Joint Mobilisation

Question 1

what are the maitland grades and how to execute them?

Answer 1

grade 1 - small amplitude performed at the beginning of range
grade 2 - large amplitude performed within resistance-free range of movement
grade 3 - large amplitude performed into resistance or limitation of range
grade 4 - small amplitude performed into resistance or limitation of range

Question 2

what are the functions of the joint mobilisation?

Answer 2

• decrease pain (grades 1 and 2) = using pain gate theory/descending inhibition
• increase joint ROM (grades 3 and 4)
  = use soft tissue stretching
  = use synovial sweep

Question 3

what does tissue stretching do?

Answer 3

• stretch tight tissues/immobile tissues around a joint

- causes an increase in the range of movement

Question 4

what does synovial sweep do?

Answer 4

• allows movement of synovial fluid in the joint capsule

- increases lubrication and so increases movement

Question 5

How to describe pain gate theory to patients?

Answer 5

• 3 types of nerve fibres which send information about pain and touch to the brain through a “gate”
• nerve A sends signals about pain immediately (A-delta)
• nerve B sends signals about non-painful sensations (A-beta)
• nerve C sends signals about pain a long time after nerve A (C-fibres)
• when nerve B is not activated (when no non-painful sensation is felt after bump), gate remains open and nerve A and C can send signals about pain
• when nerve B is activated (eg: when u rub your head after u bump it), the gate closes fully/partially and less/no pain will be felt

Question 6

what are some contraindicators to the usage of joint mobilisation techniques?

Answer 6

• osteoporosis
• long term use of steroids
• use of anticoagulants within the last 6 weeks
• recent radiotherapy
• recent bone fracture
• recent ligament ruptures
• patient x give consent

Question 7

what are some precautions to joint mobilisation techniques?

Answer 7

• pregnancy
• children
• patients unable to relax
• mental capacity of patients to understand what they consent to
• skill level of physios
• total joint replacement
• severe scoliosis

Question 8

what is joint mobilisatiion?

Answer 8

skilled passive movement of the articular surfaces performed by a physiotherapist to decrease pain or increase joint mobility

Question 9

if patient experiences local joint pain/problems, which joint mobilisation should be used?

Answer 9

accessory joint mobilisation

Question 10

if patient experiences stiffness and lack of movement at a a joint, which technique should we use?

Answer 10

either accessory or physiological. Both can be used

Question 11

if patient experiences a severe pain at a joint, what technique do we use?

Answer 11

passive physiological joint mobilisation has its advantages