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CP 2 > Joint Mobilizations > Flashcards

Joint Mobilizations Flashcards

1
Q

how will a tight capsule impact motion?

A

it will cause early and excessive accesory motion in the opposite direction of the tightness

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2
Q

injury to a joint/structures surrounding a joint will often lead to what?

A
  1. pain
  2. loss of motion
  3. excessive motion
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3
Q

what does the term open pack position mean?

A
  1. surrounding tissue is as lax as possible
  2. maximal incongruency
  3. intracapsular space is as large as possible
  4. maximal amount of joint play available
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4
Q

describe what is meant by the closed pack position

A
  1. joint position where joint is most congruent
  2. surrounding tissue (capsule and ligaments) under maximal tension
  3. maximal stability of joint
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5
Q

when assessing joint mobility what 3 things are looked at?

A
  1. gross (quantity of movement)
  2. end-feel (quality of movement)
  3. provocation
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6
Q

what is the current classification scale used for joint mobility?

A

hypomobile

normal

hypermobile

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7
Q

what is meant by the term hypomobile?

A

the motion stops short of anatomical limit instead it stops at a pathological point of limitation

(can be due to inflammation, pain, spasm, or adhesions)

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8
Q

what is meant by the term hypermobile?

A

joint moves beyond its anatomical limit due to laxity of surrounding structures

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9
Q

what are some indications for joint mobilizations?

A
  1. break pain cycle
  2. increase joint extensibility
  3. increase extensibility of tendons, muscle, and fascia
  4. increase joint ROM
  5. promote muscle relaxation
  6. improve muscle performance
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10
Q

what 3 categories cover the benefits of joint mobilizations?

A
  1. biomechanical improvements
  2. nutritional effects
  3. neurophysiological effects
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11
Q

what are the neurophysiological effects of joint mobilizations?

A
  1. stimulates mechanoreceptors to inhibit pain impulses
  2. gate control theory
  3. descending pathway inhibition theory
  4. peripheral inflammation modulation
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12
Q

what is the gate control theory?

A

there are large myelinated fibers that synapse onto neurons. If these large fibers are activated they can overwhelm the smaller C fibers transmitting pain sensation

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13
Q

what type of joint mobilization is associated with the descending pathway inhibition theory?

A

grave V mobilization

stimulates the PAQ which results in serotonin secretion and decreased pain

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14
Q

list some absolute contraindications to joint mobilizations

A
  1. malignancy in area of treatment
  2. infectious arthritis
  3. fusion of joint
  4. fracture at the joint
  5. practioner lack of skill
  6. neurological deterioration
  7. upper cervical spine instability
  8. cervical arterial dysfunction
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15
Q

list some relative contraindications for joint mobilizations

A
  1. excessive pain or swelling
  2. arthroplasty
  3. hypermobility
  4. Osteoporosis
  5. Spondylolisthesis
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16
Q

when are joint mobilizations most effective?

A

when they are followed up by a comprehensive treatment plan including strengthening of some kind

17
Q

joint play comes in 3 types of movements. What are they?

A
  1. Compression - perpendicular to joint surface
  2. Traction/Distraction - perpendicular to joint surface
  3. Gliding - parallel to joint surface
18
Q

what are the types of joint mobilizations?

A
  1. Distractions
  2. Oscillation mobilizations
  3. sustained hold mobilizations
  4. mobilizations with movement
19
Q

what/how many grades are there for distraction mobilizations?

A

Three

  1. Grade I = piccolo (loosen)
  2. Grade II = slack (take up the slack)
  3. Grade III = stretch
20
Q

what is a Grade I Distraction Mobilization?

A

distraction force that neutralizes pressure in the joint w/o producing actual separation of the joint surfaces

no stress on joint capsule

can be used w/gliding mobs to reduce compression forces on articular surfaces

21
Q

what is a Grade II distraction mobilization?

A

slack in joint capsule is reduced through sustained distraction

separates the articulating surfaces and eliminates the play in the joint capsule

can help determine the sensitivity of the joint

22
Q

what is a Grade III distraction mobilization?

A

designed to stretch the joint capsule and soft tissues surrounding the joint to increase mobility

trying to get into the plastic region

23
Q

what region of the stress strain curve do each distraction mobilizations take place?

A
  1. grade 1 = toe region
  2. grade 2 = elastic region
  3. grade 3 = plastic region
24
Q

how many grades are there for oscillation joint mobilizations?

A

5

per Maitland Oscillation Joint Mobilization

25
Q

describe a grade I Maitland Oscillation Joint Mobilization

A

small amplitude technique performed at beginning of available ROM (first 25%)

26
Q

what is the goal of Grade I and II Maitland Oscillation Joint Mobilizations?

A

pain and spasm reduction

27
Q

describe a grade II Maitland Oscillation Joint Mobilization

A

large amplitude technique performed in middle of available ROM (middle 50%)

(going from 25-75%, back and forth)

28
Q

describe a grade III Maitland Oscillation Joint Mobilization

A

large amplitude technique performed at end of availabel ROM (last 50%)

(going from 50-100%, back and forth)

29
Q

describe a grade IV Maitland Oscillation Joint Mobilization

A

small amplitude technique performed at end of availabel ROM (last 25%)

(going from 75-100%, back and forth)

30
Q

what is the goal of Grade III and IV Maitland Oscillation Joint Mobilizations?

A

stretch joint capsule and associated structures

31
Q

what is the theory behind pain reduction from Grades I and II Maitland Oscillation Joint Mobilizations?

A

reduces pain by:

  1. improving joint lubrication and circulation to tissues related to joint
  2. rhythmic oscillations possibly activate articular and skin mechanoreceptors which play a role in pain reduction
32
Q

T/F: Grades I and II influence mechanical nociception?

A

TRUE

33
Q

what are the effects of Grades III and IV Maitland Oscillation Joint Mobilizations?

A
  1. stretches capsule and associated structures
  2. mechanical and neurophysiological effects
  3. may activate inhibitory joint and muscle spindle receptors to aid in reducing restriction of movement
34
Q

Describe a grade V Maitland Oscillation Joint Mobilization

A

high velocity thrust of small amplitude at end of available range but within its anatomical range

movement that exceeds the resistance barrier

35
Q

what is targeted with a sustained hold mobilization?

A

joint mobility and pain reduction

36
Q

what position should the joint be placed in if the goal is to improve ROM using a mobilization?

A

at end ROM if tolerable

one half of the joint is stabilized while the other half is mobilized

37
Q

what are mobilizations with movement?

A

typically combined active and passive joint mobilization

should be painless!

38
Q

what is the theory behing MWMs?

A

bony positional faults contribute to painful joint restrictions

CP 2 (13 decks)

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