The following is a brief list of the protocols used during a typical MUA procedure depending on the areas involved. This list is not all inclusive and is updated and modified regularly and dependant on individual needs. This template is a good start for understanding the protocols and utilization in patient follow up in office.
  Click here to download the Procedure Protocol in a printable Microsoft Word format.
 
Manipulation Under Anesthesia
Procedure Protocol
Lumbar Spine
1. ( R ) SLR (straight leg raise) with Contralateral Knee Extension and Stabilization-Stretch (2nd myotherapy hamstring) (hold 6 seconds)
2. ( R ) SLR with forced pedal dorsiflexion (2nd provides stabilization to opposite lower extremity and provide myotherapy and myorelease techniques to lower extremity)
3. ( R ) Three Bent Knee to Chest-Stretches (2nd stabilizes pt. hands on chest to allow for increased hip flexion) (hold 6 seconds) Neutral, medial and lateral positions.
4. ( R ) Internal hip rotation stretch
5. ( R ) Patrick Fabere-Stretch (2nd stabilizes pt. ( R ) ankle on ( L ) thigh, provides myotherapy to stretched extremity) (hold 6 seconds)
6. ( R ) Internal and External Hip Rotation-Stretch with ( R ) Hip flexed 20° and ( R ) Knee flexed 90-110° (2nd stabilizes pt. hands on chest) (hold 6 seconds)
7. ( R ) Straight Leg Abduction-Stretch (2nd stabilizes pt. hands on chest, provides myotherapy to stretched extremity) (hold 6 seconds)
8. ( R ) Straight Leg Abduction to 30° with Internal Rotation. (2nd stabilizes pt. hands on chest, provides myotherapy to stretched extremity)
9. ( R ) Leg Axial Mobilization and Joint Distraction
10. ( L ) SLR with Contralateral knee extension and stabilization -Stretch (2nd myotherapy hamstring) (hold 6 seconds)
11. (L) SLR with forced pedal dorsiflexion (2nd provides stabilization to opposite lower extremity and provide myotherapy and myorelease techniques to lower extremity)
12. ( L ) Three Bent Knee to Chest-Stretches (2nd stabilizes pt. hands on chest to allow for increased hip flexion) (hold 6 seconds) Neutral, medial, and lateral positions.
13. ( L ) Internal hip rotation stretch.
14. ( L ) Patrick Fabere-Stretch (2nd stabilizes pt. ( L ) ankle on ( R ) thigh, provides myotherapy to stretched extremity) (hold 6 seconds)
15. ( L ) Internal and External Hip Rotation-Stretch with ( L ) Hip flexed 20° and ( L ) Knee flexed 90-110° (2nd stabilizes pt. hands on chest) (hold 6 seconds)
16. ( L ) Straight Leg Abduction-Stretch (2nd stabilizes pt. hands on chest, provides myotherapy to stretched extremity) (hold 6 seconds)
17. ( L ) Straight Leg Abduction to 30° with Internal Rotation (2nd stabilizes pt. hands on chest, provides myotherapy to stretched extremity)
18. (L) Leg Axial Mobilization and Joint Distraction
19. Double Bent Knees to Chest coupled with Flexion of Lumbar Spine (2nd stabilizes pt. hands on chest to allow for increased hip flexion and lumbar flexion)
20. Double Bent Knees in ( R ) 45° Oblique Direction-Stretch (2nd stabilizes pt. hands to chest) (hold 6 seconds) (myotherapy applied to thoraco-lumbar musculature)
21. ( R ) Lumbar Rotation with Left Straight Leg Extended Over ( R ) Side of Adjusting Bench-Stretch (2nd stabilizes pt. hands on chest and shoulder flat on adjusting bench) (hold 6 seconds)
22. Double Bent Knees in ( L ) 45° Oblique Direction-Stretch (2nd stabilizes pt. hands to chest) (hold 6 seconds) (myotherapy applied to thoraco-lumbar musculature)
23. ( L ) Lumbar Rotation with Right Straight Leg Extended Over ( L ) Side of Adjusting Bench-Stretch (2nd stabilizes pt. hands on chest and shoulder flat on adjusting bench) (hold 6 seconds)
24. ( R ) Lateral Decubitus Position-Side Posture Manipulation (2nd stabilizes pt. hands on chest)
25. ( R ) Hip Extension
26. ( R ) Lateral Decubitus Position-( R ) Scapular Manual Protraction Manipulation (2nd stabilizes pt. hands on chest)
27. ( L ) Lateral Decubitus Position-Side Posture Manipulation (2nd stabilizes pt. hands on chest)
28. (L) Hip extension
29. ( L ) Lateral Decubitus Position-( L ) Scapular Manual Protraction Manipulation (2nd stabilizes pt. hands on chest)
Thoracic Spine
30. (R) Scapular Distraction and Mobilization
31. Accompany above procedure with distraction and hold (2nd applies myotherapy and myo-release techniques to affected shoulder girdle musculature, including levator scapulae, rhomboids, paraspinals)
32. (L) Scapular Distraction and Mobilization
33. Accompany above procedure with distraction and hold (2nd applies myotherapy and myo-release techniques to affected shoulder girdle musculature, including levator scapulae, rhomboids, paraspinals)
34. Anterior Thoracic Manipulation
Note: If thoracic region is only region treated, include:
a. ( R ) Lateral Decubitus Position-( R ) Scapular Manual Protraction Manipulation (2nd stabilizes pt. hands on chest)
b. ( L ) Lateral Decubitus Position-( L ) Scapular Manual Protraction Manipulation (2nd stabilizes pt. hands on chest)
c. ( R ) Cervical Lateral Flexion-Stretch (2nd stabilizes ( L ) shoulder in S-I direction) (hold 6 seconds)
d. ( L ) Cervical Lateral Flexion-Stretch (2nd stabilizes ( R ) shoulder in S-I direction) (hold 6 seconds)
Cervical Spine
35. Axial Cervical Traction (2nd stabilizes shoulders in S-I direction)
36. ( R ) Cervical Lateral Flexion-Stretch (2nd stabilizes ( L ) shoulder in S-I direction) (hold 6 seconds)
37. Accompany above procedure with contralateral myotherapy, myo-release and muscle lengthening, performed in combination by primary and 2nd
38. ( L ) Cervical Lateral Flexion-Stretch (2nd stabilizes ( R ) shoulder in S-I direction) (hold 6 seconds)
39. Accompany above procedure with contralateral myotherapy, myo-release and muscle lengthening, performed in combination by primary and 2nd
40. ( R ) Cervical Rotation to 45° Accompanied by Maximal Cervical Flexion-Stretch (2nd stabilizes shoulders) (hold 6 seconds)
41. ( L ) Cervical Rotation to 45° Accompanied by Maximal Cervical Flexion-Stretch (2nd stabilizes shoulders) (hold 6 seconds)
42. ( R ) Maximal Cervical Rotation-Stretch (2nd stabilizes shoulders) (hold 6 seconds)
43. ( R ) Maximal Cervical Rotation with Cervical Flexion-Stretch (2nd stabilizes shoulders) (hold 6 seconds)
44. ( L ) Maximal Cervical Rotation-Stretch (2nd stabilizes shoulders) (hold 6 seconds)
45. ( L ) Maximal Cervical Rotation with Cervical Flexion-Stretch (2nd stabilizes shoulders) (hold 6 seconds)
46. Cervical Forward Flexion - Stretch (2nd stabilizes shoulders) (hold 6 seconds)
47. Accompany above procedure with posterior paraspinal myotherapy, myo-release and muscle lengthening, performed in combination by primary and 2nd
48. Stair Step Cervical Spine Posterior to Anterior Facet Plane Motion, along Each Vertebral Level (7 levels) (2nd stabilizes shoulders)
49. Stair Step Cervical Spine in Oblique Posterior to Anterior Facet Plane Motion, along each Vertebral Level (7 levels) (2nd stabilizes shoulders)
50. Cervical-Thoracic Junction Flexion - Stretch (2nd stabilizes chest)
51. (R) Cervical-Thoracic Junction Oblique Flexion and Lateral Bend -Stretch (2nd stabilizes thorax and provides contralateral shoulder distraction)
52. (R) Cervical-Thoracic Junction Oblique Flexion and Lateral Bend -Stretch (2nd stabilizes thorax and provides contralateral shoulder distraction)
53. Cervical-Thoracic Junction Distraction in Flexion with myotherapy and myo-release techniques (2nd stabilizes chest)
54. ( R ) Lateral Flexion Cervical Manipulation (May include multiple restricted/ effected motor units) (2nd stabilizes pt. hands on chest)
55. ( L ) Lateral Flexion Cervical Manipulation (May include multiple restricted/ effected motor units) (2nd stabilizes pt. hands on chest)
Legend:
Primary Doctor
Assisting Doctor
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