joint mobilizations - types & technique Flashcards
what are the types of joint mobs
distraction
oscillation mobilization
sustained hold mobilization
manipulations
what are the target impairments of oscillation mobilizations and manipulations
guarding, pain, joint hypomobility
what do you need to consider in regards to oscillation mobilizations and manipulations
address extensibility
consider stress strain curve of collagen tissue when considering efficacy of joint mob for improved mobility
what are the target impairments for sustained hold mobs
joint mobility: end range
pain: beginning range to mid range
what do you need to address in regards to sustained hold mobs
tissue extensibility directly to allow motion (when enough force applied for enough time according to stress strain curve for collagen)
what is the joint position during mobilizations
resting position
when wanting to improve ROM, at end ROM if tolerable
one half of joint should be stabilized, while other half is mobilized
what is the therapist position during mobilizations
both stabilizing and mobilizing hands should be as close as possible to joint line
clinicians hands should make maximum contact with patients body
what is the directions of mobilization
based on convex/concave rule and which part of joint is being mobilized and which is being stabilized
oscillations
1-3 secs
typically 1-5 sets for 15-60 seconds
*can do more if needed
sustained holds
typically 1-5 sets for 5-30 seconds each
more commonly used to treat ROM
technique tips
allow gravity to assist
your body and mobilizing part should act as 1
body mechanics
reassess afterwards
where should your forearm be while performing joint mobs
align with the intended direction of your force
when should you stop for the day while performing joint mobs
when you see a large improvement or when improvement completely stops
how do you know what direction to push for joint glides
arthrokinematics
convex/concave rules
what direction should you perform grades 1 and 2
in the direction which initially caused their pain
open pack position
how do you determine which direction you perform grades 3 and 4
- determine what motion you want to improve - osteokinematic
- determine what joint you are mobilizing
- determine which part is moving and which is stationary
- convex / concave
- convex - opposite, concave - same
- end range
what direction would i mobilize the femur to improve hip extension
anterior
mobilization with movement
type: typically combined active and passive joint mob
what is the golden rule of MWMs
should be painless
what do you do if there is pain while doing MWMs
change direction of force, correct pressure or not use it
what is the theory of MWMs
bony positional faults contribute to painful joint restrictions
what are the guidelines for MWMs
pain free
apply 10 times before reassessing joint motion
overpressure should be applied at end range of AROM
what direction of joint glide would you perform in non-weight bearing to improve ROM in ankle dorsiflexion
posterior
what direction of joint glide would you perform in non-weight bearing to improve ROM in tibiofemoral flexion
posterior
what direction of joint glide would you perform in non-weight bearing to improve ROM in GH IR
posterior
what direction of joint glide would you perform in non-weight bearing to improve ROM in radiocarpal extension
anterior
what grade of joint mob glides would you want to perform for GH hypomobility without pain
grade 3 and 4
what grade of joint mob glides would you want to perform for GH pain without hypomobility
grade 1 and 2, grade 5
what grade of joint mob glides would you want to perform for GH hypomobility with pain
grade 1 and 2 then 3 and 4
what are we working to improve if the a grade 3 GH joint distraction is done
stretching, general mobility
what are we working to improve if the a grade 2 inferior patellofemoral mob is done
pain
what are we working to improve if the a grade 3 anterior hip mob is done
hip extension
what are we working to improve if the a grade 3 posterior radiohumeral mob is done
elbow extension