Accessory Movements for a specified joint - active

Question 1

What is the purpose of this technique?

Answer 1

Reproduces symptoms - helps work out what structures are being stressed
Identifies whether movement patterns are normal or abnormal
Identify factors that have contributed to changes in a condition
Acts as a marker to assess effectiveness of given treatment

Question 2

How do you know if the measurement is normal?

Answer 2

Easily moves joint through their full range
No resistance
No trick movements

When applying overpressure:
- Soft tissue should have a soft end feel
- Capsular or firm soft tissue should have a firm end feel (fairly hard halt to movement)
- Bone to bone or hard tissue should have a hard end feel (abrupt halt to movement

End feels can be compared to contralateral side where appropriate, or what is considered normal

Question 3

How is this treatment applied?

Answer 3

1) Explain procedure & informed consent
2) Ensure patient is safe comfortable and in an appropriate starting position
3) Instruct and demonstrate movement to the patient and ask them to replicate
4) Observe movement and provide guidance and correction if necessary
5) Add overpressure and assess end feel
6) Check patient for any adverse affects

Question 4

What structures/processes are being assessed?

Answer 4

Joints and associated muscles:
- Reproduction of symptoms and/or Muscle spasm
- Range of Movement
- Resistance through range and at end of range
- Quality of Movement

Question 5

Describe the end feel of healthy soft tissue

Answer 5

Soft end feel

Question 6

Describe the end feel of healthy capsular or firm soft tissue

Answer 6

Firm: A fairly hard halt to
movement

Question 7

Describe the end feel of healthy bone to bone or hard tissue

Answer 7

Abrupt halt to movement.

Question 8

How can you tell whether a person’s movement are within their own norms?

Answer 8

Compare movement of affected side to contralateral side

Question 9

Contraindications

Answer 9

Immediately post injury
Early unstable fracture
Sub-luxation/Dislocation
Intolerable pain
Incomplete muscle/ligament tear
Compromised circulation

Do you have any recent injuries I should be aware of?
Is there any pain in this particular area?
Are you generally feeling well today?

Question 10

What should you document?

Answer 10

Date, Time, Patient name
Explanation of procedure & gaining informed consent
What movements were performed, in what position & how
End feel comparison to other side
Adverse affects?
Sign