Manual therapy according to Kaltenborn / Evjenth approach

Manual therapy according to the Kaltenborn / Evjenth approach is a specialist part of musculoskeletal physiotherapy which consists of differential and specific examination and therapy of joints, muscles and peripheral nerves. Unlike classical therapy, which uses osteokinematic movement to obtain movement in the joint, manual therapy uses arthrokinematic, translational movement (traction and sliding). This way of moving the joint is less invasive and painful than the above because it does not create pressure on the articular cartilage and evenly tenses the passive joint structures. The approach was devised in the 1950s by physiotherapists Olaf Evjenth and Freddy Kaltenborn from Norway. They created the approach from existing knowledge of osteopathy, Cyriax approach, sports physiotherapy and kinesiology.

Review

Kaltenborn / Evjenth has a systematic approach to examination where a differential examination of structures that can cause pain and restriction of movement (joint, muscle, nerve) begins. Provocative and relaxing tests with appropriate clinical thinking are used to differentiate the joints. Once the joint is deciphered, the problem begins with a specific examination of the joint (including active and passive movements, examination of the final sensation, and translational movements).

Therapy

When a specific problem is found that causes reduced functional activity, one goes either to mobilization, if there is a problem of hypomobility, or to stabilization, if there is a problem of hypermobility in the joint. Translational joint mobilization / manipulation techniques are used to increase mobility. Manual therapy according to the Kaltenborn / Evjenth approach uses three stages of joint mobilization where the first two are used to reduce pain and the third to mobilize the joint that is restricted in movement.

Manipulation is the next, fourth stage of mobilization and is also used to increase joint mobility when the third stage does not give a result.
During muscle therapy, various mobilization techniques are used - functional massage (Evjenth), friction massage (Cyriax), stretching over postisometric relaxation, retained friction on the submaximal stretched muscle and self-stretching.

Physical therapy Zagreb

Specific muscle stabilization techniques are used to increase stability. If a nerve problem is found, decompression therapy is performed with caudal / cranial traction, maximum opening of the canal where the nerve passes and sliding of the nerve. Positive signs of upper motor neuron damage are a contraindication to manual therapy (if the problem is not first diagnosed by a neurologist). Finally, by repeated translational movement and functional movement, the effect of therapy is examined.