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508 > Joint Mobilization > Flashcards

Joint Mobilization Flashcards

1
Q

What are physiologic movements?

A

Motion that can be created volitionally (actively)

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2
Q

What are non-physiologic movements?

A

Motion that does not occur in isolation voluntarily

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3
Q

What are component movements? What is an example of this motion?

A

-Motion that occurs in combination with physiologic motion
-Ex. Clavicular rotation during arm elevation; Tibial external rotation with knee extension

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4
Q

What is joint play?

A

-Occurs only in response to an outside force
-Involves end feels
-Pertains to accessory motions of joint play that are needed for normal physiological range (distraction, glides, and tilts)

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5
Q

What are the characteristics of mobilization?

A

-Skilled passive movement
-Low velocity
-Does not go beyond end range
-Can be graded I-III or I-IV

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6
Q

What are the characteristics of manipulation?

A

-Low amplitude
-High velocity
-Thrust
-Intentionally moves joint beyond end range

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7
Q

What are the grades of motion (for Maitland)?

A

I-IV are all oscillatory with either:
-Small amplitude (6-12 per second)
-Large amplitude (3-6 per second)
-Before or after “first stop” (change of tissue resistance at end range) but before the “final barrier”

V- A high velocity, low amplitude thrust (HVLAT)
-Intentionally moving beyond the final barrier

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8
Q

Describe Grade 1-4 for Maitland

A

Grade 1: before R1, small and fast oscillations
Grade 2: Up to R1, big and slow oscillations (push, relax)
Grade 3: between R1 and R2, big and slow oscillations
Grade 4: Up to R2, small and fast oscillations

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9
Q

What are the types of passive joint movement (Kalltenborn joint mobs)?

A

-Compression
-Traction
-Translatoric (gliding)

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10
Q

Describe the 3 grades of motion for Kalltenborn?

A

Grade I: There’s still loose slack; Just enough to nullify compressive forces; applied only to traction mobilization
Grade II: tissue slack taken up, surrounding joint tissue tightened (assess tissue and subjective response)
Grade III: Tissue deformation, moving beyond R1

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11
Q

What is the purpose of Grade II for Kalltenborn? Grade III?

A

Grade II- pain relief; Assess joint play/reactivity
Grade III- Increase mobility

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12
Q

What are the different end feels through Nordic System (Kalltenborn)?

A

Soft- soft tissue approximation or muscle stretch
Firm- Capsular or ligamentous
Hard- Bone or cartilage

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13
Q

What are the quantity grades for Nordic System/Kalltenborn?

A

0= Ankyloses (joint has no motion)
1-2= hypomobile (do joint mobs)
3= normal
4-5= Hypermobile
6= Unstable

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14
Q

What are the indications for passive joint motion?

A

-Pain relief and muscle guarding
-Increase joint mobility in the presence of stiffness

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15
Q

What is compression used for?

A

Recreating symptoms

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16
Q

What are the grades of traction Kalltenborn?

A

Grade I: relieve pain and muscle guarding
Grade II: relieve pain and assess joint play/reactivity
Grade III: increase mobility

17
Q

What are the neurophysiologic benefits/characteristics to passive joint mobilization with regards to Type I receptors (postural)?

A
  • Found in joint capsules
    -Small diameter, myelinated fibers
    -Low threshold, continually firing, slow adapting
    -Both static and dynamic firing mechanoreceptors
    -Small motions lead to increased firing
    -Promote body awareness in space
    -Degenerate with age
18
Q

What are the neurophysiologic benefits/characteristics to passive joint mobilization with regards to Type II (dynamic) receptors?

A

-Found in joint capsule and articular fat pads
-Medium diameter, myelinated fibers
-Dynamic mechanoreceptors
-Low threshold, fast adapting
-Movement and direction
-Associated with marked discharge

19
Q

What are the neurophysiologic benefits to passive joint mobilization with regards to Type III (inhibitive) receptors?

A

-Found in ligamentous structures, specially of spinal column
-Large myelinated fibers, identical structurally to the GTO
-Dynamic mechanoreceptors
-High threshold, slow adapting fibers
-Involves GTO
-Firing leads to reflex inhibition to surrounding muscles

20
Q

What are the neurophysiologic benefits/characteristics to passive joint mobilization with regards to Type IV (nociceptive) receptors?

A

-Found in most joint structures
-Lattice like, unmyelinated fibers and free nerve endings
-Generally high threshold firing fibers/pain receptors

21
Q

What do small, oscillatory movements do?

A

-Fire Type I and II’s, inhibiting pain and muscle guarding

22
Q

What does end range dynamic movements (thrust) do?

A

Fire Type III leading to inhibition of muscle guarding

23
Q

What are the contraindications to use of passive motion?

A

-Hypermobility/instability
-Any active disease process (flu, infection, malignancies)
-Conditions of acuity, substantial inflammation, reactivity (swelling, warmth, or muscle guarding

24
Q

Examples of hypermobility/instability contraindications for passive motion

A

Recent fracture, ligamentous sprains, RA, osteoporosis

25
Q

What are the accessory motions used in assessment and treatment for Kalltenborn?

A

-Compression (provocation assessment technique only)
-Traction
-Gliding

26
Q

What does grade II and III do (for gliding) per kalltenborn?

A

Grade II: pain relief, assess joint play and reactivity
Grade III: Improve mobility

27
Q

What are grades I-IV used for (Maitland)?

A

-Grades I and II are used to reduce pain
-Grades III and IV are used to increase mobility

28
Q

What grade mobilizations are used to begin and end all mobilization sessions to facilitate relaxation and to relieve pain?

A

Grade I and II mobilizations

29
Q

What position should initial Maitland mobilization techniques be performed in?

A

Loose-packed position

30
Q

What direction are the roll and glide for convex-concave?

A

Convex moving on concave = opposite
Concave on convex= same

31
Q

To improve GH flexion, which direction would the glide need to be directed in?

A

Apply Posterior glide

32
Q

To improve GH extension, which direction would glide need to be applied in?

A

Apply anterior glide

33
Q

To improve GH IR, which direction would glide need to be applied in?

A

Apply posterior glide

34
Q

To improve GH ER, which direction would glide need to be applied in?

A

Apply anterior glide

35
Q

To improve GH ABD, which direction would glide need to be applied in?

A

Inferior glide

36
Q

When GH abduction occurs, which directions does the glide occur?

A

Humeral head glides inferiorly

37
Q

Which direction does humeral head move to increase ABD ROM?

A

Mobilize humeral head in inferior direction

38
Q

What are the steps for any joint mob?

A
  1. Figure out which way joints move (convex on concave and vice versa)
  2. Assess ROM
  3. Joint play
  4. Compression
  5. Choose technique
  6. Reassess
39
Q

What are the 4 neurophysiological benefits to passive joint mobilization?

A

-Type 1 receptors (postural)
-Type II (dynamic)
-Type III (inhibitive)
-Type IV (nociceptive)

508 (11 decks)

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