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Risks associated with manual therapy

The risks of major adverse events associated with manual therapy are low, but the relative risk of adverse events appears to be greater with drug
therapy. Mrs Dorothy Beecham is on multiple medication that will affect the way, she will be treated in our clinic. She's also been diagnosed with DVT,
osteoarthritis, COPD, myocardial infarction and type II diabetes that would be an absolute contraindication for several techniques employed in Manual
therapy for use in the local region. Below are the techniques that should be avoided for Mrs. Dorothy Beecham
1. Soft tissue Techniques are to be avoided due to DVT as this can increase the risk of a clot being dislodged and travelling to the lungs. High blood
pressure is associated with carotid plaque formation which could then be ruptured in case of soft tissues manipulation causing internal bleeding.
2. Lymphatic drainage technique are to be avoided in general and specifically pedal pump and thoracic pump technique is to be avoided. Thoracic
pump needs to be avoided as she's got Osteoarthritis and exerting pressure over the thoracic cage could potentially cause a fracture. Pedal pump should
be avoided as this can dislodge the blood clot and can cause pulmonary embolism.
3. Articulatory techniques are absolutely contraindicated in student clinic in the presence of DVT as this can dislodge the blood clot.
4. HVLA techniques should be avoided in patients on anticoagulants and with osteoporosis. Thus HVLA techniques are contraindicated in this case,
even though risk of a stroke or tissue damage amongst the seniors and healthy subjects is extremely low. Due to osteoporosis, patient is also susceptible
to cauda equina after the spinal manipulation.

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Document: 317058751.doc
Author: Sonja Cleary Test User
Save Date: RMIT University

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