Consent to Treat

Physical Therapy Consent for Treatment and Thrust Joint Mobilization/Manipulation
Joint Mobilization/Thrust Manipulation

According to IFOMPT, “joint mobilization is a manual therapy technique comprised of skilled passive movements that are applied at varying speeds and amplitudes to joints, muscles or nerves with the intent to restore optimal motion, function, and/or reduce pain.”

Joint manipulation is a manual therapy technique involving a quick thrust to a joint to provide immediate pain relief and improved mobility. Joint manipulation typically, but not always, causes audible “click” or “pops.”

What should you expect to feel during and following thrust manipulation?

You should expect to feel mild discomfort prior to the thrust as the therapist finds the appropriate position to perform the manipulation. When positioning is appropriate, he/she will perform a quick thrust that may cause audible “pops” to occur. This is a normal and desired response. You may likely feel some discomfort when the thrust is performed, but the chance of damage to surrounding tissues is rare. Typically, feelings of discomfort and apprehension resolve immediately after or within minutes.

Patients typically feel better immediately after a successful joint manipulation. In some cases, patients may have soreness or headaches later in the evening or the following day, but it usually dissipates within a few days. It is important to note that some patients may experience worsening symptoms which should not be a cause for alarm.
Anything we need to know prior to treatment? Please select your answer.
1. Have you recently had the following symptoms: double/blurry vision, swallowing difficulties, dizziness/lightheadedness aggravated by neck motion, or fainting/blackout?*
2.Have you ever suffered any direct trauma injury?*
3. Do you have any bone-density issues such as osteoporosis/osteopenia?*
4. Have you ever had any broken bones?*
Statement of Consent for Joint Mobilization and Manipulation

I confirm I have read and understand the above information, and have been given a chance to have any questions answered. I consent to having joint mobilization and thrust manipulation treatments, and I understand that I can refuse treatment at any time.
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Physical Therapy Consent for Treatment and Thrust Joint Mobilization/Manipulation

Joint Mobilization/Thrust Manipulation

What should you expect to feel during and following thrust manipulation?

Anything we need to know prior to treatment? Please select your answer.

Statement of Consent for Joint Mobilization and Manipulation