Accessory Spine Mobilisation

Question 1

What’s an accessory mvt?

Answer 1

• Small passive mvt based on concave/convex rule in the joints

Question 2

Grade I

Answer 2

Small amplitude mvt at the beginning of the available ROM, no resistance

Question 3

Grade II

Answer 3

large amplitude mvt through the middle of the ROM, no resistance

Question 4

Grade III

Answer 4

Large amplitude mvt from the middle to the limit of the ROM

Question 5

Grade IV

Answer 5

small amplitude mvt at the very end ROM

Question 6

Grade V

Answer 6

High velocity thrust of small amplitude beyond the ROM

(Requires advanced training is not commonly used in physio)

Question 7

What do we use Grade III & IV for?

Answer 7

Incr. grade of motion

Question 8

What are Grade I & II for?

Answer 8

Reduction of pain

Question 9

Which treatment is a low amplitude technique

Answer 9

Oscillation

Question 10

Treatment : Oscillation
Why do we use them?

Answer 10

1-5 sets of 5-60s
→ To treat pain

Question 11

Treatment : Prolonged hold
When is it applied & why?

Answer 11

5-30s
1-5 reps
→ At end range to treat stiffness

Question 12

How to determine what causes the pain in mvt?

Answer 12

The side of pain combine with the mvt will determine if the pain is due to a compression or a stretch

(Pain is ++ post)

Question 13

How works combined mvt & pain?

Answer 13

1. Mvt determine where is the stretch & compression (opposite angle)
2. Pain determine the most involved pattern

Question 14

SIN

Answer 14

S = severity of pain (mild, moderate,severe)
I = Irritability (none, moderate, high)
N = Nature of the disorder

Question 15

EXEMPLE : High SIN,RR+Ext => pain
Which mvt will reduce pain?

Answer 15

LR + Flex or Flex + LR

Question 16

In high SIN what do you want to do?

Answer 16

Found the mvt that reduce the most the pain

Question 17

In low SIN what do you want to do?

Answer 17

Asses 4s different combinations, looking for the most provocative position (most pain)

Question 18

How to palpate spine for low sin?

Answer 18

Neutral -> gradually more provocative position

Question 19

How to palpate the spine for high SIN?

Answer 19

Neutral -> gradually less provocative position

Question 20

How to mobilize/treat the spine for a low SIN?

Answer 20

Unilateral PA in the side of pain in neutral -> then most painful position

Question 21

How to mobilize/treat spine in a high SIN?

Answer 21

Unilateral PA in side of pain in neutral -> less painful position -> neutral -> painful position