Lecture 1

Question 1

what are mobilizations?

Answer 1

passive manual techniques applied to joints + related soft tissues @ varying speed + amplitude

Question 2

what is joint play?

Answer 2

amount of movement available between joint surfaces @ capsular level

Question 3

what are physiologic movements?*osteokinematics

Answer 3

movements px can do voluntarily

Question 4

what are accessory movements? *Also known as component movements

Answer 4

movements within the joint and surrounding tissues that are necessary for ROM but can not be actively controlled

Question 5

what are arthrokinematics?

Answer 5

study of the movements that occur between the articular surfaces, inside
the joint (accessory movements)

Question 6

what is congruency?

Answer 6

max achieved when articular surfaces have the tightest fit

Question 7

what are normal end feels?

Answer 7

bone on bone
STA
tissue stretch/ ligamentous
muscular
capsular/firm

Question 8

What are abnormal end feels?

Answer 8

muscle spasm
empty
springy
early bone on bone
boggy
muscular
capsular - before end range

Question 9

what is subluxation?

Answer 9

incomplete or partial dislocation- often involves secondary trauma to surrounding soft tissue

Question 10

what is manipulation?

Answer 10

thrust- high velocity, short amplitude-( patient cannot prevent)

Question 11

what are the 2 shapes of joint surfaces?

Answer 11

ovoid + sellar

Question 12

what is ovoid?

Answer 12

one surface convex
one surface concave

Question 13

what is a sellar surface?

Answer 13

one surface convex in one direction - concave in the opposite ex. thumb/saddle

Question 14

what is distraction?

Answer 14

joint surfaces pulled apart- require specific angle

Question 15

what is compression?

Answer 15

joint surfaces approximated

Question 16

what is roll?

Answer 16

one articular surfaces rolls on another
- always in same direc. as bone in motion+ associated with glide

Question 17

what is spin?

Answer 17

accessory movement- bone moves in circular fashion around stationary imaginary axis

Question 18

what is glide?

Answer 18

one articular surface glides on another

Question 19

what are the benefits of joint mobilizations?

Answer 19

pain control
joint lubrication
improves tissue health

Question 20

what are indications for joint mobilozations?

Answer 20

1. pain + mm guarding
2. reversible joint hypomobility
3. positional faults/subluxations
4. progressive limitation
5. functional immobility
6. poor proprioception

Question 21

list absolute contraindications of joint mob./assessment

Answer 21

hypermobility + instability
acute inflammation
bone lesions
CT lesions
bacterial infection/ sepsis
excessive pain
spinal cord lesion
joint replacement

Question 22

what are precautions in joint mobs.?

Answer 22

joint effusion?
prolonged corticosteroid
history neoplasm/radiation
osteoporosis
neurological signs
pregnancy- relaxin

Question 23

what are the two systems for grading?

Answer 23

graded oscillation technique(maitland)
Sustained translatory techniques (kaltenborn)

Question 24

what is grade 1 sustained?

Answer 24

small-amplitude distraction or glide applied where no stress is placed on capsule.
pain relief, non-corrective grade of mobilization.

Question 25

what is grade 2 sustained ?

Answer 25

enough distraction or glide is applied to tighten the tissues around the joint to
tissue resistance. This is also a non-corrective grade and can be used to decrease pain and
maintain ROM.

Question 26

what is grade 3 sustained?

Answer 26

distraction or glide is enough to put a stretch on the joint capsule and on
periarticular structures. Movement is through the tissue resistance. This is a corrective
grade used to stretch the joint structures and increase ROM and joint play

Question 27

what is grade 1 oscillation?

Answer 27

small amplitude rhythmic oscillations performed at beginning of the range,
before tissue resistance. Performed at approximately 3-5 cycles per second.

Question 28

what are grade 2 oscillations?

Answer 28

: large amplitude oscillations performed within the range, before tissue
resistance. Performed at 2 cycles per second.

Question 29

what are grade 3 oscillations?

Answer 29

: large amplitude oscillations performed within tissue resistance (in and out), but
before the joint limit. Performed at 2 cycles per second

Question 30

what are grade 4 oscillations?

Answer 30

small amplitude oscillations performed just beyond tissue resistance but before
the joint limit. Performed at approximately 3-5 cycles per second.

Question 31

what are grade 5 oscillations?

Answer 31

small amplitude, high velocity movement (not oscillatory) that begins at the
tissue resistance and ends up at the anatomical limit of the joint (manipulation). This is
not in our scope of practice

Question 32

what is the goal of grade 1 + 2 oscillations?

Answer 32

reduce pain (oscillations have an inhibitory effect on
perception of painful stimuli by repetitively stimulating mechanoreceptors to block
nociceptors).

Question 33

what are the uses of grade 3 + 4 oscillations?

Answer 33

improve ROM

Question 34

what grades can cause irritation due to higher frequency?

Answer 34

1+4

Question 35

how long can grade 1 + 4 oscillations be done for?

Answer 35

15- 30 seconds with few seconds rest up to 5 sets
(rapid and may cause irritation)

Question 36

how long can grade 2+3 oscillations be done for?

Answer 36

up to 1 minute

Question 37

what grade would you do for a first appointment joint mobilizations?

Answer 37

grade 1 or 2 oscillation

Question 38

what should be taught to px after increasing ROM

Answer 38

ROM exercises in newly gained range p-free