Hazle Charles R, Lee Matthew
Division of Physical Therapy, University of Kentucky, Lexington & Hazard, KY, USA.
KORT-Nicholasville, Kentucky Orthopedic Rehab Team, Nicholasville, KY, USA.
J Man Manip Ther. 2016 Jul;24(3):120-7. doi: 10.1080/10669817.2015.1119371.
The practice of manual therapy (MT) is often difficult when providing care for large patients and for practitioners small in stature or with other physical limitations. Many MT techniques can be modified using simple principles to require less exertion, permitting consistency with standards of practice even in the presence of physical challenges. Commonly used MT techniques are herein described and demonstrated with alternative preparatory and movement methods, which can also be adopted for use in other techniques. These alternative techniques and the procedures used to adapt them warrant discussion among practitioners and educators in order to implement care, consistent with the best treatment evidence for many common musculoskeletal (MSK) conditions. The inclusion in educational curricula and MT training programs is recommended to enrich skill development in physical therapists (PTs), spanning entry-level practitioners to those pursuing advanced manual skills.
在为体型较大的患者以及身材矮小或有其他身体限制的从业者提供护理时，手法治疗（MT）的实施往往很困难。许多MT技术可以通过简单的原则进行修改，以减少用力，即使在存在身体挑战的情况下也能符合实践标准。本文描述并演示了常用的MT技术以及替代的准备和移动方法，这些方法也可用于其他技术。这些替代技术及其使用的调整程序值得从业者和教育工作者进行讨论，以便实施与许多常见肌肉骨骼（MSK）疾病的最佳治疗证据相一致的护理。建议将其纳入教育课程和MT培训项目，以丰富物理治疗师（PT）的技能发展，涵盖初级从业者到追求高级手法技能的人员。
