AIPIE
A
Assess
Observation
observing entry of patient, gait, demeanour from beginning
Effect 1
Reduce pain (endorphin release; reduction of muscle tension; distraction & positive psychological effect)
Contraindictions
Cuts or open wounds, bruises, varicose veins, fracture, burns, some skin conditions, pregnancy, epilepsy, asthma, autoimmune disorders, immunosuppressed, hypertension, chronic heart failure, chronic kidney failure
What is effleurage/stripping?
direction : in line w/ muscle fibres, peripheral to central
moderate/firm constant full hand contact
on : muscles
I
Interpret
History/Subjective Evaluation
Find out as much as you can about what happened to your client
- Precise area of pain/symptoms
- How did it happen and how long ago
- What aggravates or eases symptoms
- Past history and medical history
- Medication use?
- 24hr behavior (about pain) - Additional questions that may help
alert to serious pathologies
- Social history
- Goals - Use of body chart!
Effect 2
Promotion of parasympathetic activity (relax)
Precautions
Fever, blood clots/DVTs, inflammation, undiagnosed lump/tumour, advanced kidney/respiratory/liver failure, acute injury (24-48 hours), skin infection, systemic contagious/infectious disease, uncontrolled hypertension, pre-eclampsia (pregnancy)
What is petrissage?
direction : circular/variable compressive action (ie. kneading/squeezing)
moderate/variable hands firm in V shape, alternate hands
on : muscles
P
Plan
Physical (Objective) evaluation
neurological/vascular/clearing/screening/functional tests
articular/muscular tests (AROM/PROM, muscle strength, muscle length etc)
palpation
Effect 3
Influence on body chemistry (increase circulation of blood flow/oxygen; increase lymphatic circulation)
What is palpation?
method of feeling with the fingers or hands during a physical examination, physiotherapist touches & feels body to examine size, consistency, texture, location, and/or tenderness of body part.
What is skin rolling?
where a restriction is felt
direction : along/across a tissue
technique : pinches/pulls skin away then gently rolled forward in continuous forward motion
on : connective tissue over muscles, connective tissue between surface of skin to deeper & underlying tissues
I
Implement
Treatment/Intervention and Evaluation
advice/education, soft tissue massage, manual treatment, taping, exercise, hot/cold treatments
Effect 4
Mechanical effects (break down adhesions/scar tissue; increase flexibility + range of motion)
What is friction?
firm, fingertips
on : ligaments, tendons, fascia and muscles, scar tissue
E
Evaluate
Evaluation of treatment
outcome measures, after initial consultation : patient should understand/know their diagnosis & prognosis; things themselves as well as the physio can do to help; things to avoid; have a collaboratively developed treatment plan
Effect 5
Promotion of restorative sleep
What is ischeamic pressure/trigger pointing?
direction : direct sustained compression, 30 seconds
firm
on : muscles