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JOINT MOBILIZATIONS > Foundational Theory > Flashcards

Foundational Theory Flashcards

1
Q

What are osteokinematic movements?

A

the gross, big movements of bones that occur at joints

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2
Q

What are examples of osteokinematic movements?

A

flexion, extension, abduction, etc…

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3
Q

What are arthrokinematic movements?

A

smaller movements that occur within joints, enabling the greater movements that occur at the joints

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4
Q

What are some examples of arthrokinematic movements?

A

roll, glide, spin

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5
Q

What does passive accessory mobilization/manipulation refer to?

A

externally imposed, small amplitude passive motion intended to produce gliding or traction at a joint

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6
Q

What does passive physiological mobilization/manipulation refer to?

A

pROM

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7
Q

What does “loose pack” or “resting position” refer to?

A

the position where the periarticular tissues/joint capsule is the most lax and there is the most space between the articular surfaces

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8
Q

The most comfortable position for a patient with joint pain is usually…

A

resting/loose pack

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9
Q

What is “actual resting position”?

A

whatever the most comfortable position is for the patient, with the least amount of soft tissue tension - unique to the patient

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10
Q

What is the treatment plane?

A

the plane you are mobilizing within, which is parallel to the articulating surfaces (look at the concave plan and imagine it flattened)

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11
Q

If a concave surface moves on a stable convex surface, roll and slide must occur…

A

in the same direction as the osteokinematic movement

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12
Q

If a convex surface moves on a stable concave surface, roll and slide must occur…

A

in the opposite direction of the osteokinematic movement

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13
Q

What occurs in ‘spinning’?

A

one point of one surface remains in contact with the articulating surface while rotating in relation to it

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14
Q

In rolling, one point comes into contact with another point _____ from the original contact point on both surfaces

A

equidistant

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15
Q

In glide/slide, the point of contact stays the same on which articulating surface?

A

the moving surface

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16
Q

Restricted ROM is most often associated with a decrease in which arthrokinematic movement?

A

gliding

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17
Q

Differentiate sellar vs. ovoid joints

A

sellar - one surface is concave in one direction and convex in the direction perpendicular to it

ovoid - one surface is completely concave, the other completely convex

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18
Q

What is ‘excursion’?

A

the amount of movement available in the joint capsule

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19
Q

Which grades of excursion present a corrective opportunity for joint mobilization?

A

grade 1 or grade 2

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20
Q

You would never try to mobilize/increase mobility in joints with which grades of excursion?

A

grade 0, or 4, 5, 6

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21
Q

Articulating surfaces are maximally congruent in what position?

A

closed-pack

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22
Q

The position a joint will assume in the case of synovial effusion is…

A

resting position

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23
Q

What does ‘capsular pattern of restriction’ refer to?

A

the predictable pattern of restriction that occurs in a synovial joint when pathological conditions exist, affecting the whole joint capsule. this is listed from most restricted to least

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24
Q

To position the joint to prepare for a mobilization, what should you do?

A

move the joint to the point of restriction, then back off by approximately 10 degrees before performing it

OR for some you may start from resting position

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25
Q

Joint play assessment should be done in what position?

A

resting

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26
Q

List the absolute contraindications of joint mobilizations.

A 
recent fracture
neoplasm
acute inflammatory disease (like RA)
joint sepsis
bacterial infection
acute pain response
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27
Q

What are the non-corrective grades of sustained glide and of corrective oscillations?

A

sustained glide:
1 + 2

oscillations:
1 + 2

28
Q

What are the corrective grades of sustained glide and corrective oscillations?

A

sustained glide:
3

oscillations:
3 + 4

29
Q

End feel: firm, leathery, with a slight creep, may describe…

A

a capsular end feel

30
Q

End feel: firm, with no give/creep, may describe…

A

ligamentous end feel

31
Q

A bony end feel may suggest…

A

hypertrophic bone changes IF accompanied by restricted movement

32
Q

End feel: rubbery, less abrupt than capsular, may describe…

A

muscular end feel

33
Q

“Pronounced, springy rebound - accompanies noncapsular restriction from a mechanical block, such as a loose body or displaced meniscus” may describe which end feel?

A

internal derangement

34
Q

What would the end feel be like in the case of adhesions and scarring?

A

sudden sharp arrest in one direction

35
Q

What end feel is described? “similar to normal but with pain and mm guarding, stiffness in early range that increases until end is reached”

A

soft capsular

36
Q

In the case of a pannus, what would the end feel be like?

A

soft, crunchy squelch which may be due to synovial infold or trapped fat pad

37
Q

Hypomobility without pain suggests…

A

chronic adhesion or contracture

38
Q

Normal mobility with pain suggests…

A

mild sprain without capsular fiber disruption

39
Q

Normal mobility with pain can be treated with…

A

gentle mobilization to decrease pain and promote normal alignment of fibres in healing process

40
Q

Hypermobility with pain suggests…

A

partial sprain of capsular tissue

41
Q

Hypermobility without pain suggests…

A

complete sprain of capsular tissue

42
Q

Hypermobility with pain can be treated with…

A

gentle mobilization to decrease pain and promote normal alignment of newly forming collagen

43
Q

Pain that increases with distraction and decreases with compression suggests…

A

ligamentous or other capsular structures’ involvement rather than the articulating surfaces

44
Q

What identifies the elastic phase?

A

tissue will return to original configuration when force is removed

45
Q

What occurs in the plastic phase?

A

permanent elongation of tissue even once force is removed

46
Q

What does the ‘necking point’ refer to?

A

a decrease in load is accompanied by an increase in deformation, suggests that breaking point is about to be reached

47
Q

What is the failure or breaking point in the stress-strain curve?

A

where separation of elongated tissue occurs

48
Q

____ speed oscillations may relax mm guarding

A

slow

49
Q

Oscillatory techniques are recommended for ______

A

pain management or high tonicity

50
Q

What is the function of oscillations in a prolonged stretch?

A

to reduce the amount of discomfort and facilitate maximal relaxation

51
Q

What are the pathological conditions that would affect the whole joint?

A

effusion, capsular fibrosis, and pseudo-fibrosis (or relative capsular fibrosis)

52
Q

Movement that is perpendicular to the treatment plane would mean you are doing a…

A

distraction

53
Q

Movement that is parallel to the treatment plane would mean you are doing a…

A

glide

54
Q

What are the absolute contraindications?

A 
recent fracture
metabolic bone disease
acute inflammatory disease
neoplasms
ankylosing of joint
joint sepsis/bacterial infection
acute pain response to mobilization
hesitancy/no consent
55
Q

What is the capsular pattern of restriction for the glenohumeral joint?

A

ER > abd > IR

56
Q

Describe the resting position for the shoulder joint

A

55-70 degrees of abduction + 30 degrees horizontal adduction

57
Q

What would closed pack position be for the shoulder joint?

A

maximal horizontal abduction + external rotation

58
Q

Describe an Excursion Grade 1

A

Considerable limitation

59
Q

Describe an Excursion Grade 0

A

Absolutely no movement between articular surfaces

60
Q

Describe an Excursion Grade 2

A

Slight limitation

61
Q

Describe an Excursion Grade 3

A

Normal!

62
Q

Which excursion grade is used for ‘normal’ mobility?

A

3

63
Q

Describe a joint with an excursion grade of 6?

A

unstable joint, stabilization exercises likely unsuccessful, most likely a surgical case

64
Q

There are _ grades of excursion, _ kaltenborn grades, and _ maitland grades.

A

6, 3, 4

65
Q

Small or large: describe the amplitude of oscillations for each of the Maitland grades

A

1 - small
2 - large
3 - large
4 - small

66
Q

Which Maitland grade would this be: “small amplitude movement at the beginning of the available ROM”

A

grade 1

67
Q

Which Maitland grade would this be: “small amplitude within/at tissue resistance”

A

grade 4

JOINT MOBILIZATIONS (7 decks)

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