Joint Mob Flashcards
What is Manual Therapy?
Guide to Physical Therapist Practice: Skilled hand movements intended to improve …
What is Mobilization/ Manipulation?
Guide: A manual therapy technique comprising a continuum of skilled passive movements to the joints and/or related soft tissues that are applied at varying speeds and amplitudes, including a small-amplitude/high velocity therapeutic movement
How do you classify movelements?
Classic/ Physiological/ Osteokinematic: PROM and AROM
Manipulation: Non-thrust (distraction and glide), and thrust
Accessory Movements: Component motions and joint play
How do we determine if joint integrity and mobility is impaired?
From the systems review, the PROM will be restricted and/ or painful
What is a capsular pattern?
What are the capsular patterns for the UE joints?
- The proportional loss or limitation of passive range of motion that suggests inflammation in that joint
- Shoulder: ER - ABD - IR
Elbow: Flex & Ext
Forearm: Pronation and Supination restircted equally
Wrist: Equal in all directions
Finger: limit in all directions (slight more limit in flex)
MCP 2-5: “
MCP 1: “
CMC 2-5: equal in all directions
CMC 1: abduction - extension
What are some contradictions to joint manipulation?
If a pt is hypermobile or has a specific disease (OA) have to be really careful
What is the treatment plane of joint mobs?
In the line of the concavity. All glides are parallel and all distractions are perpendicular
Why do we use distraction?
Glides?
- Unweight joint surfaces
- Relieve pressure on intra-articular structures
- Stretch the capsule/adhesions
- Assist in reduction of a dislocation\
_ Stretch capsule/ adhesion
How do you grade joint play?
0 Ankylosis
1 Considerable Hypomobility
2 Slight Hypomobility
3 Normal
4 Slight Hypermobility
5 Considerable Hypermobility
6 Unstable
What are the grades for oscillation glides/ distractions?
I: Small amplitude, beginning of range
II: Large amplitude, beginning to middle of range, short of first tissue stop
III: Large amplitude, past first tissue stop, up to second tissue stop
IV: Small amplitude, maintained between first and second tissue stop
What are the grades for sustained stretches in glides or distraction?
I: Small amplitude, beginning of range, short of first tissue stop
II: Large amplitude, from middle of range up to first tissue stop
III: Large amplitude, past first tissue stop, up to second tissue stop
When do you use a grade 5 thrust?
- Done at barrier to motion
- Utilized when joint play grade is 2/6 only
- Selected if other grades are unsuccessful
What are the expected outcomes of joint mobs?
Grade I and II
Decrease Pain
Aids in Nutrition and Repair
Grade III and IV
To Restore Normal Motion, Which –
Improves function and performance
Improves tolerance to insult