IntroductionManipulationSUBLUXATION and LISTINGSCONTACT POINTSection 1?촉진Spine Palpation촉진 Palpation척추 관절의 중립 위치에서의 가동성 평가를 위한 촉진경추 촉진 C/S Palpation경추 촉진(C1 laterality) C/S Palpation(C1)흉추, 요추 관절의 동작 촉진 TS/LS Joint Play Palpation : 여러 분절 극돌기 접촉흉추, 요추 관절의 동작 촉진 TS/LS Joint Play Palpation : 특정 분절 횡돌기 접촉흉추 요추 관절의 회전성 및 기울기 동작 촉진 TS/LS Joint Play Palpation : 특정 분절 극돌기 접촉흉추 요추 관절의 회전성 동작 촉진 TS/LS Joint Play Palpation : 특정 분절 횡돌기 접촉척추 관절의 가동 끝부분에서의 가동성 촉진 평가후두환추 관절 Atlantooccipital joint의 구조후두골 굴곡 및 신전 평가 Occiput flexion and extension evaluation후두골 회전 평가 Occiput rotation evaluation후두골 외측 굴곡 평가 Occiput lateral flexion evaluation후두골의 측면 이동 Occiput lateral shift환추골 관절의 가동범위 끝부분 평가 end play evaluation of C1C2-T4 굴곡 및 신전 Flexion and extensionC2-T4 : 회전 RotationC2-T4 외측 굴곡 Lateral flexionT5-L5 굴곡 및 신전 Flexion and extensionT5-L5 회전 RotationT5-L5 외측 굴곡 Lateral flexionLocation of AP, TP, MP from SP늑골의 가동성 평가를 위한 촉진 늑골의 일반적인 움직임제 1-2번 늑골 가동성 평가를 위한 촉진제 3-5번 늑골 가동성 평가를 위한 촉진제 6-10번 늑골 가동성 평가를 위한 촉진제 1-10번 늑골의 개별 촉진 검사제 11-12번 늑골 가동성 평가를 위한 촉진천장 관절의 가동범위 끝부분에서의 가동성 평가를 위한 촉진골반 동작 촉진(선 자세) Pelvis Palpation(Standing position)천골과 골반의 동작 촉진(선 자세) Sacrum and Pelvis Palpation(Standing position)천장관절 동작 촉진(엎드린 자세) SI Joint play Palpation(Prone position)사지관절 동작 촉진견갑골의 외회전 동작 촉진 Scapula external rotation movement견갑골의 내·외회전 동작 촉진 Scapula rotation mobility견흉관절 M-L/L-M 글라이딩 동작 촉진 Thoracoscapula M-L/L-M gliding mobility상완골 전후/후전, 외측 글라이딩 동작 촉진 Humerus Rotation, A-P/P-A/M-L gliding mobility상완골 상하 동작 촉진; 중립/굴곡/외전상태 Humerus S-I in neutral, flexion, abduction상완골 후방 글라이딩 동작 촉진 Humerus posterior gliding mobility흉쇄관절의 가동범위 끝부분에서의 평가를 위한 촉진견쇄관절의 가동범위 끝부분에서의 평가를 위한 촉진종축 및 내/외측 글라이딩 동작 촉진 Longitudinal, M-L/L-M gliding mobility요척골, 요상완골 관절의 A-P, P-A 및 스핀 동작 촉진 Radial head A-P/P-A gliding and spinning mobility종축견인/M-L, L-M glide/M-L, L-M tilt/A-P, P-A glide하지관절 동작 촉진대퇴골 상하 동작 촉진; 중립/굴곡 Femur S-I mobility in neutral, flexion대퇴골 전후/후전 동작 촉진 Femur A-P/P-A gliding mobility대퇴골 후방 글라이딩 동작 촉진 Femur posterior gliding mobility대퇴골 회전 동작 촉진 Femur rotation mobility경골 내회전 외회전 동작 촉진 Tibia rotation mobility경골 전후/후전 동작 촉진 Tibia A-P/P-A mobility무릎 내/외측 글라이딩 동작 촉진 Knee M-L/L-M gliding mobility경비골관절 전후/후전 글라이딩 동작 촉진 Proximal Fibula P-A/A-P gliding mobility경비골관절 하상/상하 동작 촉진 Proximal Fibula I-S/S-I gliding mobility발목관절 족배굴곡/족저굴곡 동작 촉진 Ankle dorsiflexion/Plantar flexion movement발목관절 전단 동작 촉진 Tibiotalar joint shearing mobility발목관절 내번 외번 동작 촉진 Tibiotalar joint inversion eversion movement중족골 A-P/P-A 전단 동작 촉진 Metatarsal A-P/P-A shearing mobility발목 외전, 내전 동작 촉진 Ankle Abduction, Adduction mobility거골하관절 가동성 동작 촉진 Subtalar joint mobilitySection 2?후두골RPS, LPS Occiput : MP pushRPS, LPS Occiput : ZA pushRL, LL Occiput : MP pushRL, LL Occiput : ZA pushPI Occiput : base Occiput pushPI Occiput : base Occiput scoopingRPI, LPI Occiput : base Occiput pushRAI, LAI Occiput : base Occiput pushSection 3?경추Dynamic Thrust TechiqueRL, LL : Atlas(TP push)RP, LP : all Cervicals(AP push; thumb contact)RP, LP : all Cervicals(AP push; index contact)RP, LP : C2-C7(AP pull; supine position)RP, LP : C2-C7(AP pull; sitting position)RP, LP : C2-C7(AP push)Non-force TechniqueRP LP : Atlas(TP push ; Non-force technique)RL, LL C1 : TP push, non force techniqueRP, LP : Axis(SP push ; Non-force technique)RP, LP : C3-C7(AP push ; Non-force technique)Upper cervical(C0-C3) tractionCervical Stair-step TechniqueCyriax MethodStraight pullTraction with leverageSlow stretch : RotationSlow stretch : Side flexionSide glideAnterior to posterior glide전략 STRATEGYSection 4?흉추RP, LP : C7-T2(SP push)RP, LP : T1-T4(TP push)RP(S, I), LP(S, I) : T4-T12(TP push)RP, LP : T1-T12(TP/SP push)RI, LI : T5-T12(TP push)PI : T1-T12(TP push)AI : T1-T12(TP push)Supine Thoracic AdjustingRP, LP : T1-T12(TP push)Section 5?요추RP, LP : L1-L5(Mammillary push ; Pelvis lift)RP, LP : L1-L5(Mammillary push ; Leg lift)RP, LP : L1-L5(Mammillary push ; Side position)RP, LP : L1-L5(Mammillary push ; Sitting position)RP, LP : L1-L5(SP push ; Side position)RP, LP : L4-L5(SP push ; Non-force technique)RP, LP : L1-L5(SP pull)RP, LP : L1-L5(SP pull and push)Inferiorities : L1-L5(MP push)Disc herniation : Lumbar and sacrum(SP and apex push)Manual decompression traction : Lumbar discCyriax MethodDisc Reduction TechniqueStretch Type IStretch Type IILeg OverMcKenzie Leg OverReverse StretchReverse Stretch with ThighCentral PressureUnilateral Pressure : Leg liftUnilateral Pressure : Double pisiformStretch in Prone Lying전략 STRATEGYAnti-deviation TechniqueAnti-deviation Technique : RotationAnti-deviation Technique : ExtensionAnti-deviation Technique : Self-exerciseSection 6?골반과 천골RPIN, LPIN : Innominate(PSIS push ; prone position)RPIN, LPIN : Innominate(PSIS push ; side position)RAIS, LAIS & RPIN, LPIN : Sacrum and Innominate(ST lig. Contact)RPIN, LPIN : Innominate(PSIS push; trunk lift)RPIN, LPIN : Innominate(MET)RAIN, LAIN : Innominate Rotate(ASIS and IT rotate)RAIN, LAIN : Innominate Rotate(ASIS pull; side position)RAIN, LAIN : Innominate(IT push)RAIN, LAIN : Innominate(ASIS pull; trunk lift)RAIN, LAIN : Innominate(MET)SI joint EX(In-flare) : Out-flare METSI joint IN(Out-flare) : In-flare METInferiority : Innominate(Leg pull)RAIS, LAIS : Sacrum(Sacral base, notch push and pull)Non-force TechniqueFixated SI joint : Sacrum(Sacral lift)Fixated SI joint : Sacrum(Pelvis pull)Fixated SI joint : Sacrum(Sacral pull)Fixated SI joint : Sacrum and lumbar mobilizationSection 7?상지ShoulderShoulder general mobilizationShoulder pendular/Rotation mobilizationShoulder S to I adjustment : in flexionShoulder S to I adjustment : in abduction(Sitting position)Shoulder S to I adjustment : in abduction(Supine position)Shoulder A to P adjustmentShoulder P to A adjustmentShoulder internal rotation adjustment : Supine positionShoulder internal rotation mobilization : Standing positionShoulder external rotation adjustmentShoulder I to S adjustmentScapula internal rotation mobilizationScapula external rotation mobilizationClavicle S to I adjustment : SC jointClavicle S to I adjustment : AC jointClavicle I to S adjustment : SC jointClavicle I to S adjustment : AC jointClavicle A to P adjustment : SC jointClavicle A to P adjustment : AC jointClavicle P to A adjustmentShoulder centeralizationCapsular stretching(Cyriax method)Distraction(Cyriax method)ElbowElbow extension mobilizationElbow flexion mobilizationTennis ElbowPosterior radial head adjustment : Extra-articular patternMill’s manipulation : Extra-articular patternRadioulnar joint M to L and I to S glide : Extra-articular patternElbow pronation/Extension : Extra-articular patternRadioulnar joint inferior glide : Intra-articular patternOlecranon S-I adjustment : Golf elbowPulled elbow : Pronation/flexionWrist수근관 증후군 Carpal tunnel syndromeWrist general mobilizationWrist compression : Carpal tunnel syndromeLunate A to P adjustment : Carpal tunnel syndromeWrist pronation and deviation mobilization : Carpal tunnel syndromeWrist lateral gliding mobilizationMetacarpal A-P, P-A mobilizationSection 8?하지Hip JointFemur long axis distraction : Leg pullFemur long axis distraction : GT(greater trochanter) pushFemur S to I adjustment in flexionFemur internal rotation adjustmentFemur external rotation adjustmentFemur internal external rotation mobilization : Belt 사용Femur P to A adjustmentFemur A to P adjustmentFemur centeralizationFemur flexion mobilization : Belt 사용Capsular stretching in flexion(Cyriax method)Capsular stretching in extension(Cyriax method)Capsular stretching in medial rotation(Cyriax method)Loose body 1st manipulation(Cyriax method)Loose body 2nd manipulationKnee JointKnee A to P adjustmentKnee P to A adjustmentFibula I to S adjustmentFibula S to I adjustmentFibula A to P adjustmentFibula P to A adjustmentKnee internal rotation adjustment : in extensionKnee external rotation adjustment : in extensionKnee internal/External rotation mobilization: in flexion(Type 1)Knee Internal/External rotation mobilization : in flexion(Type 2)Knee valgus mobilization ; Tibia lateral translationKnee valgus mobilization ; Tibia lateral translation(Belt 사용)Lateral collateral ligament mobilizationMedial collateral ligament mobilizationCyriax loose body : 1. Basic manipulationCyriax loose body : 2. Flexion manipulationCyriac loose body : 3. Extension manipulationManiscus reduction manipulationMCL adhesion rupture manipulation : FlexionMCL adhesion rupture manipulation : ExtensionMCL adhesion rupture manipulation : InternalMCL adhesion rupture manipulation : ExternalFoot & AnkleLateral malleolus I to S mobilizationTalus D to P(dorsal to plantar) mobilizationTalus D to P(dorsal to plantar) adjustmentTalus P to D(plantar to dorsal) mobilizationTalus P to D(plantar to dorsal) adjustment : Type 1Talus P to D(plantar to dorsal) adjustment : Type 2Subtalar joint mobilization : Thumbs movementSubtalar joint mobilization : Hands movementSubtalar joint traction403Section 9?악관절도수치료를 위한 검사 앞니 정렬 상태 검사 Alignment test하악골 능동적 가동성 검사 : 타입 1 Mandible movement test : Type 1하악골 능동적 가동성 검사 : 타입 2 Mandible movement test : Type 2하악골 능동적 가동성 검사 : 타입 3 Mandible movement test : Type 3하악골 수동적 가동성 평가 Passive movement evaluation하악골 최대 가동성 검사 Maximum mobility test근막 이완 Myofascial Release하악골과 상악골의 근막 이완 Mandible and maxilla MFR경구개 근막 이완 Hard palate MFR악관절의 일반적 근막 이완 General TMJ MFR내익돌근 및 외익돌근 이완 Medial and lateral pterygoid muscle release교근 이완 Masseter muscle release도수치료 Manipulation하악골 돌기의 상방 변위(일측성) Superior condylar subluxation(Unilateral)하악골 돌기의 상방 변위(양측성) Superior condylar subluxation(Bilateral)하악골 돌기 외측 변위 Lateral condylar subluxationTMJ 디스크 복원 TMJ Disc reduction악관절 탈골 교정 TMJ Dislocation reduction플라이카 증후군 Plica entrapment 복원하악골 돌기 전후 가동술 Condyle AP mobilizationSection 10?늑골거상늑골 도수치료1번 거상늑골 치료2-10번 거상늑골 치료11/12번 거상늑골 치료하강늑골 도수치료1번 하강늑골 치료 ; 전, 중사각근2번 하강늑골 치료 ; 후사각근3-5번 하강늑골 치료 ; 소흉근6-10번 하강늑골 치료 ; 전거근11-12번 하강늑골 치료흉곽 이완 도수치료흉곽 이완 : Rib cage mobilization흉곽 이완 : Rib cage release(MET)흉골 이완 : Sternum mobilizationSection 11?연부조직GestrocnemiusHamstrings : Lateral and medial portionErector spinaeUpper trapezius/Levator scapulaThoracolumba fascia and latissimus dorsiSuboccopitalis : C0/C1 decompressionTibialis anteriorQuadricepsAbdominalis : Step 1Abdominalis : Step 2Abdominalis : Step 3Pectoralis major and sternalisPectoralis minorPeroneusTensor fascia lataeHip triangleRib cageSplenius capitis/CervicisSternocleidomastoid(SCM)Lateral septum of biceps and tricepsMedial septum of biceps and tricepsExtensor carpi muscle groupFlexor carpi muscle groupAdductorsIliopsoas횡경막 이완 Diaphragm ReleaseTentoriumThoracic outletDiaphragm type 1Diaphragm type 2Pelvic diaphragm type 1Pelvic diaphragm type 2Popliteus diaphragmPlantarfasciaPeripheral Nerve StretchingRadial nerve stretchingUlnar nerve stretchingMedian nerve stretchingSciatic nerve stretchingFemoral nerve stretchingTibial nerve stretchingPeroneal nerve stretchingCyriax MethodSupraspinatus : Tenoperiosteal junctionSupraspinatus : Musculotendon junctionInfraspinatus : Tenoperiosteal junctionSubscapularis : Tenoperiosteal junctionBiceps long head : Intra-articular of tendonExtensor carpi : Tendon body(Brevis) (Extra-articular tennis elbow pattern)518Flexor carpi : Tendon body(Golf elbow)Medial collateral ligamentMedial coronary ligament