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23 Cards in this Set
- Front
- Back
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What are the 5 components of Graston (in order)
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1. soft tissue warm-up
-cardiovascular (bike or treadmill), ultrasound, paraffin, hot moist packs, etc. 2. graston technique 3. stretching 4. strengthening -high repetition, low load 5. cryotherapy |
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what are the different strokes
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1. sweep
2. fan 3. brush 4. strum 5. J-stroke 6. swivel 7. scoop 8. framing |
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what is sweeping used for and what tools can be used
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scanning
(GT 1, 2, 4, 5, 6) |
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what is fanning used for and what tools can be used
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treatment (not scan)
(GT 1, 2, 4, 5, 6) |
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what is brushing used for and what tools can be used
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desensitizing
(any tool) |
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what is strumming used for and what tools can be used
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treatment
(GT 3, 4, 6) |
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what is the J-stroke used for and what tools can be used
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treatment
(3, tip of 6) |
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what is the swivel stroke used for and what tools can be used
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treatment
(1, knob of 2, 5, 6) |
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what is scooping used for and what tools can be used
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treatment
(1, 2, 4, 5, 6-concave part) |
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what is framing used for and what tools can be used
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treatment
(2-concave, 3) |
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what is the angle of attack
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30-60 degrees (avg=45 degrees)
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what happens when you increase the angle of the GT tool
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you get deeper penetration/ it is more aggressive
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does the GT # or "Grastech" face up?
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"Grastech" (except when using the treatment tip of GT 6, then the GT # is up)
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What are the indications of Graston
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-Tendinopathies
-Fascial Syndromes -MFPS -Ligament pain syndromes -Edema reduction -Scar tissue/adhesions -Entrapment syndromes |
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What are the relative contraindications of Graston
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-cancer
-burn scars -Kd dysfxn -pregnancy -medications -rheumatoid arthritis -acute inflammation -varicose veins -osteoporosis -lymphedema -Reflex Sympathetic Dystrophy (now called Chronic Regional Pain Syndrome) -Polyneuropathies -unhealed, closed, non-complicated fractures (soft tissue component) |
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What are the absolute contraindications of Graston
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-open wounds/unhealed suture sites/ sutures
-Thrombophlebitis -uncontrolled HPTN -inflammatory conditions due to infection -contagious or infectious skin conditions -hematoma/myositis ossificans -osteomyelitis -unstable fractures |
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What does GISTM stand for
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Graston Instrument Soft Tissue Mobilization
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What are the GT parameters
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1. tx duration
(each session and tx plan) (~1 min) 2. Instrument (shape, edge, angle) 3. Intensity (depth) 4. Frequency 5. Rate 6. Amplitude (length) 7. Direction (clock) 8. patient/clinician position 9. rate/pressure/depth |
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common mistakes
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-assess in MULTIPLE directions
-monitor tx edge and angle -proper pressure application (not too much or too little) -Tempo of stroke: do NOT speed -Tx time:~1 (more is not better) -application of emolient (glide, don't plow) -stop slippage/stress: clean instruments/ hands thoroughly -therapeutic exercises are CRITICAL |
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the effects of immobilization and trauma on connective tissue
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1. permanent loss of GAGs and H2O
2. collagen synthesis degradation 3. irregular laying down of collagen and cross links 4. ligaments, tendons and joint capsules weaken |
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effect of immobilzation and trauma on muscle tissue
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-loss of sarcomeres/ms weight
-decreased protein, mitochondria, and enzymes -increased fibrosis at musculotendinous jxn in healing tissue -ms contusions heal with scar tissue of dense connective tissue -decreased ms extensibility |
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benefits of soft tissue mobilization
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-movement maintains balance btwn collagen synthesis and degredation
-mvmt activates alignment of fibroblasts and myofibroblasts in the direction of stress -facilitates GAG production, thus maintains inter-fiber distance and lubrication -restores joint motion -due to the viscoelastic nature of CT, stretching causes plastic elongation, although the elastic comonenet returns to normal. This property is announced overtime -fibrinolysis with intermittent compression/stretching |
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Graston technique is a form of...
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deep manual procedure (even though an instrument is used) and it reinitiates the inflammatory process
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