|
chrishkpt -> Re: does Mulligan Therapy work? (February 5, 2001 7:15:00 AM)
|
Thanks Bonmar for your reply and sharing on your experience =) i am happy for your succes in delivering the therapy.
In fact, how do you feel about mulligan approach? Do you prefer this to Maitland approach?
Personally, i like mulligan approach better since it is more functional. I also want to add somethings you didnt mentioned, i.e. the spinal mobilisation with arm movement(SMWAM).
Since this technique involves moving the patient's arm and at the same time glide the facet jt, i will think that the effect will be more able to be generalised or transferred to patient's functional movement. Besides, the idea of gliding the facet superiorly as well as anteriorly sounds logical to release the facet jt and glide it.
Betty, i think Bonmar have answered your question well. And i just want to share that I will think this approach is more funcional and one important point is that this approach emphasize the PAIN FREE movement; if pain is present during the therapy, it is either the gliding is in wrong treatment plane or teh level choosen is wrong. So, the patient can really feel better and have a better outcoome as a result of increased pain free movement.
Bonmar, i have a problem here. I find that unilateral SNAG is quite difficult, and i am really not sure if i can really hook the articular pillar with my fingers. How do you feel about that?
[QUOTE]Originally posted by bonmar:
Chris,
The difference between Maitland and Mulligan techniques are as follows:
Mulligan: 1)No oscillation is used
2)The mobilizations are wt bearing
3)The joint treatment plane is
considered.
These were the differences the instructor gave at the seminar this weekend. I do have to add, however, that NAGS (acronym for natural apophyseal glides) are oscillatory in nature but are wt bearing. SNAGS (sustained natural apophyseal glides) are obviously not oscillatory and again wt bearing.
As far as whether to mobilize using the Maitland techniques or Mulligan techniques, it was stated, "whatever works best for you at the time." It is the belief, however, that using wt bearing techniques will increase the chance that the mobilization will remain effective once the patient stands up!!
I have utilized SNAGS for cervical patients (I will have to let you know how the T/L patients do as I have just learned these techniques) and have found them to be fairly successful. If you are treating the proper joint with the proper hand placement, etc., improved painfree ROM is achieved(sometimes total). The techniques (NAGS, SNAGS) are very gentle, completely painfree in nature (unless you are doing them wrong), and very easy to use. If one technique does not prove to be successful, you can easily try another one.
I have just purchased Brian Mulligan's book titled, "Manual Therapy "NAGS", "SNAGS", "MWMS" etc. (Fourth Edition). It has all the techniques enclosed (although I do feel you should be trained by someone knowledgable with Mulligan's techniques). It can be purchased through OPTP at 1-800-367-7393. With S&H, the price was $35.90.
Betty, Brian R Mulligan, FNZSP (Hon),Dip MT teaches manual therapy internationally (since 1972) and has published numerous atricles. I'm sure you can find some of these articles in the New Zealand Journal of Physiotherapy (I would help you here but I do not know how to hyperlink...as well as the fact that I could not find this journal through an internet search [IMG]http://www.rehabedge.com/forums/frown.gif[/IMG] ).
I will keep you posted, if interested, regarding the success I am having with the new techniques learned this past weekend.
One other thing to add: The instructor, Russell Woodman, strongly advised any manual therapist to purchase the following book titled "Ombregt: System of Orthopedic Medicine" published by W.B. Saunders. Apparently, it would be well worth the $160.00. I plan on ordering it. Good luck!![/QUOTE]
|
|
|
|