Joint mobilisations and tens Flashcards
What’s a joint mobilisation
Skilled passive movement of physio to increase ROM/ joint mobility and decrease pain, applied where there’s reduced mobilisation of a joint that can be restored
What are osteokimematics
Clear movements of bones which are visible from the outside, arise from rotation around joint axis E.G flexion, extension, open or closed action
What are arthrokinematics
Unobservable articular accessory motion between adjacent joint surfaces, (roll, glide and spin) these accessory motions take place with all active and passive movements and are necessary for full, pain free range of motion , can’t occur independently or voluntary and if restricted can limit physiological movement
Types of arthrokinematic motion
Joint play- movement not under voluntary control(passive) can’t be achieved by active muscular contraction
What’s a roll movement
Refers to the rolling of one joint surface on another, in the knee the tibial condyles roll on the tibial plateau
What’s a slide movement
Refers to the gliding of one component over another in the hand the proximal phalanx slides over the fixed end of metacarpal
What’s a spin movement
Rotation of a segment about a stationary axis, E.G proximal radio ulna joint , usually with rolling and sliding
What’s the concave convex rule
When a convex surface moves on a stable concave surface, the sliding of the convex articulating surface occurs in the opposite direction to the motion of the bony lever during flexion there’s an anterior to posterior glide of the Tibia, opposite on extension, most joint mobilisations done in open pack position so you can test slide of the surface, modify techniques to target the position the patient has symptoms in
Indications for joint mobilisations
Restoration of movement to a joint, accessory movements, specific to joint, pain, spasm, tissue tightness
Effects of joint mobs
Improves ranges of active, passive and accessory joint movements, increases length of joint soft tissue structures and surrounding soft tissue structures, decreases muscle spasm
What’s are pain control mechanisms
Central pain control, pain gate theory, central pain descending inhibition of peri-aquaductal grey matter (PAG) in the brain stem and spinal cord
Dorsal (PAG): non opioid, noradrenalin, blocks substance, par spinal cord level and ventral (PAG): opioid mechanism, serotonin
What’s the gate control theory
Low threshold, large diameter, myelinated AB fibres (mechanoreceptors) response dorsal horn to A and c fibres
What’s tens
Method of electrical stimulation whereby low frequency electrical currents are applied to the skin via leads and wires stimulating sensory nerves for symptomatic relief of pain
Does tens work
Regular use of tens leads a significant reduction of dosage in pain medication could aid pain medication for optimal pain management
