Joint Mobilization Flashcards
What is Maitland Grade 1?What is the purpose?
-small amplitude and fast (6-12 per second)
- at the beginning of range BEFORE R1
-do not stretch the tissue
-PURPOSE: to decrease pain and irritability
what is Maitland grade 2? what is the purpose?
-large amplitude and slow (3-6 per second)
-starts at the beginning of ROM and ends within available ROM up to R1 (first resistance)
-do not stretch the tissue
-PURPOSE: to decrease pain and irritability
what is Maitland grade 3? what is the purpose?
-large amplitude and slow (3-6 per second)
-starts at midrange and moves into stiffness from R1 to R2
-stretch the tissue
-PURPOSE: to stretch the joint capsule or passive tissues to increase ROM/ mobility
what is Maitland grade 4? what is the purpose?
-small amplitude and fast (6-12 per second)
-moves into stiffness that is primarily focused at R2
-stretch the tissue
-PURPOSE: to stretch the joint and passive tissue to increase ROM/mobility
which Maitland grades do NOT STRETCH the joint or passive tissues?
grade 1-2
Describe slack with regard to Maitland’s grades of motion
In grade 1, the tissue is still loose. In grade 2, the slack is being taken up, In grade 3 and 4, the tissue is being stretched.
What are the passive joint movements by kaltenborn? When are they indicated?
-compression as a provocation technique
-traction
-gliding
Passive joint movements are indicated for relief of pain or muscle guarding and restoration of normal joint mobility in the presence of stiffness.
what are contraindications to passive joint movement?
-hypermobility and instability
-recent fractures, ligament sprains, RA, osteoporosis
-active disease processes
-inflammation, swelling, warmth, muscle guarding
what are the benefits of passive movement (type 1 receptors)?
Type 1 receptors are postural receptors.
-They fire with small oscillatory movement and inhibit pain and muscle guarding
- they are found in the joint capsule and are small and myelinated
-low threshold and slow adapting
-they promote body awareness
what happens when type 1 receptors degenerate
Since type 1 receptors promote body awareness, degeneration will decrease coordination
what are the benefits of passive movement (type 2 receptors)?
Type 2 are dynamic receptors. -Small oscillatory movements fire type 2 which inhibit pain and muscle guarding.
- found in the joint capsule and articular fat. Medium sized and myelinated.
-low threshold and fast adapting
-where are we going in space
what are the benefits of passive movement (type 3 receptors?)
-Type 3 receptors are inhibitive receptors.
-end range thrusts fire type 3 receptors leading to inhibition of muscle guarding
- found in ligament and are large and myelinated
-high threshold and slow adapting
-firing will lead to reflex inhibition of surrounding muscles.
what are the benefits of passive movement (type 4 receptors)?
Type 4 receptors are nociceptive receptors.
- found in most joint structures and are unmyelinated fibers and free nerve endings
- have a high threshold
what movements fire Type 1 and Type 2 receptors?
small oscillatory movements
both will inhibit pain and muscle guarding
what movement will fire type 3 receptors?
dynamic movements and end range thrusts will fire type 3 receptors which leads to inhibition of muscle guarding
what is a soft end feel?
soft tissue approximation or tissue stretch
what is a firm end feel?
capsular or ligamentous
what is a hard end feel?
bone or cartilage
what are the Kaltenborn quantity grades of movement?
0= anklosed (does not move)
1-2= hypomobile (only mobilize if they have tight tissues)
3= normal
4-5= hypermobile
6= unstable
You should not mobilize patients that are graded ______ .
patients that are 4-5 (hypermobile) or 6 (unstable) should not be mobilized.
There are 3 grades of motion according to Kaltenborn. What is grade 1?What is the purpose?
You are unweighting the tissue, just enough to nullify compressive forces. It should be used ONLY in traction to relieve pain and muscle guarding and to move joint fluid.
There are 3 grades of motion according to Kaltenborn. What is grade 2?What is the purpose?
The slack is being taken up. The surrounding joint tissues are being tightened. Used in traction to relieve pain, assess joint play and reactivity (gliding as well)
There are 3 grades of motion according to Kaltenborn. What is grade 3?What is the purpose?
Actual deformation “stretch” occurs. Moving beyond first stop into resistance. Used in traction and gliding to increase mobility.
What grade of mobilization should a joint mob begin and end with? why?
grade 1 and grade 2 because they facilitate relaxation and pain relief.
all mobilization should be performed in the _____ position
loose pack
what does it mean when there is a limitation during mobility testing when the concave surface is moving?
the restriction is likely due to a contracture of the trailing portion of the capsule
what does it mean when there is a limitation during mobility testing when the convex surface is moving?
restriction is likely due to an inability of the convex moving surface to move into the contracted position of the capsule. Could be due to adhesions in the capsule.
