Accessory Spine Mobilisation Flashcards
What’s an accessory mvt?
- Small passive mvt based on concave/convex rule in the joints
Grade I
Small amplitude mvt at the beginning of the available ROM, no resistance
Grade II
large amplitude mvt through the middle of the ROM, no resistance
Grade III
Large amplitude mvt from the middle to the limit of the ROM
Grade IV
small amplitude mvt at the very end ROM
Grade V
High velocity thrust of small amplitude beyond the ROM
(Requires advanced training is not commonly used in physio)
What do we use Grade III & IV for?
Incr. grade of motion
What are Grade I & II for?
Reduction of pain
Which treatment is a low amplitude technique
Oscillation
Treatment : Oscillation
Why do we use them?
1-5 sets of 5-60s
→ To treat pain
Treatment : Prolonged hold
When is it applied & why?
5-30s
1-5 reps
→ At end range to treat stiffness
How to determine what causes the pain in mvt?
The side of pain combine with the mvt will determine if the pain is due to a compression or a stretch
(Pain is ++ post)
How works combined mvt & pain?
- Mvt determine where is the stretch & compression (opposite angle)
- Pain determine the most involved pattern
SIN
S = severity of pain (mild, moderate,severe)
I = Irritability (none, moderate, high)
N = Nature of the disorder
EXEMPLE : High SIN,RR+Ext => pain
Which mvt will reduce pain?
LR + Flex or Flex + LR
In high SIN what do you want to do?
Found the mvt that reduce the most the pain
In low SIN what do you want to do?
Asses 4s different combinations, looking for the most provocative position (most pain)
How to palpate spine for low sin?
Neutral -> gradually more provocative position
How to palpate the spine for high SIN?
Neutral -> gradually less provocative position
How to mobilize/treat the spine for a low SIN?
Unilateral PA in the side of pain in neutral -> then most painful position
How to mobilize/treat spine in a high SIN?
Unilateral PA in side of pain in neutral -> less painful position -> neutral -> painful position
