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NMSKI > joint mobilisation 3 > Flashcards

joint mobilisation 3 Flashcards

1
Q

indications for joint dysfunction and pathology

A

analgesia
improve joint hypomobility
improve functional ability

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2
Q

joint pathology involves what 3 systems

A

muscle
neural
articular

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3
Q

stokes and young effects of joint injury

A

joint injury
immobilisation
muscle atrophy
muscle weakness

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4
Q

mechanism of action of joint mobilisation

A

mechanical

neurophysiological

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5
Q

types of nociceptors

A

a delta fibres

c fibres

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6
Q

what type of fibre is a delta fibre

A

mehcanical

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7
Q

a delta fibre is responsible for what kind of pain

A

1st / Fast Pain
Well-localized
Sharp / Prickling

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8
Q

a delta neurotransmitter

A

Glutamate neurotransmitter

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9
Q

what type of fibre is c fibre

A

polymodal

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10
Q

c fibre is responsible for what kind of pain

A 
2nd / Slow Pain
Diffuse
Dull
Aching
Burning
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11
Q

c fibre neurotransmitter

A

Substance P neurotransmitter

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12
Q

spinothalamic signals waddel 2004

A 
pain signals are filtered, selected and modulated at every level
spinal cord
spinothalamic
medulla
midbrain
primary somatosensory cortex
thalamus
corpus callosum
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13
Q

grades in glides that are large amplitude

A

grade 2 and 3

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14
Q

mobilisation effects

A

end of range EOR passive movemnts
increase joint ROM
decrease peri articular muscle spasm, intra articular pressure, joint afferent nociceptor activity
stimulates large diameter joint afferents for increased movement

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15
Q

end of rang joint rehabilitation

A

muscle inhibition - decrease in peri-articular tension
decrease in intra articular pressure -|> decrease in pain
decrease in nociceptor activity

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16
Q

local mechanical effect to joint mobilisation

A

CHANGE TO COLLAGEN EXTENSIBILITY
effect on immobilisation on joint
permanent length change - micro trauma 0 force needed

17
Q

how is immobilisation of joint settle

A

adhesions form within 15 days and are dense at 2/12

18
Q

neurophysiological effect of joint mobilisation

A

MOTOR EFFECT – CHANGE IN SPASM most likely due to analgesia  removal of pain stimulus
analgesia

19
Q

neurophysiological effects of analgesia

A

SPINAL CORD – Type I Mechanoreceptors in joints have inhibitory effect at SC on type IV nociceptor activity: PAIN GATE Mechanism

20
Q

neurophysiological effects of analgesia in higher central nervous system

A

HIGHER CNS – ACTIVATION OF DESCENDING INHIBITION OF PAIN
SYMPATHETIC EFFECTS – initial hypoalgesia associated with increase in SNS activity (↓ skin temp & ↑ skin conductance) demonstrated after Gr III PA x 1 min x 3 sets in CxSp  higher CNS involvement & probably dPAG stimulated

21
Q

psychological effects of manual therapy

A

positive placebo response

22
Q

biomechanical effects of manual therapy

A

altered tissue extensibility - > repair and tissue remodelling
altered fluid dynamics

23
Q

physiological effects of manual therapy

A

stimulation of gating system and descending endogenous opioid system -> pain relief
muscle inhibition
reduced intra articular pressure

24
Q

CONTRAINDICATIONS TO JOINT MOBILISATIONS

A

Joint dislocation or unhealed fracture
Immediate post-op to tendons, muscle, joint capsule or skin
Acute joint flare-up e.g. RA
Malignancy / bone disease

25
Q

JOINT MOBILISATION PRECAUTIONS

A 
Infection / inflammatory process in or close to joint
Early stage of healing
Analgesia or Muscle relaxants taken
?response
Bone fragility e.g. osteoporosis
for high grades only
hypermobile or subluxed joint
haemophilia
26
Q

TECHNIQUE SELECTION DEPENDS ON

A 
DIAGNOSIS
HISTORY & STAGE OF DISORDER: 
PRESENTING SIGNS & SYMPTOMS***
 contraindications or precautions
response to techniques
27
Q

for pain recommended techniques

A

Accessory mobilisations in neutral without pain (Gr I – II)

Physiological (large amplitude) without pain (Gr II)

28
Q

recommended techniques for stiffness

A 
Physiological mobilisatons at limit of range (Gr III – IV)
Accessory Rx in Physiological range / at limit (Gr III – IV)
Grade V (accessory & physiological Manipulations)
29
Q

recommended techniques for stiffness and pain

A

Rx primary component first
Primary Pain – Accessory or Physiological (Gr II)
Primary Stiffness – Accessory or Physiological (Gr III – IV) at limit, respecting pain

30
Q

TO CAUSE PAIN OR NOT TO CAUSE PAIN WITH JOINT TECHNIQUES?

A

severity
irritability
nature of condition - stage of healing

NMSKI (38 decks)

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