Joint mobilisation Flashcards

1
Q

Why do we mobilise joints

A

Healthy joints
Dysfunctional joints e.g. Ankle sprain (ATFL)
Pathological joints e.g. Osteoarthritic shoulder (glenohumeral) joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

mobilisation

A

‘passive movements performed in such a way that at all times they are within the control of the patient so that he can prevent the movement if he so chooses.’  small - large amplitude, low velocity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

manipulation

A

‘sudden thrust or movement of small amplitude, performed at a speed that renders the patient powerless to prevent it.’  small amplitude, high velocity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

physiological(osteokinematics) movements

A

those that patient can carry out actively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

accessory arthrokinematic movements

A

those that patient cannot perform himself but which can be performed on him by someone else
Possible because all joints have certain slackness in capsule & surrounding ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PROM

A

Passive movements –
Physiological movements that are performed by the therapist – at a single joint or at several joints in sequence to maintain joint range & muscle length
Not graded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PPM

A

Passive Physiological Mobs (Graded)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PAM

A

Passive Accessory Mobs (Graded)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Arthrokinematics

A

(direction of glide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

arthrokinematics is determined by

A

by morphology (shape) of joint surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Kaltenborn’s Convex-Concave rule

A

Arthrokinematics (direction of glide) is determined by morphology (shape) of joint surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AP accessory movements

A

anteroposterior glide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PA accessory movements

A

posteroanterior glide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Longitudinal caudad

A

caudad

in line with long axis of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

lat

A

Lateral distraction

or lateral glide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ceph/comp

A

Longitudinal cephalad

17
Q

med

A

Medial glide

18
Q

rotator cuffs invest Glenohumeral GH

A

joint capsule and controls humeral head movements

19
Q

where does RTC centre

A

‘centres’ the humeral head to assist in stability of a very mobile joint

20
Q

RTC has an impact on

A

on HH gliding directions (think of cellophane)

21
Q

shoulder rotation

A

EXTERNAL ROTATION / EXTENSION

INTERNAL ROTATION / FLEXION (ELEVATION)

22
Q

in vivo

A

consider impact of tightening capsule and rotator cuff musculature

23
Q

Accessory Movement Exam can:

A

Identify & localise symptomatic joint
ASSESS - Define nature of joint motion abnormality
NORMAL vs. HYPOMOBILE vs. HYPERMOBILE
TREAT - Provide basis for selection of treatment techniques.

24
Q

Exam technique

A
Apply pressure close to joint line, examine unaffected side first for comparison.
note QUALITY 
RANGE of motion
Pain behaviour through range
Resistance
25
grade I
Small-amplitude movement performed at the beginning of range
26
grade II
Large-amplitude movement performed within a resistance-free part of the range.
27
Grade III
Large-amplitude movement performed into resistance or up to the limit of the range.
28
Grade IV
Small-amplitude movement performed well into resistance.
29
Accessory movements in clinical settings
Position pt comfortably Examine joint on unaffected side first & compare Examine initially without feedback – helps learning Use largest area of skin contact possible for max patient comfort Keep thumbs straight
30
how should force be applied
Where possible, clinician’s forearm should lie in direction of applied force Apply force smoothly & slowly through range to either assess or treat (grades)