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Joint Mobilization > Class 1 - Terms, I&CI, Assess, S&S Curve, Excursion, End feel > Flashcards

Class 1 - Terms, I&CI, Assess, S&S Curve, Excursion, End feel Flashcards

1
Q

D) Osteokinematic mvmt

D) Arthrokinematic

A

Gross mvmt of bone @ jt: FLX

Mvmt occuring w/i jt: Slide, roll, glide

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2
Q

D) Passive accessory mobilization/manip

D) Muscle Energy Technique (MET)

A

EXTERNAL imposed small amplitude passive motion to produce a GLIDING/TRACTION @ jt.

Passive jt mvmt induced by ACTIVE contrax of Pt own Mm

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3
Q

D) Mobilization w/ mvmt

D) Passive Physiological Mobilization/manipulation

A

Passive Jt. Motion w/ AROM

PROM

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4
Q

Explain the concave convex rule and its significance to joint manipulation

A

Concave moving on convex, slide and roll occurs in same direction
Convex moving on concave, slide and roll is in opposite direction

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5
Q

What is a component or accessory joint motion?

A

Arthrokinematic mvmts that must/involuntarily accompany the osteokinamtic mvmt (roll of femur @ FLX of knee)

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6
Q

6 Abs CI to Jt Play

A
  • Neoplasm
  • Jt sepsis
  • bact infection
  • Acute inflammatory cond (e.g. Acute RA)
  • Recent Fracture
  • Acute (P) resp to manipulation
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7
Q

What are the corrective grades of oscillations, and what is the correct grade
of sustained glide?

A

G3-4 are corrective grade
G3: Large amplitude oscillation w/i tissue resistance and backing out. 2-3 cycles/second (Rhythmic)
G4: Small amplitude oscillation w/i tissue resistance. 5 cycle/s

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8
Q

Oscillatory mvment: Fast vs. slow

Choice of oscillatory vs sustained:

____ is used w/ all gliding test/mobil

A

Inhibit pain (fast and small amp) vs muscle guard (irrelgular rhythm w/ slow & large amp to trick Mm) for acute or to prep for stretch in chronic

Pt resp.

Traction Gr 1

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9
Q

How do we mv jt to avoid tension to capsule and ligaments

Oscillation purpose: Acute vs Chronic

A

Mgmt @ beginning or mid-pt of joint play amplitude

Acute: PROM mobilization, vs Chronic: intermittent @ initiation btw stretch & end to relax Mm

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10
Q

Stretch for capsular adhesion/tightness: first move jt to the limit ______

Must be _______ (cadence) b/c

Slack in taken up in jt play is ______ as mvmt performed

A

of pathologic amplitude and attempt to incr. amplitude

Rhythmic & slow, avoid Mm reflx contraction

Slack not released

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11
Q

Stops: used when_____

Tp uses their _____ as a stop which allows for _____ and for the pt, ____ (example)

A

Stretch limits of osteokinematic re: tight capsule

Body (trunk, forearm/thigh), progressive incr ROM, for pt indicates exact extent of mvmt to reduc anticipatory Mm guarding (thigh next to ghj for int/ext rot)

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12
Q

Indictations of Jt Mob (6)

Add:

A

Incr jt extensibility ROM - capsular adhesion

Decr (P)

Promote relaxation (oscillation)

Incr. Mm strength due to more aligned jt components

Incr positional fault

Jt nutrition

Meniscoid impingement, spinal jt disc herniation, SNS change, placebo

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13
Q

Preeacutions (4)

A

Dx not fully evaluated

Jt ankylosis (mobilize jt above & below)

Hypermobility

Local area: local jt/skin infection, malignancy, acute fracture

Inflammatory arthritis/effusion, dise compromising integrity of periarticular tissue, LT corticosteroid

Protect spasm

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14
Q

What to do when joint mobes results in (P)

Why do we do the MNRS of HOPMNRS

A

Chg position, hand placement, circulatory PROM to calm down S&S

Rule out specific conditions

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15
Q

Resting aka ____ defn

Most comfortable for ____

If resting can’t be done, place _____

A

Loose pack position: most lax/greatest accessory mvmt, anatomical resting position (most glide, roll, spin)

Pt w/ jt pain comfort

Least amt of tissue tension (asking actual resting position for pt - let go)

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16
Q

Accessory motion assesed by moving _____

Majority of jt mobes is _____

Tx plane

Example jt:

A

one bone on other = arthrokinematic

Perpendicular: Distraction or compression

Parallel to Tx plane - Glide (majority of jt mobes) (eg. GHJ & humerus)

17
Q

Stress-strain curve:

A

Tensile force to tissue, goes through strains:
1st stage - Elastic, returns to original configuration post force

2nd stage - Plastic, permanent elongation of tissue post-force

3rd stage - failure/breaking = separation of elongated tiss, stress fracture

Necking pt (2.5) decrease in load accompanied by incr in deformation, breaking pt about to be reach

18
Q

Jt play aka _____ defn

Accessory motion examination entails (3)

A

Excursion
Jt mobility eval using glide or traction re: available motion through tissue resist

Amt of excursion per direction

Presence of pain

Type of tissue resistance @ end of range for accessory motion

19
Q

Grades of excursion:

A

0-6
0: No motion btw artic surf - ankylosed = CI

1-2: considerable to slight limitation in excursion, indicated

3: Normal excursion - not indicated

4-5: Slight to considerable increase in excursion. not indicated, treat w/ stabilization exercuses, education on posture/position to avoid

6: Unstable jt, CI for mobil, Tx w/ stabilization, pt edu re: posture & position avoid, taping, lower success

20
Q

End Feel

A

resistance to mvmt felt when going to end pt of mvmt.

Patho depending on feel @ pt in ROM or movement

21
Q

End feel

Defn:

Normal End feels:

A

Ligamentous - slight recoil (ABD of knee)
Capsular - firm (full gh EXT ROT)
Bony - no recoil/abrupt
Soft tissue approx: Knee/Elb FLX
Muscular - Rubbery feeling, less abrupt than capsular (hamstring stretch)

22
Q

End feel:

Strictly pathological (3/5)

A

Mm spasm - usually P), some synov inflamm

Capsular -
Hard: tight resist to creep, chronic inflamm
Soft: w/ P), Mm guard - acute inflamm

Boggy: soft mushy feel, no syn inflamm (w/ capsular)

23
Q

End feel:

Strictly pathological (2/5)

If bit of resistance before end P) it’s____

A

Internal derangement: springy (noncapsular from mechanical block - elbow/knee)

Empty - no restriction, stopped due to severe P) - acute bursitis of v. severe fracture. Mm do not contract

Mm spasm.

24
Q

Ovoid joint/synovial

Sellar joint

Ex)

A

Surface A) entirely convex, B) entirely concave

Surface A) concave in one direction, and convex in perpendicular direction

Sterno-clavicular

25
Q

Intervention:

Never perform in____

A

Start - resting position (safest), verify safety,

Next - move to position approximating restricted ROM

Close packed: capsule/lig max stretch (most tamped down with some twisting) & jt most congruous

26
Q

Kaltenborn

Maitland

A

Sustained glide - 1-3, for tractions

Oscilation 1-5 grading system, glide intervention. 5 being out of scope.

27
Q

Closed packed position

Resting position

A

Articular surfaces most aligned, jt capsule is twisted, surfaces approximated, no furter mvmt in the direction is possible.

Most synovial effusion, articular surfaces separated, capsule is relaxed

Joint Mobilization (1 decks)

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