Joint Mobilization

Question 1

Physiologic movements

Answer 1

motions that can be created volitionally (actively)

Question 2

Non-physiologic movements

Answer 2

motion that does not occur in isolation voluntarily

Question 3

component movements

Answer 3

occur in combinations with physiologic motion (ex. scapular motion with GH flexion)

Question 4

joint play

Answer 4

occur only in response to an outside force. (end feels)

Question 5

Accessory motions

Answer 5

Distraction, glides, and tilts. joint play that is needed for normal physiological range

Question 6

Mobilization

Answer 6

• skilled passive movement
  -low velocity
• does not go beyond end range
• can be grated 1-3 / 4 depending on system used

Question 7

Manipulation

Answer 7

-low amplitude
-high velocity
-thrust
- intenstially moved beyond end range
-grade 5 mob

Question 8

Maitland grade 1

Answer 8

oscillatory movement with small amplitude fast velocity right at the start of motion (way before R1)

Question 9

Maitland grade 2

Answer 9

oscillatory movement with a large amplitude and slow velocity. Goes right to R1 but not past.

Question 10

Maitland grade 3

Answer 10

oscillatory movement with a large amplitude and slow velocity. Goes from R1 to R2

Question 11

Maitland grade 4

Answer 11

oscillatory movement with a small amplitude and fast velocity at the end of end range

Question 12

Kalltenborn compression

Answer 12

Not graded. Only used to see if symptoms can be reproduced

Question 13

Kalltenborn traction grade 1

Answer 13

the unweighting of the joint. Use to relieve pain, muscle grading, and move joint fluid.

Question 14

kalltenborn traction grade 2

Answer 14

taking the tissue to slack. used to releive pain and assess joint play and reactivity

Question 15

Kalltenborn traction grade 3

Answer 15

used to stretch the muscle to get tissue deformation. used to increase mobility

Question 16

Kalltenborn gliding grade 2

Answer 16

assess joint play and reactivity (take to R1)
used to increase mobility

Question 17

Kalltenborn gliding grade 3

Answer 17

used to improve mobility and take to R2

Question 18

Kalltenborg definition of soft end feel

Answer 18

soft tissue approximation or muscle stretch

Question 19

Kalltenborg definition of a firm end feel

Answer 19

capsular or ligamentous

Question 20

Kalltenborg definition of a hard end feel

Answer 20

bone or cartilage

Question 21

Mobility 0 ranking

Answer 21

ankylosed (not moving)

Question 22

Mobility 1-2 ranking

Answer 22

hypomobile (this is where you should preform joint mobs)

Question 23

Mobility 3 ranking

Answer 23

normal

Question 24

Mobility 4-5 ranking

Answer 24

hypermobile (do not do joint mobs on these patients)

Question 25

Mobility 6 ranking

Answer 25

unstable (dislocation)

Question 26

Indications for Passive Joint Motion

Answer 26

1) relief of pain and muscle guarding 2) restoration of normal joint mobility in the presence of stiffness

Question 27

Type 1 Postural Receptors

Answer 27

- Found in joint capsules - Small in diameter, myelinated fibers - Low threshold, continually firing, and slow adapting - Both static and dynamic firing mechanoreceptors -Small motions lead to increased firing -degenerate with age ---- Stimulated by small oscillatory mobs to decrease pain and muscle guarding

Question 28

Type 2 Dynamic Receptors

Answer 28

- found in the joint capsule and articular fat pads - mediam in diameter, myelinated fibers -dynamic mechanoreceptors - low threshold and fast adapting - movement and direction - associated with marked discharge -------Stimulated by small oscillatory mobs to decrease pain and muscle guarding

Question 29

Type 3 Inhibitive Receptors

Answer 29

- found in ligamentous structures - large myelinated fibers, identically structurally to the GTO (fastest of the 3) - dynamic mechanoreceptors - High threshold, slow adapting fibers - Firing leads to reflex inhibition to surrounding muscles ------- stimulated by grade 5 joint mob (thrust) to inhibit muscle guarding

Question 30

Type 4 nociceptive receptors

Answer 30

- found in most joint structures -unmyelinated fibers and free nerve endings - generally high threshold firing fibers

Question 31

what type of fibers does small, oscillatory movements fire?

Answer 31

type 1 and type 2; inhibiting pain and muscle garding

Question 32

what types of fibers does end range dynamic movements (thrust) fire

Answer 32

type 3; leading into inhibition of muscle guarding

Question 33

Contraindications to use of Passive motion

Answer 33

1) hyper mobility/ instability (fracture, sprain, RA, Osteoporosis) 2) any active disease process 3) conditions of acuity, inflammation, and reactivity

Question 34

Which grades of Maitland should be used to reduce pain

Answer 34

grades 1 and 2

Question 35

which grades of Maitland should be used to increase mobility

Answer 35

grades 3 and 4

Question 36

where should you begin and end all mobilization sessions

Answer 36

with grade 1 and 2 to facilitate relaxation and pain management

Question 37

Direction of mobilization to improve ankle talus dorsiflexion glide

Answer 37

anterior to posterior (AP)

Question 38

Direction of mobilization to improve ankle planter flexion glide

Answer 38

posterior to anterior (PA)

Question 39

Direction of mobilization to improve knee extension glide moving the tibia on the femur

Answer 39

Posterior to anterior (PA)

Question 40

Direction of mobilization to improve knee extension glide moving the femur on the tibia

Answer 40

Anterior to posterior (AP)

Question 41

Direction of mobilization to improve knee flexion glide moving the tibia on the femur

Answer 41

Anterior to Posterior (AP)

Question 42

Direction of mobilization to improve knee flexion glide moving the femur on the tibia

Answer 42

posterior to anterior (PA)

Question 43

Direction of mobilization to improve hip flexion glide

Answer 43

Anterior to posterior (AP)

Question 44

Direction of mobilization to improve hip extension glide

Answer 44

Posterior to anterior (PA)

Question 45

Steps with joint mobilization

Answer 45

1) assess ROM 2) assess end feel 3) compression 4) distraction (if needed) 5) go through the grades start with grade 1 6) reassess pain or ROM 7) use new range

Question 46

Shoulder Flexion Joint Glide Mobilization

Answer 46

Anterior to posterior glide (AP)

Question 47

Shoulder extension joint glide mobilization

Answer 47

Posterior to anterior glide (PA)

Question 48

Shoulder Abduction joint glide mobilization

Answer 48

superior to inferior glide

Question 49

Shoulder external rotation glide

Answer 49

posterior to anterior glide (PA)

Question 50

Shoulder internal rotation glide

Answer 50

anterior to posterior glide (AP)

Question 51

Wrist extension (carpels on ulna and radius) glide

Answer 51

posterior to anterior glide (PA)

Question 52

Wrist flexion (carpels on ulna and radius) glide

Answer 52

anterior to posterior glide (AP)

Question 53

Elbow (ulna on humerus) flexion glide

Answer 53

posterior to anterior (PA)

Question 54

Elbow (ulna on humerus) extension glide

Answer 54

anterior to posterior (AP)

Question 55

Elbow (humerus on ulna) flexion glide

Answer 55

anterior to posterior (AP)

Question 56

Elbow (ulna on humerus) extension glide

Answer 56

Anterior to posterior (AP)

Question 57

what receptor type has a low threshold

Answer 57

1 and 2

Question 58

what receptor types has a high threshold

Answer 58

3 and 4

Question 59

what are the sizes of the fiber types smallest to largest

Answer 59

1,2,3

Question 60

what fiber types are found in joint capsules

Answer 60

1, 2 (also in fat pads), 4

Question 61

what fiber type is found in ligaments and spine

Answer 61

3

Question 62

what fiber type's stimulation encourages more firing

Answer 62

1

Question 63

what fiber type has a marked discharge

Answer 63

2

Question 64

what fiber type leads to reflex inhibition

Answer 64

3

Question 65

what fiber type is not myelinated

Answer 65

5