accessory mobilisations to peripheral joint

Question 1

how to perform

Answer 1

grade 1-2: 1 hand, small resistance
grade 3-4: more resistance, to end range
x30 reps

longitudinal/T

Question 2

contraindications

Answer 2

MSK: osteoporosis, radiography, surgery, unstable & artificial joint, infection & recent surgery on joint, cancer, unstable fracture
CR:
CV: anti-coagulant drugs
N: no consent, fear
pregnancy, unknown/chronic pain, dependency, infection, not reached skeletal maturity, bone density problems, eating disorder, previous failed response

Question 3

rational

Answer 3

Manual therapy - hands applying force with therapeutic intent, using external force to mobilise a joint
increases elasticity & nerve mobility, reduces stiffness, pain & swelling, relaxes muscle tone
increases RoM in a painful/non painful joint for better overall function

Question 4

physiological effects

Answer 4

Increase joint movement, stretch adhesions
Decrease pain & muscle spasm
controlling pain at spinal cord level
Function, less fear, sleep
dopamine release, cortisol
improved blood flow, lymphatic drainage, healing, removing toxins

Question 5

structures

Answer 5

msk - muscles, joint
NS
circulatory

Question 6

principles

Answer 6

grades 1-5
Concave-convex rule - stable convex, moving concave surface
glide in same/opposite direction as joint movement

choose grades based on joint stiffness, pain, fear
1-2: painful joint
3-4: stiff joint
deciding method position, range, amplitude, rhythm and duration