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10/30/2008

Orthopedic Manual Therapy Program (OMT)

Overview of the Program

The OMT program was implemented in 2003 to provide skilled manual physical therapy care to patients. PRORehab®, p.c. therapists are currently being trained through the North American Institute of Orthopedic Manual Therapy. The NAIOMT system is modeled to provide a progressive series of courses and instruction with a strong emphasis on biomechanics, mobilization/manipulation and the interaction of the extremity with the spine (the quadrant system).

The PRORehab®, p.c. OMT Program is a specialized program that offers advanced biomechanical assessment and treatment to a multitude of musculo-skeletal conditions and is dedicated to provide:

  • Safe, effective and efficient manual physical therapy care to our patients
  • Biomechanical treatments based on growing evidence base that supports manual therapy.
  • Timely, effective care to allow the patient to return to work or play
  • Shorter course of therapy, reduced time off and significant cost savings to all involved parties.

What is OMT?

Orthopedic Manual Therapy is divided into 3 parts:

  1. ORTHOPEDIC: Relating to disorders of structures forming joints, together with associated muscles, connective tissues, nerve roots and peripheral nerves (neuro-muscular-articular system)
  2. MANIPULATIVE: The skilled and specialized use of manual and/or mechanically applied movement techniques, as a part of comprehensive orthopedic physical therapy for movement disorders. Our techniques include joint gapping or gliding at 90° or parallel to the joint surfaces respectively opposed to rotational techniques.
  3. THERAPY: Relating to therapy by a physical therapist based on The International Seminars of Orthopedic Manipulative Therapy and teachings of James Cyriax, Olaf Evjenth, Walter Hinsen, Freddy Kaltenborn and Allan Stoddart.

OMT is not:

  • Treating Infants/Children for
    • Structural leg length differences
    • Severe Kyphosis or scoliosis
    • Infantile colic, skin eczema, learning disorders, ear infections, respiratory tract infections, asthma, any infectious disease process or any state of decreased immunity.
  • Treating patients for
    • Bacterial or viral infections, cancer, states of decreased immunity, the common cold, diabetes, systemic arthritis, heart disease, high blood pressure, menstrual cramps, liver disease or urinary tract infections.

Evidence Based Treatment

Morton JE. Manipulation in the treatment of acute low back pain.
Journal-of-Manual-and-Manipulative-Therapy1999; 7(4): 182-9.
Conclusions: Patients who receive orthopedic manipulation with an exercise program for acute low back pain of mechanical origin are likely to improve more than patients who receive an exercise program alone.

Vicenzino B; Collins D; Benson H; Wright A. An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation
Journal-of-Manipulative-and-Physiological-Therapeutics. 1998 Sep; 21(7): 448-53.
Conclusions: Manual therapy produces a treatment-specific initial hypoalgesic and sympathoexcitatory effect beyond that of placebo or control.

Bang MD; Deyle GD. Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome.
Journal-of-Orthopedic-and-Sports-Physical-Therapy 2000 Mar; 30(3): 126-37.
Conclusions: Manual physical therapy applied by experienced physical therapists combined with supervised exercise is better than exercise alone for increasing strength, decreasing pain, and improving function in patients with shoulder impingement syndrome.

Koes et al. Manual Therapy, physical therapy or continued care by a general practitioner for patients with neck pain.
Annals of Internal Medicine, 2002, 136:713-722.
Conclusions: Patients who received manual therapy were more likely report improvement than patients who received other forms of treatment.

Hides et al. Long-term effects of specific stabilizing exercises for first episode low back pain.
Spine 2001; 26: 243-248.
Conclusions: Patients who performed stability exercises were 12 and 9 times less likely to experience recurring low back pain at 1 and 3 years respectively.