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MPT 2 > Joint Manipulation > Flashcards

Joint Manipulation Flashcards

1
Q

definition of joint manipulation/mob

A

skilled passive movements to the joints and or related soft tissues that are applied at varying speeds and amplitudes

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2
Q

thrust joint manipulation

A

high velocity, low amplitude therapeutic movements within or at end range of motion

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3
Q

what grade is high velocity low amplitude mob?

A

5

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4
Q

maitland’s theory

A

move a peripheral or vertebral segment to increase motion or decrease pain

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5
Q

who identified graded passive movements

A

maitland

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6
Q

kaltenborn’s theory

A

restore movement allowed by shape of surface (convex/concave)

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7
Q

cyriax’s theory

A

stretch joint capsule
alter shape/reduce strain of disc

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8
Q

evjenth’s theory

A

stretch muscles spanning joint

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9
Q

mennell’s theory

A

restore joint play

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10
Q

strain/counterstrain theory

A

decrease soft tissue strain to facilitate muscle relaxation

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11
Q

myofascial release theory

A

decrease tension in soft tissue to increase segmental movement to decrease likelihood that dysfunction returns

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12
Q

A ______ is something the patient complains of while a _______ is an objective finding

A

symptom, sign

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13
Q

T or F: a joint sign is an objective finding

A

T: anything found within a joint, its structures or movements that is abnormal

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14
Q

comparable sign

A
  • reproduction of the patient’s complaint of pain through examination
  • reproduces the pt’s symptoms
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15
Q

asterisk sign

A

outstanding signs used for quick reassessment of a patient’s progress

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16
Q

how many asterisk signs should you try to find

A

1-2

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17
Q

for pain, what is the goal of treatment

A

reduce, centralize, and eliminate the pain

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18
Q

for stiffness, what is the goal of treatment

A

reproduce the pain (with respect) moving further into range to reduce stiffness

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19
Q

pain is often _______ while stiffness is localized

A

diffuse

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20
Q

is pain or stiffness usually worse at night?

A

pain

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21
Q

does stiffness usually cause limitations? what about pain?

A

stiffness no, pain yes

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22
Q

in pain-dominant patients, pain is usually constant while in stiffness dominant it is ___________

A

intermittent

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23
Q

T or F: stiffness is usually chronic

A

T

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24
Q

pain is aggravated by ________ activity and is slow to reduce while stiffness is aggravated by ________ activity and only lasts a short time

A

mild, vigorous

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25
Q

in pain dominant, pain is usually ______ than a 5/10 while in stiffness-dominant pain is usually _________ than a 5/10

A

greater, less

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26
Q

T or F: pain dominant is often aggravated by repeated movements

A

T: but for stiffness dominant repeated movements often increase range

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27
Q

_______ dominant has pain at rest, early, and mid-range whereas ________ dominant usually only has pain at end range

A

pain, stiffness

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28
Q

T or F: stiffness dominant usually has spasms

A

F: but pain does!

29
Q

Your pt c/o constant 7/10 shoulder pain that gets worse at night. He is very guarded and doesn’t want to move his shoulder. On objective exam you find he has pain at rest, early, and mid-range. He also has spasm and as you continue your exam his pain increases. Is this pt most likely pain or stiffness dominant?

A

pain
**your exam on someone who is pain-dominant may not be as in depth

30
Q

Your pt c/o 5/10 shoulder pain only w/ overhead movements. On objective exam, you find he has limited abduction, flexion, and ER. No spasms are found. As you continue your exam and moving his shoulder around his range slightly increases. Is this pt most likely pain or stiffness dominant?

A

stiffness

31
Q

what grades of mobs do you use for pain? what about stiffness?

A

grade 1-2
grade 3-4

32
Q

goal of mobs for pain

A

stay short of resistance to reduce pain

33
Q

goal of mobs for stiffness

A

go into/through barriers to produce pain in order to increase range

34
Q

for ________ dominant you use most free movements for manual treatment and exercise while for _______ dominant use most restricted movements for treatment

A

pain
stiffness

35
Q

pain is likely an ______ condition, while stiffness is likely a ______ condition

A

inflammatory, mechanical

36
Q

3 signs of irritable patient/pain

A

1 - easily provoked, 10 mins or less of activity
2 - constant or severe intermittent pain
3 - takes 10 mins or more to settle pain back to baseline

37
Q

treatment for irritable pain

A
  • grade 1 or 2 mobs for brief and few bouts
  • PROM, AAROM, AROM
  • light resistance exercise with fewer reps to be repeated throughout the day
38
Q

treatment for non-irritable pain

A
  • grade 3-4 mobs for longer and more bouts
  • ROM also into barrier and end range
  • higher resistance and reps
39
Q

R1

A

onset of resistance

40
Q

R2

A

resistance limit

41
Q

P1

A

onset of pain

42
Q

P2

A

pain limit

43
Q

S1

A

onset of spasm

44
Q

S2

A

spasm limit

45
Q

A (on movement diagram)

A

beginning of movement

46
Q

B (on movement diagram)

A

end of normal ROM

47
Q

L (on movement diagram)

A

abnormal limit to a ROM

48
Q

passive physiological

A

typical PROM

49
Q

passive physiological intervertebral movements

A

used to assess movements at individual spinal levels

50
Q

passive accessory intervertebral motions (PIVMS)

A

movements available in a joint performed passively by the therapist

51
Q

TJM

A

thrust joint manipulation
grade 5

52
Q

3 motions occurring when you do mobs

A

1 - osteokinematics
2 - arthrokinematics
3 - compression and distraction

53
Q

bone motion (flexion, abduction, rotation) is what kind of kinematics

A

osteokinematics

54
Q

osteokinematics are described from anatomical __________

A

neutral

55
Q

rolls and glides are what kind of kinematics? these are also known as accessory motions

A

arthrokinematics

56
Q

how many grades of movement are there

A

5

57
Q

grade 1

A

small amplitude, short of resistance

58
Q

grade2

A

large amplitude, short of resistance

59
Q

grade 3

A

large amplitude to 50% of R1-R2

60
Q

grade 4

A

small amplitude to 50% of R1-R2

61
Q

grade 5

A

small amplitude, high velocity thrust at end of available range

62
Q

type 1 and 2 mechanoreceptors

A

in joint capsules
low threshold, excited with oscillations

63
Q

type 3 mechanoreceptors

A

in joint capsules, extracapsular ligs
excited by stretching

64
Q

type 4 mechanoreceptors

A

in capsules, ligaments, fat pads, and blood vessels
- pain receptors

65
Q

what type of mechanoreceptrs do you NOT want to excite

A

type 4

66
Q

what are some contraindications of joint mobs

A
  • vertebral artery insufficiency
  • acute RA
  • instability
  • unhealed fracture
  • cauda equina
  • acute inflammation
  • psychological or undiagnosed pain
  • pain that doesn’t relate to movement
  • bone disease
  • joint effusion
  • malignancy
67
Q

precautions for joint manipulation

A
  • excessive pain
  • total joint replacement
  • fusion
  • neuro deficit
  • osteoporosis
  • spondylolishesis
  • pregnancy
  • acute trauma
  • foraminal encroachment
  • steroids or anticoagulants
68
Q

you should stabilize ________ and mobilize ________

A

proximally, distally

MPT 2 (11 decks)

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