Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK 1 > 9/16 - Peripheral Joint Mobilization > Flashcards

9/16 - Peripheral Joint Mobilization Flashcards

1
Q

what are 2 main goals of joint mobilization

A

modulate pain
treat joint impairments limiting ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how does joint mobilization treat joint impairments limiting ROM

A

replicate normal joint mechanics while minimizing abnormal compressive stresses on articular cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what do you need to know in order to determine if joint mobilization is indicated

A

knowledge of anatomy, arthrokinematics, and pathology of neuromuscular system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a joint mobilization/manipulation

A

skilled, passive manual therapy techniques applied at joint and related soft tissues at varying speeds and amplitudes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

osteokinematic

A

“motion you see”
movements of bones in space
- flex, ext, ABD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

arthrokinematic

A

“motion you feel”
accessory motion b/w adjacent joint surfaces
- roll
- glide
- spin
occurs w all A/PROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do you assess osteo vs arthrokinematics

A

osteo - typical AROM/PROM assessment
arthro - joint play

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is joint play

A

passive movement
- can’t be achieved by active ms contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a component movement

A

involuntary obligatory joint motion
- occurs w active motion

ex: scapular upward rotation (component) w shoulder flexion (active)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

arthrokinematic motion: roll

A

new points on one surface come in contact w new points on another surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are other words for a glide

A

slide
translation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what arthrokinematic motion is the majority of joint play assessments

A

glide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

arthrokinematic motion: glide

A

translatory motion
one point on one surface contacts new points on another surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

arthrokinematic motion: spin

A

rotation around a single point of contact
- CW or CCW direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe osteo and arthro motion when concave moves on convex

A

osteo and arthro move in the same direction

ex: tibia on femur, flexion means a posterior roll and posterior slide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe osteo and arthro motion when convex moves on concave

A

osteo and arthro move in opposite directions

ex: humerus on glenoid, when flex or ABD arm - humerus glides inferiorly and rolls superiorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

obligate translation

A

restricted capsular mobility will cause translation AWAY from tightness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some reasons you could have limited shoulder flexion

A

limited inferior glide
- capsule tightness
tight muscles / ms length
pain / anticipated pain
- empty end feel or pt stops you
- more indicative of pain/guarding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

where is the treatment plane

A

perp to axis
parallel to joint surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

traction

A

separation of joint surfaces perp to treatment plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what can traction do and how does it accomplish this

A

help w pain and mobility
- applies load to entirety of joint capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

gliding (in terms of treatment plane)

A

joint surfaces displaced parallel to treatment plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

if no gliding is occurring what does this likely indicate

A

issue w capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

overall grades for traction

A

grade 1 - unweighting
grade 2 - taking up slack
grade 3 - capsule & ligaments stretched

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

describe grade 1 traction

A

unweighting/loosening
- not pulling hard enough to feel end point
- won’t feel anything stopping motion

26
Q

when is grade 1 traction typically indicated

A

helpful to dec pain
good for people w high reactivity

27
Q

describe grade 2 traction

A

taking up the slack
as you separate
- the first time you feel some tissue resistance
- feel some tension

28
Q

describe grade 3 traction

A

capsule and ligaments stretched
- get to end of available motion

29
Q

how do you assess joint mobility

A

it is difficult - poor intra/intertester reliability

quantity graded in mm
quality graded by “end feel”

comparison to uninvolved side
- assess that side first

30
Q

why are soft hands important when doing a joint mobility assessment

A

if you grab to hard, can make patient guard

31
Q

describe handling technique in a joint mobility assessment

A

soft hands
hands close to joint line (most proximal)
palpate joint line to inc sensitivity to motion

32
Q

why is it important for a patient to be relaxed for a joint mobility assessment

A

guarding or tightening muscles can limit motion
- can feel like a false end range

how relaxed pt is correlates to PT handling techniques and how supported pt feels

33
Q

what are things of note when assessing the quality of joint mobility

A

onset of resistance/ms guarding
end feel - normal?
pain provocation - reactivity?

34
Q

joint mobility grades

A

0 - no movement, ankylosed
1 - mod, marked hypomobility
2 - slightly hypomobile
3 - normal
4 - slightly hypermobile
5 - mod, marked hypermobility
6 - unstable, dislocated, subluxed

35
Q

what joint mobility grade do you not mobilize

A

grade 0**

shouldn’t be mobilizing grades 4 or 5

36
Q

what joint mobility grades are mobilization indicated for

A

grades 1 and 2

37
Q

what joint mobility grade is no treatment needed at all for

A

grade 3

38
Q

what joint mobility grade is the treatment plan assessment for adjacent hypomobility, stabilization exercise, taping, bracing

A

grade 4 and 5

39
Q

what are indications for mobilization

A

pain, ms guarding & spasm
reversible hypomobility
positional fault / subluxation

goal to achieve full unrestricted pain free ROM

40
Q

grade 6 treatment plan

A

bracing, splinting, casting, surgical stabilization

41
Q

how does joint mobilization help w pain, ms guarding and spasm

A

gentle techniques stimulate mechanoreceptors to inhibit transmission of nociceptive stimuli

42
Q

how does join mobilization reverse hypomobility

A

progressively vigorous techniques

43
Q

how can joint mobilization help w a positional fault / subluxation

A

relocate joint
- seen w patella and shoulder

44
Q

what are 3 neurophysiological effects of mobilization

A
  1. stim of mechanoreceptors
  2. dec nociceptive stim of brainstem/SC
  3. proprioceptive & kinesthetic awareness
45
Q

what are 3 mechanical effects of mobilization

A
  1. inc blood supply and nutrients to area
  2. stretch/elongate hypomobile structures such as capsular or ligamentous tissue
  3. break adhesions
46
Q

contraindications to mobilization (8)

A
  1. most acute cases
  2. malignancy in area
  3. infectious arthritis
  4. metabolic bone dz
  5. fusion / ankylosis
  6. OM
  7. fx
  8. ligament rupture
47
Q

precautions for mobilization (7)

A
  1. excessive pain/swelling
  2. arthroplasty
  3. pregnancy
  4. hypermobility
  5. spondylolisthesis
  6. RA
  7. vertebrobasilar insufficiency
48
Q

why is excessive pain/swelling a precaution for mobilization

A

can indicate something more serious is happening and should look further into it

49
Q

why is arthroplasty a precaution for mobilization

A

depending on surgery technique can change how you mobilize the joint

50
Q

grades of mobilization

A

I - small amplitude at beginning of range
II - large amplitude w/i available range
III - large amplitude reaching end range
IV - small amplitude movement at end range

V - high velocity thrust manipulation

51
Q

what are grades 1 and 2 for joint mobilization helpful for

A

for pain
- stimulate mechanoreceptors

not for inc motion bc not in end range

52
Q

what are grades 3 and 4 for joint mobilization helpful for

A

ROM and joint play
- getting into end range
- putting load onto tissues

53
Q

how do you pick what grade of joint mobilization to implement

A

what the goal is

54
Q

what is the role of pain in how you determine the grade of joint mobilization to implement

A

just bc have pain doesn’t mean you can only do grades 1 or 2
- if have <5/10 pain, and person is hypomobile you can do grades 3 or 4

the pain is relatively low
primary problem is hypomobility
- addressing this will help relieve pain

one thing to be uncomfortable, as long as they can tolerate it

55
Q

how do you stabilize for joint mobilization

A

stabilize one segment and be as close to joint line as possible

56
Q

what is the procedure for joint mobilization (7)

A

explain what you are going to do
pt position and PT position
joint position
stabilization
direction of force
amt of force
pt response

57
Q

what are mobilization treatment variables (6)

A

grade of technique
rhythmic or sustained
position of joint
direction of movement
sx guides selection of techniques
always re-exam joint for change in ROM

58
Q

what position do you typically start joint mobilization in

A

open pack
- there is equal slack in the joint

59
Q

after doing joint mobilization what is an important next step

A

to do something active to engage the muscle

60
Q

what are treatment considerations for grades I and II

A

neurophysiological effect to treat pain
- neuromodulation on sensory innervation of joint mechanoreceptors & pain receptors

neutralizes joint pressures

61
Q

what are treatment considerations for grades III and IV

A

mechanical effect to treat stiffness / hypomobility
- inc mobility

plastic deformation of capsule

MSK 1 (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions