01.14.2016 Foot/Ankle (Part 2) & Joint Mobs

Question 1

Intervention includes (5)

Answer 1

Assessment
Prescribed intervention
Parameters
Ability to describe to another potential compensation
Reassessment

Question 2

Osteokinematics: Reference

Answer 2

AOR

Question 3

Arthrokinematics: Reference

Answer 3

Surface

Question 4

DF: separation of…

Answer 4

Navicular & Cuneiforms

Question 5

Joint has: (3)

Answer 5

One closed packed
Many open packed: treatment
One resting position: test mobility & treat

Question 6

Assessment of joint mobility: (2)

Answer 6

1) relies on perception of motion

2) will guid intervention

Question 7

Joint play:

Answer 7

Force & movement used during testing & treatment

Question 8

Kaltenborn’s

Answer 8

Straight line movement
End-feel testing
Grade 1: loosening
Grade 2: tightening
Grade 3: stretching
Amount of movement & perceived resistance
*Joint based mechanical approaches, joint stretch
*Cyriax, Mennall, Stoddard

Question 9

Grade 1: loosening

Answer 9

extremely small traction force, no appreciable increase in joint separation, normal compressive forces acting on the joint

Question 10

Grade 2: tightening

Answer 10

movement 1st takes up slack in tissue surrounding joint & tightens the tissues

Question 11

Grade 3: stretching

Answer 11

movement applied after slap has been taken up and all tissues become taut

Question 12

Maitland’s

Answer 12

Rotation & translational
Oscillatory
Abnormal resistance to motion
4 Grades
*Neurophysiologic mechanisms of pain

Question 13

Grade 1:

Answer 13

small amplitude movement at beginning of the movement

Question 14

Grade 2:

Answer 14

large amplitude movement performed within the free range but not moving any resistance (perceived stiffness)

Question 15

Grade 3:

Answer 15

large amplitude movement performed up to the limits of perceived range

Question 16

Grade 4:

Answer 16

small amplitude movement performed at the limit of the perceived range

Question 17

Direct Method (Glide testing)

Answer 17

Passive translatoric gliding movements applied in all possible directions to determine restrictions
*Relies on end-feel

Question 18

Indirect Method (Convex-Concave)

Answer 18

Relationship between normal bone rotations & gliding component

• Limited joints
• Severe pain
• Early clinicians

Question 19

5 primary end-feels

Answer 19

Normal:

1) Capsular/Firm
2) Bony/Hard
3) Soft

Abnormal:

4) Boggy
5) Empty

Question 20

Joint characteristics: (3)

Answer 20

Quality
Quantity
End-feel

Question 21

Joint mobs: indications

Answer 21

• Painful restriction of accessory joint motion w/ loss of rotational motions
• Inadequate ROM w/ capsular end-feel

Question 22

Treatment:

Oscillatory

Answer 22

1) Test to determine grade of reproducing pain
2) Apply oscillatory motion at grade lesser than reproducing pain
3) Rate of oscillation 2-3Hz for 40 secs
4) Re-assess to determine the grade reproducing pain

Question 23

Treatment:

Sustained

Answer 23

1) Select grade
2) Hold 7-10 secs
3) Repeat x3
4) Reassess in standing & walking

Question 24

Manipulate

Answer 24

High velocity, low amplitude
Close to end range of motion
Repeat 2x & reassess