More on Rapid and Slow Responders

Here are some points from my recent lecture on Soft Tissue Patterns on Rapid and Slow Responders.

I also wrote about this here. Also, try google image for deranged person or derangement. Some odd results in there! Anyway...

I chose those terms as classifications instead of derangement and dysfunction because MDT clinicians often call a patient deranged. Who is deranged? A patient who is responding quickly to repeated loading or the clinician for calling a patient that to their face?

1) Rapid Responders

will have a greater than 25% change in

ROM
pain

location
intensity
duration

function

are often limited in one direction and have a directional preference (DP)
they are acute or subacute
if chronic, they most likely have episodic Sx presentation, despite having it for months/years, it goes away for long periods of time
do not exhibit signs of central sensitization typically
respond to repeated end range loading, and most manual treatments, but mechanically need the right direction to start moving and feeling
will have greater improvements lasting between visits

2) Slow Responders

are usually chronic in nature
may or may not have central sensitization and fear avoidance for movement
usually have poor motor patterns developed in response to pain and/or lack of mobility
will have less than 25% improvement in pain, ROM, strength, etc after a treatment
respond better to graded exposure to movement
need a lot of education on the importance of movement, but end range is usually not tolerated well
this may be an area that is adjacent to a rapid responding one