Joint mobility lecture

Question 1

Give 6 reasons for reduced ROM

Answer 1

Pain, muscle weakness, nerve injury, fear avoidance, joint stiffness, muscle tightness.

Question 2

Give 6 reasons for loss of ROM through lack of movement

Answer 2

Plaster, told not to move, had surgery, bad posture, loss of consciousness e.g. in ICU, joint disease e.g. OA

Question 3

What are the effects of immobilisation on ligaments? (3)

Answer 3

The total collagen mass decreases
Decrease in tensile strength and stiffness - don’t want them like this as they are more likely to snap
Shortens - if they are not being used then they are not going to be remodeled.

Question 4

What are the effects of immobilisation on the joint capsule? (2)

Answer 4

Decrease in tensile strength and stiffness.

Adheres to underlying cartilage and other structures = stickiness

Question 5

What are the effects of immobilisation on the hyaline cartilage? (3)

Answer 5

A decrease in protoglycan content and an increase in water content
Softening -> collagen fibres splitting ->OA
Adhesion formation between joint surfaces

Question 6

Name the benefits of joint mobility exercises (8)

Answer 6

Increase/maintain joint ROM
Reduce pain by the pain gate mechanism
Restore mechanical and structural properties of ligaments, joint capsules and tendons
Prevent cartilage degeneration
Maintain elasticity and contractility of muscles
Improve proprioception
Prevent DVT
Enhance synovial diffusion

Question 7

What are the two types of joint mobility exercise

Answer 7

Active - done by the person

Active-assisted - helped by another body part/object

Question 8

When may you prescribe active-assisted exercises? (3)

Answer 8

Patient not allowed to fully activate muscles e.g. surgically repaired tendon
Patient unable to activate muscles
Extra force is required to reach the end of range

Question 9

Name the principles of mobility exercises (7)

Answer 9

Patient is stable, safe and in a comfortable position
Area free from restrictive clothing e.g. no jeans
Isolate specific joint and movement
Move through complete range
Short hold (approx 3s)
Approx 5-10 reps
Approx repeat 3 times a day and build up gradually

Question 10

What are the contraindications? (3)

Answer 10

When it will disrupt the healing process or surgical repair
When it increases pain
When it increases inflammation