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Clinical Prac II > Joint Mobilizations > Flashcards

Joint Mobilizations Flashcards

1
Q

Injury to a joint or structures surround a joint will often lead to…

A
  • pain
  • loss of motion
  • excessive motion
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2
Q

3 roles of the joint capsule

A
  • seals joint space
  • provides stability by limiting movements
  • provides active stability via its proprioceptive nerve endings
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3
Q

What position should you perform an assessment?

A

-open-packed/resting position

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4
Q

glenohumeral open-packed position

A
  • 55 deg abduction
  • 30 deg horizontal adduction
  • slight ER
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5
Q

zygapophyseal (spine)

A
  • midway b/t flexion and extension
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6
Q

temporomandibular

A
  • mouth slightly open
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7
Q

acromioclavicular

A
  • arm resting by side
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8
Q

sternoclavicular

A
  • arm resting by side
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9
Q

ulnohumeral

A
  • 70 deg flexion

- 10 deg supination

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10
Q

radiohumeral

A
  • full extension

- full supination

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11
Q

proximal radioulnar

A
  • 70 deg flexion

- 35 deg supination

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12
Q

distal radioulnar

A
  • 10 deg supination
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13
Q

radiocarpal (wrist)

A
  • slight flexion and ulnar deviation
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14
Q

carpometacarpal

A
  • midway b/t abduction-adduction and flexion-extension
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15
Q

metacarpophalangeal

A
  • slight flexion
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16
Q

interphalangeal

A
  • slight flexion
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17
Q

hip

A
  • about 30 deg flexion & 30 deg abduction

- 0-5 deg ER

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18
Q

tibiofemoral

A
  • 25 deg flexion
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19
Q

patellofemoral

A
  • full extension
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20
Q

talocrural (ankle)

A
  • 10 deg plantar flexion

- midway b/t extremes of inversion and eversion

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21
Q

subatlar

A
  • midway b/t extremes of ROM
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22
Q

midtarsal

A
  • midway b/t extremes of ROM
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23
Q

tarsometatarsal

A
  • midway b/t extremes of ROM
24
Q

metatarsophalangeal

25
interphalangeal
- slight flexion
26
3 types of gross quantity of movement
- hypomobile - normal - hypermobile
27
3 types of end feel (quality of movement)
- firm - hard - empty
28
Provocation
- painful | - painless
29
hypomobile
- motion stops short of anatomical limit at pathological point of limitation (pain, spasm, adhesion, inflammation)
30
hypermobile
- joint moves beyond its anatomical limit because of laxity of surrounding structures
31
manual therapy techniques involving movement of articulating surfaces with intention of:
- regaining normal ROM - improving joint capsule extensibility - regaining normal distribution of forces and stresses on a joint - reducing pain - lubricating joint surfaces - providing nutrition to joint structures
32
absolute contraindications of joint mobilizations
- malignancy in area of treatment - active inflammation and/or infectious joint - ankylosis of joint - fracture at the joint - practitioner lack of ability - neurological deterioration - diseases with affect integrity of ligaments - arterial insufficiency
33
relative contraindications (take caution and be selective on treatments)
- excessive pain or swelling - arthroplasty - hypermobility - metabolic bone disease - pregnancy - spondylolisthesis
34
biomechanical mechanisms
- motion improvement - positional improvement - increase joint capsule extensibility
35
nutritional effects
- synovial fluid movement | - improve nutrient exchange
36
neurophysiological
- stimulates mechanoreceptors to inhibit pain impulses - gate control theory - descending pathway inhibition theory - peripheral inflammatory modulation
37
gate control theory
- pain signals sent to the brain, stimulating different nerves during treatment to close doors so brain can not follow the continued pain
38
compression
- approximation of joint surfaces; force perpendicular to joint plane
39
traction/distraction
- separation of joint surfaces; force perpendicular to the joint plane
40
gliding
- force direction parallel to joint surface
41
Grade I distraction
- toe region on stress-strain curve - very minimal amplitude of traction force, minimal stress on the joint capsule - reduces compression forces on articular surfaces - pain reduction, used with gliding mobilizations
42
Grade II distraction
- "take up the slack" elastic region on stress-strain curve - slack in joint capsule and surrounding tissues is taken up - can help to determine the sensitivity of the joint - used to alleviate pain, assess joint play, and/or reduce muscle guarding
43
Grade III distraction
- stretch / plastic region on stress-strain curve - designated to stretch joint capsule and soft tissues surrounding the joint to increase mobility - used to assess end feel or increase movement - ***general mobility***
44
Grade I Joint Mob
- small amplitude technique performed at beginning of available ROM (0-25%) - GOAL- reduce pain and muscle guarding, improve joint lubrication/nutrition
45
Grade II Joint Mob
- large amplitude technique performed in middle of available ROM (25-75%) - GOAL- reduce pain and muscle guarding, improve joint lubrication/nutrition
46
Grade's I & II joint mob
- pain relief and muscle guarding - no direct mechanical effect on restrictions - influences mechanical nociception - often used before and after grade III and IV mobes - *** stimulating nerves
47
Grade III joint mob
- large amplitude technique performed at end range of available ROM (50-100%) - feel joint capsule push against you - GOAL- stretching joint capsule and associated structures (ligaments, muscles attaching in the area)
48
Grade IV joint mob
- small amplitude technique performed at end of available ROM (75-100%) - GOAL- stretching joint capsule and associated structures (ligaments, muscles attaching in the area)
49
Grade III & IV joint mob
- primarily stretching techniques - mechanical and neurophysiological effect - may activate inhibitory joint and muscle spindle receptors to aid in reducing restriction of movement
50
Grade V joint mob
- high velocity thrust of small amplitude at end of available range but within its anatomical range - movement that exceeds the resistance barrier - commonly referred to as high velocity thrust technique or joint manipulation - GOAL- decrease pain and muscle guarding
51
types of joint mobilizations
- distractions - oscillation mobilizations - sustained hold mobilizations - manipulations
52
oscillation
- target impairments: guarding, pain, joint hypomobility | - address extensibility
53
sustained hold mobilizations
- target impairments: joint mobility, pain - pain: beginning range to mid range - joint mobility- end range
54
oscillations timing
- 1-3 sec | - 1-5 sets for 15-60 sec each
55
sustained holds timing
- 1-5 sets for 5-30 sec each | - more commonly used to treat ROM
56
Golden rule of mobilization with movement
- PAINLESS

Clinical Prac II (1 decks)

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