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Joint Mob > Lec > Flashcards

Lec Flashcards

1
Q

Passive, skilled manual therapeutic techniques applied at varying speeds and amplitudes use if physiologic and accessory motions

A

Mobilization/Manipulation

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2
Q

Self stretching techniques that specifically use joint traction or glides that direct the stretch force to the joint capsule

A

Self-mobilization / Automobilization

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3
Q

Concurrent application of sustained accessory mobilization and an active physiologic movement to end range to be able to do passive end-of-range over pressure or stretching without pain as a barrier

Brian Mulligan

A

Manipulation with movement (MWM)

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4
Q

MWM applicable when (4)

A
  1. No CI for manual therapy
  2. (+) local musculoskeletal pathology on eval.
  3. (+) localized loss of movement and/or pain associated with function
  4. (-) pain during and immediately after treatment
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5
Q

High velocity, short amplitude motion such that the patient cannot prevent the motion

Performed at end of pathologic limit

A

Thrust

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6
Q

(True/False) thrust is done multiple times

A

False

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7
Q

Thrust is intended to (3)

A

Alter positional relationships

Snap adhesions

Stimulate joint receptors

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8
Q

Medical procedure

A

Manipulation under anesthesia

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9
Q

Active isometric contraction of deep muscles that are attached near the joint and whose line or pull can cause the desired accessory motion

Stabilization is at distal attachment of the muscle

A

Muscle energy

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10
Q

Types of physiologic movements (2)

A

Voluntary

Osteokinematics

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11
Q

Types of accessory movements (5)

A

Involuntary

Component motions

Joint play

Compression

Traction

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12
Q

Motions that accompany active motion but are not under voluntary control

A

Component motions

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13
Q

Motions that occur between the joint surfaces as well as the ‘give’ in the joint capsule allowing the bones to move

A

Joint play

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14
Q

Joint play is necessary for

A

Normal joint functioning

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15
Q

Can be demonstrated passively but not done actively

A

Joint play

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16
Q

Roll, slide, compression, distraction, spin

A

Joint play

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17
Q

Joint shapes (2)

A

Ovoid

Sellar (saddle)

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18
Q

For these to occur, sufficient capsule laxity or joint play is needed

A

Roll, slide, combined roll-sliding, spin

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19
Q

Surfaces incongruent

A

Roll

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20
Q

Surfaces congruent

A

Slide

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21
Q

Surfaces more congruent more sliding

A

Roll-slide

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22
Q

Rotation of a segment about a stationary mechanical axis

A

Spin

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23
Q

New points to new point resulting in swing. ( angular motion of bone )

A

Roll

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24
Q

Same points to new points

A

Slide

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25
Q

Same point creates arc of a circle

A

Spin

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26
Q

Always in the same direction as the angulating bone, concave or convex

A

Roll

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27
Q

Opposite direction if convex. Same if concave (uses concave convex rule)

A

Slide

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28
Q

If alone, separation and compression (may lead to joint damage)

A

Roll

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29
Q

Some movements can cause or control sliding movement

A

Roll-slide

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30
Q

In normal joints, does not occur alone

A

Roll

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31
Q

No pure movement of this motion because no joint surface is congruent

A

Slide

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32
Q

In roll slide, sliding does what?

A

Restore joint play

Reverse joint hypomobility

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33
Q

In roll-slide, rolling is not used when?

A

To stretch tight joint capsule because it causes joint compression

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34
Q

Rarely occurs alone but in combination with rolling and sliding

35
Q

Passive angular stretching (4)

A

May cause increased pain or joint trauma

Use of a lever significantly magnifies force at the joint

Excessive joint compression in direction of the rolling bone

Roll without slide does not replicate normal joint mechanics

36
Q

Joint glide stretching (4)

A

Safer, more selective

Force applied close to joint surface, controlled at intensity compatible to pathology

Direction of force replicates sliding component of joint mechanics, doesn’t compress cartilage

Amplitude of motion small but specific, forces selectively applies to the desired tissue

37
Q

Decrease in joint space

Occurs when weight bearing

Provides stability when muscles contract

A

Compression

38
Q

During rolling, compression occurs on?

A

Angulating side

39
Q

In normal compression

A

Help move synovial fluid and maintain cartilage health

40
Q

In abnormal compression

A

Articulate cartilage changes and deteriorates

41
Q

Distraction or separation of joint surfaces

42
Q

Pulling of long axis of bone

A

Long-axis traction

43
Q

Pulling at right angle based on concave side

A

Distraction or joint traction or joint separation

*I honestly don’t get this

44
Q

Effects of joint motion (3)

A

Stimulates biological activity by moving synovial fluid

Maintains extensibility and tensile strength of articular and periarticular tissues

Provides sensory input for proprioceptive feedback

45
Q

How does immobilization lead to jt contra tired and ligament ours weakening

A

Immobilization

Fibrofatty proliferation

Intra-articular adhesions

Jt contra tires and ligamentous weakening

46
Q

Proprioceptive feedback relative to (5)

A

Static position and sense of speed of movement (1)

Change of speed of movement (2)

Sense of direction of movement (1&3)

Regulation of muscle tone (1,2,&3)

Nociceptive stimuli (4)

47
Q

Indications (5)

A

Pain, muscle guarding, spasm

Reversible joint hypomobility

Positional faults/ subluxations

Progressive limitations

Functional mobility

48
Q

Limitations (2)

A

Cannot change disease process

Skill of therapist will affect outcome

49
Q

Contraindications (3)

A

Hyper mobility

Joint effusion

Inflammation

50
Q

Precautions (10)

HB MUTE SEN

A

Hyper mobility in associated joints
Bone disease detectable on X-ray

Malignancy
Unsealed fracture
Total joint replacements
Excessive pain

Systemic connective tissue disease
Elderly (weak connective tissue, diminished blood circulation)
Newly formed connective tissues

51
Q

Eval and assessment for pain

A

Before tissue limitation: inhibit pain
At tissue limitation: gentle specific stretching
After tissue limitation: aggressive stretching

52
Q

Eval and assessment for joint capsule

A

Capsular pattern

Firm capsular end-feel

Decreased joint-play movement

53
Q

Eval and assessment for ligaments

A

Limited when there is decreased joint play and pain when stressed

Joint mob applied to their line of stress

54
Q

Eval and assessment for subluxation (dislocation or loose intra-articular structures)

A

Joint manipulation or thrust

55
Q

Small amplitude rhythmic oscillations beginning of range

56
Q

Large amplitude rhythmic oscillations within range not reaching limit

57
Q

Uses for grade 1 & 2

A

For painful joints (inhibitory)

Improve nutrition to cartilage

58
Q

Large amplitude rhythmic oscillations up to the limit of available motion stressed into tissue resistance

59
Q

Small amplitude rhythmic oscillations at the limit of available motion stressed into tissue resistance

60
Q

Uses of grade 3 & 4

A

Stretching maneuvers

61
Q

Small amplitude high velocity thrust technique

62
Q

Uses of grade 5

A

Snap adhesions

Reposition dislocation

63
Q

Speed of grade 1 & 4

64
Q

Rhythm of grade 2 & 3

A

Smooth regular oscillations at 2-3 per second for 1 or 2 minutes

65
Q

Small amplitude distraction, no stress on the capsule

Equalizes cohesive forces, minimal tension and atmospheric pressure acting on the joint

A

Grade I (loosen)

66
Q

Enough distraction or glide to tighten tissues around joint. “Taking up the slack”

A

Grade II (tighten)

67
Q

Distraction or glide; amplitude large enough to place a stretch on joint capsule and surrounding periarticular structured

A

Grade III (stretch)

68
Q

Use of grade I (loosen)

A

All gliding motions relief of pain

69
Q

Use of grade II (tighten)

A

Initial treatment: to determine sensitivity of the joint

Done intermittently: may inhibit pain

If glide, maintain jt play when ROM is not allowed

70
Q

Use for grade III (stretch)

A

Stretch jt structures to increase jt play

71
Q

Application of distraction for pain

A

7-10 seconds w/rest between cycles

72
Q

Application of stretching for pain

A

Apply minimum of 6 sec w/ partial release then repeat with slow, intermittent stretches of 3-4 sec intervals

73
Q

Low intensity

No stretch on joints

A

Grade I & II (graded oscillations)

74
Q

Similar intensity

Applied stretch at end range

A 
Grade III and IV (graded oscillations) 
Grade III ( sustained stretch )
75
Q

Dosage is determined by

A

Px response to treatment and state of disease

76
Q

All joint mob techniques are done

A

At resting position of joint

Or position of least joint pain then progress to end range then apply mobilization

77
Q

To prevent unwanted stress

A

Stabilize bone

78
Q

Movement should be _______ to the treatment plane(2)

A

Parallel or perpendicular

79
Q

A plane perpendicular to a line running from the axis of rotation to the middle of the concave articular surface

A

Treatment plane

80
Q

Position is determined by the concave bone

A

Treatment plane

81
Q

Applied perpendicular to treatment plane

A

Joint traction

82
Q

Applied parallel to the treatment plane

83
Q

Initiation and progression. (4)

A

Always start with grade II distraction
(For joint reactivity)

Note changes within 24 hours

For mobilization of stretch, perform every other day
( for decrease of soreness and for tissue healing to occur)

Joint and ROM should be reassessed after treatment and before next treatment

84
Q

Manual therapy techniques that are used to modulate pain and treat joint dysfunctions that limit ROM by specifically addressing the altered mechanics of the joint

A

Joint mobilization

Joint Mob (1 decks)

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