Grades

Question 1

Grade 1 Maitland

Answer 1

small amplitude movement at the beginning of the available range of movement. (0 – 30%) within the spines resistance

Question 2

Grade 2 Maitland

Answer 2

large amplitude movement within the available range of movement (20 – 70%) within the spines resistance

Question 3

grade 3 Maitland

Answer 3

large amplitude movement that reaches the end range of movement (50 – 100%) into the spines resistance

Question 4

grade 4

Answer 4

small amplitude movement at the very end range of movement (80 – 100%) into the spines resistance

Question 5

mobilisations pain reliefs through what?

Answer 5

hypoalgesia - neurological effect decreasing the nervous system’s sensitivity to painful stimuli.

Question 6

pain gate theory

Answer 6

=melzack and wall (1965)

explains that non-painful input closes the nerve gate to painful input and prevents pain sensation from reaching the CNS

Question 7

descending pain inhibition 3

Answer 7

1. The non-nociceptive neurones connect to the brain SSC.
2. the SSC stimulates neurones in periaqueductal gray area of the mid brain
3. stimulates cells in medulla such as nucleus raphe and Magnus
4. This activates the endogenous opioids to suppress pain through the release of serotonin and nor-adrenalin
5. stimulates the inhibitory neurone in dorsal horn and blocks ascending pain impulses

Question 8

McKenzie 1960 exercises 3

Answer 8

1. Lying in prone - 3 minutes can create lordosis of lumbar spine
2. Extension in lying with elbows under shoulders press up into lumbar extension, the goal is to reach end of full range then return to the table
   - Each time trying to push into a further range- 10 reps in a rhythmic manner
   - Therapist can apply PA glide whilst patient performs movement
3. Press up to hands

Question 9

McGill exercises 3

Answer 9

1. curl up
2. side bridge
3. bird dog

Question 10

McGill curl up 4

Answer 10

1. Lie down on your back. Extend one leg and bend the knee of the other leg.
2. Put your hands under the lower back to maintain the natural arch of your spine.
3. Pull your head, shoulders and chest off the floor, as though they were all locked together. Lift them up as one unit. Keep your back in neutral position. Don’t tuck your chin or let your head tilt back.
4. Hold for 10 seconds. Slowly lower yourself down. Do half of the repetitions with your left leg bent and half with your right leg bent.

Question 11

side bridge

Answer 11

1. Lie on your side, with your forearm on the floor and elbow underneath your shoulder. Place your hand on the opposing shoulder to stabilize your torso. Pull your feet back so the knees are at a 90-degree angle.
2. Lift the hips off of the floor and hold for 10 seconds. Try to maintain a straight line from your head down to your knees. Make sure that your hips are in line with the rest of your body. When completed turn over to other side. (Optional: For a greater challenge, straighten the legs instead of bending them).

Question 12

Bird dog 3

Answer 12

1. hands-and-knees position on the floor.
2. Raise the left arm forward while simultaneously extending your right leg back until both are parallel to the floor. Ensure that hips are aligned with the torso and not tilted to one side.
3. Hold for 10 seconds. Repeat on the other side.

Question 13

whats a SNAG Mulligan 1974

Answer 13

Sustained Natural Apophyseal Glides.

Question 14

whats a NAG Mulligan 1974

Answer 14

Natural Apophyseal Glides

Question 15

MWM Mulligan 1974

Answer 15

mobilisation with movements

Question 16

SNAGs mulligan 1974 4

Answer 16

1. SNAGs can be applied to all the spinal joints, the rib cage and the sacroiliac joint.
2. The therapist applies the appropriate accessory zygapophyseal glide while the patient performs the symptomatic movement.
3. They are not the choice in conditions that are highly irritable.
4. Although SNAGs are usually performed in weight bearing positions they can be adapted for use in non weight bearing positions.

Question 17

NAGs mulligan 1974 6

Answer 17

1. NAGs are used for the cervical and upper thoracic spine.
2. They consist of oscillatory mobilizations instead of sustained glide like SNAGs, and it can be applied to the facet joints between 2nd cervical and 3rd thoracic vertebrae.
3. NAGs are mid-range to end range facet joint mobilizations applied antero-superiorly along the treatment planes of the joint selected.
4. Useful for grossly restricted spinal movement.
5. NAGs for the treatment of choice in highly irritable conditions
6. One hand around patients head, don’t cover ears. The other grips the vertebra- upward diagonal movement oscillatory

Question 18

MWM Mulligan 1974 1

Answer 18

1. the concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end range applied by the patient. Passive end-of-range overpressure, or stretching, is then delivered without pain as a barrier.

Question 19

contraindications 5

Answer 19

Any pathology that leads to significant bone weakening
Neurological: cord compression, cauda equina compression, nerve root compression with increasing neurological deficit
Vascular: aortic aneurysm, bleeding into joints
Lack of diagnosis
Patient positioning can not be achieved because of pain or resistance.