Joint mobilisation

Question 1

Physiological Movements

Answer 1

Mvmts that a health person can consciously perform - flexion, extension etc
Active- mvmt performed themselves
passive - another person performs

Question 2

Passive movement - assess why?

Answer 2

End feel
range of motion
symptoms

Question 3

Passive treatment = passive physiological mobilisations

Answer 3

Maitland grades 1 and 2 = pain

3 and 4 = ROM

Question 4

Grade 1
G2
G3
G4

Answer 4

small amplitude mvmt at beginning of range
G2 = big amplitude ww/in resistance free range
G3 = Big amplitude into resistance or up to limit of range
G4 - small amplitude into resistance or upto limit of range

Question 5

Rhythm

Answer 5

many different rhythms can be used - sharp and abrupt or low speed for as long as 5 seconds

Question 6

how does 3 and 4 work?

Answer 6

2 main methods
stretching soft tissues and adhesions, restoring ability of joint to undergo normal range of motion
aid lubrication of the joint through synovial sweep and therefore movement

Question 7

Theory of Action for grade 1 and 2

Answer 7

Pain Gate Theory

Descending inhibition

Question 8

Fibres

Answer 8

A delta fibres - transmit sharp pain, quickly
A beta fibres - non-painful sensation from mechanoreceptors in skin and other soft tissue structures
C fibres transmit dull pain - more slowly

Question 9

A beta fibres

Answer 9

Neurons which transport sensations have synatic connections with the pain fibres and connect to inhibatory neurons which inhibit passage of painful sensations to the brain - reducing the amount of painful sensation to the brain
Short term mechanism but long term benefits from increase ROM, endorphins etc

Question 10

Descending Inhibition

Answer 10

Once A beta fibres are stimulated from massage or mobilisations go upto higher centres of the brain where neurotransmitters are released are descend back down - like opiods reduce transmission of painful sensations to the brain.

Question 11

Pain gate and

Descending inhibition

Answer 11

Pain gate is before it gets into the brain with the non-painful sensations blocking the gate. Descending inhibition is when the non-painful sensations send a message to the brain to send some opiods back down to reduce transmission of pain

Question 12

Accessory movements

Answer 12

During physiological mvmts small mvmts occur between joint surface.
To maintain congruence of joint (stop them dislocating)
We cant do them - occur automatically

Question 13

Three main types of accessory movements

Answer 13

Roll
Slide
Spin

Question 14

Concave - Convex rule

Answer 14

When the convex (round surface) is moving the roll and slide are in opposite directions.
If the Concave surface is moving = Roll and slide in same direction

Question 15

Passive accessory movements for Assessments look at:

Answer 15

ROM
end-feel
symptoms

Question 16

Passive accessory mobilisations look at:

Answer 16

Relieving pain (Maitlands 1 and 2)
Increase/restore ROM - 3 and 4