PMC3184474_01
PMC3184474_02
Integrative Muscular Movement Technique (IMMT) therapist and patient positioning. The patient was positioned in supine for the duration of the treatment. The muscle being addressed was "pinned" by the therapist's hand (therapist's right hand in each panel). The head was then moved in a position of compression or stretch according to the muscle being treated as detailed for the sternocleidomastoid (SCM), scalene muscle group, splenius muscle group, and suboccipital muscle group. The therapist's left hand was used to passively move the patient's head in the appropriate cervical position. The individual pictured was not a patient in the current study.
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The therapist's other hand was placed on the patient's head (Figure 1). The hand used to pin the muscle was moved up the entire muscle each time, and at each position the muscle was moved into the compression and stretching positions (Figure 1).
Sequence of progression of Integrative Muscular Movement Technique (IMMT). The IMMT begins with 5-10 strokes of effleurage to warm the muscles. The sternocleidomastoid (SCM) muscle then is addressed. The therapist first uses the right hand to "pin" the muscle at its base (clavicular attachment for SCM). The head then is moved into flexion to compress the SCM and is held for 2-3 seconds followed by movement into extension for 2-3 seconds to stretch the muscle. The muscle then is placed in a neutral position, the hand pinning the muscle is moved to a position higher along the muscle belly, and the flexion (Flex)/extension (Ext) movement is repeated (denoted by solid black arrow). This sequence is repeated along the entire length of the muscle belly (typically 2-3 repetitions per muscle). The therapist then remains on the SCM and begins the same procedure except moving the head into contralateral (contralat) or ipsilateral (ipsilat) rotation (progression to the next movement denoted by colored downward arrow). The muscle is initially pinned at the base as before and the procedure is repeated along the length of the muscle. This procedure is repeated for each movement as described above for the SCM; then the therapist moves to the scalene muscle group completing the procedure for the involved motions, followed by the splenius muscle group, and lastly the suboccipital muscle group (progression between muscles denoted by dotted arrow). The entire treatment lasts approximately 20 minutes.
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Figure 2 details the compression/stretching patterns for each muscle treated.