint is locked. PPIVM assessments test the movement available at a specific spinal level through the application of a passive physiological movement. 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 identi ...
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Physical Therapy
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion. Physical therapists are known as physiotherapists in many countries. In addition to clinical practice, other aspects of physical therapist practice include research, education, consultation, and health administration. Physical therapy is provided as a primary care treatment or alongside, or in conjunction with, other medical services. In some jurisdictions, such as the United Kingdom, physical therapists have the authority to prescribe medication. Overview Physical therapy addresses the illnesses or injuries that limit a person's abilities to move and perform functional activities in their daily lives. PTs use an individual's history and phys ...
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Cervical Spine
In tetrapods, cervical vertebrae (singular: vertebra) are the vertebrae of the neck, immediately below the skull. Truncal vertebrae (divided into thoracic and lumbar vertebrae in mammals) lie caudal (toward the tail) of cervical vertebrae. In sauropsid species, the cervical vertebrae bear cervical ribs. In lizards and saurischian dinosaurs, the cervical ribs are large; in birds, they are small and completely fused to the vertebrae. The vertebral transverse processes of mammals are homologous to the cervical ribs of other amniotes. Most mammals have seven cervical vertebrae, with the only three known exceptions being the manatee with six, the two-toed sloth with five or six, and the three-toed sloth with nine. In humans, cervical vertebrae are the smallest of the true vertebrae and can be readily distinguished from those of the thoracic or lumbar regions by the presence of a foramen (hole) in each transverse process, through which the vertebral artery, vertebral veins, and i ...
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Lumbar Spine
The lumbar vertebrae are, in human anatomy, the five vertebrae between the rib cage and the pelvis. They are the largest segments of the vertebral column and are characterized by the absence of the foramen transversarium within the transverse process (since it is only found in the cervical region) and by the absence of facets on the sides of the body (as found only in the thoracic region). They are designated L1 to L5, starting at the top. The lumbar vertebrae help support the weight of the body, and permit movement. Human anatomy General characteristics The adjacent figure depicts the general characteristics of the first through fourth lumbar vertebrae. The fifth vertebra contains certain peculiarities, which are detailed below. As with other vertebrae, each lumbar vertebra consists of a ''vertebral body'' and a ''vertebral arch''. The vertebral arch, consisting of a pair of ''pedicles'' and a pair of ''laminae'', encloses the ''vertebral foramen'' (opening) and sup ...
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Spinous Process
The spinal column, a defining synapomorphy shared by nearly all vertebrates, Hagfish are believed to have secondarily lost their spinal column is a moderately flexible series of vertebrae (singular vertebra), each constituting a characteristic irregular bone whose complex structure is composed primarily of bone, and secondarily of hyaline cartilage. They show variation in the proportion contributed by these two tissue types; such variations correlate on one hand with the cerebral/caudal rank (i.e., location within the backbone), and on the other with phylogenetic differences among the vertebrate taxa. The basic configuration of a vertebra varies, but the bone is its ''body'', with the central part of the body constituting the ''centrum''. The upper (closer to) and lower (further from), respectively, the cranium and its central nervous system surfaces of the vertebra body support attachment to the intervertebral discs. The posterior part of a vertebra forms a vertebral a ...
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Passive Accessory Intervertebral Movements
Passive accessory intervertebral movements (PAIVM) refers to a spinal physical therapy assessment and treatment technique developed by Geoff Maitland. The purpose of PAIVM is to assess the amount and quality of movement at various intervertebral levels, and to treat pain and stiffness of the cervical and lumbar spine.Geoffrey Douglas Maitland, Elly Hengeveld, Kevin Banks, Kay English, (2005). ''Maitland's Vertebral Manipulation, Volume 1.'' Elsevier Butterworth-Heinemann. . Technique During assessment, the aim of PAIVM is to reproduce patient symptoms, and assess the endfeel of cervical movement, quality of resistance, behaviour of pain throughout the range of movement, and observe any muscle spasm. A posterior to anterior force of varying strength is applied by the therapist either centrally onto the spinous process, or unilaterally on either the left or right articular pillar. As a treatment technique, pain is treated by oscillations of small amplitude short of resistance, whi ...
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Natural Apophyseal Glides
Natural apophyseal glides (NAGS) refers to a spinal physical therapy treatment technique developed by Brian Mulligan.Brian R. Mulligan (2004). ''Manual therapy: NAGS, SNAGS, MWMS etc.'' (5th Ed). Plane View Services Ltd. Technique 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. Sustained natural apophyseal glides Sustained natural apophyseal glides (SNAGS) are a separate technique involving a combination of a sustained facet glide with active motion, which is then followed by overpressure. Clinical evidence A 2010 study concluded that whilst both NAGS and SNAGS showed signs of effectiveness, SNAGS demonstrated greater statistically significant efficacy over NAGS in reducing pain and disability in subjects with chronic neck pain. Another stud ...
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