Manual Therapy II

integumentary and muscular system

Teaching methodologies integrate: description of contents; analysis and discussion of concepts and
demonstration / explanation of the techniques with simulated practice among students.

Understand the theoretical bases of the soft tissue mobilization intervention directed to the systems tegumentary and lymphatic;

Acquire manual dexterity to correctly perform each of the maneuvers discussed;

Demonstrate competence to select the soft tissue mobilization maneuvers used,

relating their clinical decision to clinical reasoning based on the patient’s history, signs and symptoms and their perception of the problem and the expected results of the intervention, particularly at the soft tissue level and in dysfunction of the lymphatic system.

1 – Therapeutic Massage
History of the development of massage
Definition of therapeutic massage;
Patient assessment: global, regional.
Essential components of manipulations: rhythm, frequency, intensity, direction;
Patient positioning, physiotherapist’s posture, duration of a treatment session, products to use.
Basic techniques: gliding, kneading, pressure (static and dynamic), friction, peeling skin, skin rolling, shake,
rolling muscles, vibration, percussion.
Is approached for each maneuver: specific features, execution mode, therapeutic objectives, and
appropriateness to various body regions where it can be applied.
Effects of massage: – Global – physical, physiological and psychological; Specific – on the bloodstream,
lymphatic circulation, pain, nerve tissue, muscle tissue, blood, adipose tissue, skin, In bone tissue
metabolism in the abdominal viscera;
Indications in specific situations: pain, periarticular, tendon and periosteum pain, contractures and muscle
pain, muscle hypervigilance, pain of vascular origin, sub-cutaneous infiltrates, edema, scars , hematoma,
fibrosis, muscular atrophies.

2 – Complex decongestive therapy
Structural anatomy, topography and function of the lymphatic pathways;
Lymphatic capillaries, pre collectors, collectors, lymph nodes;
Final escape routes: Channel Thoracic and right lymphatic duct, superficial and deep lymphatic network;
drifting or pathological pathways.
Complex decongestive therapy Leduc):
Treatment phases: Phase I – reduction; Phase II – Maintenance;
Manual Lymphatic Drainage
Hygienic care
Compression (multilayer bands, pressure therapy, elastic sleeves), muscular contraction;
Evacuation and reabsorption manoeuvres and its implications in the physiological processes of filtration and
reabsorption; Rules of application;

Chronological order of manoeuvres;
Application of Manual Lymphatic Drainage manoeuvres in the upper and lower limbs;
Sequence base of the treatment:
Oedema of the arm; forearm; hand and the entire upper limb;
Swelling of the thigh; leg and foot and the entire lower extremity;
Multilayer bands.

NAO

Primary Bibliography:
Mario-Paul Cassar ( 2001). Manual de Massagem Terapêutica . Manole.
– Wood e Becker (1984) Massagem de Beard. Manole.
– Connective Tissue Manipulation – Towards a Scientific rationale, Liz A. holey. Physiotherapy, 1995, Vol 81,
nº 12.
– Sandler S. The physiology of the tissue massage. Journal of Bodywork and movement Therapies, 1999.
– Holey EA. Connective tissue massage: a bridge between complementary and orthodox approaches. Journal
of
Bodywork And Movement Therapies, 2000.
– Cavezzi A, Michelini S. Phlebolymphoedema: From Diagnosis to Therapy. Bologna: Edizione P.R, 1998
– Leduc A, Leduc O. Le Drainage Lymphatic: Theorie et Pratique. Paris: Masson, 1995.
– Leduc A, Leduc O. Le Drainage Lymphatic: Traitment Physique de l’oedema du Bras. Paris: Masson, 1990.
Schingale F. Lymphoedema: Hannover: schluteushe, 2003;
Leduc O. Rehabilitation after breast cancer treatment. The european Journal of lymphology, 2008; 19 (55)