Lecture #1

Question 1

What is an open-packed (loose) position?

Answer 1

When the capsule is relaxed, there is the most room in the joint, most fluid in the joint, and when there is the greatest joint play (aka the joint is a loose as it can be)

Question 2

What is a closed-packed position?

Answer 2

When there is hardly any seperation–only slight separation can occur with traction.

Question 3

What is a zero position?

Answer 3

Anatomical position

Question 4

Where do we take ROM measurements from?

Answer 4

From zero positoin.

Question 5

What is the actual resting position?

Answer 5

Whatever position we refer to relax in

Question 6

What is the physiological end feel?

Answer 6

Characteristic feeling at the end of ROM of a joint

Question 7

How many types of end feels are there? What are they?

Answer 7

3:
Soft: tissue approximation or soft tissue stretch
Firm: capsular or ligamentous stretching
Hard: bony or cartilaginous block

Question 8

What is an example of a soft end feel?

Answer 8

Muscle interphase

Question 9

What is an example of a firm end feel?

Answer 9

Most joints & ligaments

Question 10

What is an example of a hard end feel?

Answer 10

Bony contact (as during elbow extension)

Question 11

How do we grade joint motion?

Answer 11

0-6 scale

Question 12

On the scale of joint motion, which numbers do 0-2 represent?

Answer 12

Hypomobility
0= no movement
1= considerably decreased movement
2= slightly decreased movement

Question 13

On the scale of joint motion, what does a 3 represent?

Answer 13

Normal motion

Question 14

On the scale of joint motion, what does 4-6 represent?

Answer 14

Hypermobility
4= slightly increased movement
5= considerably increased movement
6= complete instability

Question 15

What is the purpose of joint mobs?

Answer 15

To try and decrease pain or increase mobility

Question 16

When do we not use joint mobs?

Answer 16

If the joint is already hypermobile

Question 17

What is the use of hands-on techniques to evaluate, treat, and improve the status of neuromuscular conditions?

Answer 17

Manual therapy

Question 18

True or false:

The patient can stop the motion during a joint mob

Answer 18

True

Question 19

What is joint mobilization?

Answer 19

Passive movement of a joint to relieve pain or restore mobility using physiological or accessory movements

Question 20

What is a joint 5 mob?

Answer 20

A manipulation–this is outside the scope of our practice.

Question 21

What are they two types of joint motion?

Answer 21

Physiological and accessory

Question 22

What type of joint motion is accessory?

Answer 22

Arthrokinematic

Question 23

What type of joint motion is physiological?

Answer 23

Osteokinematic (bone motion)

Question 24

What is movement that can be performed voluntarily by the patient?

Answer 24

Osteokinematic (flexion, extension, abductinon, etc.)

Question 25

What are movements that are not voluntary or controlled but necessary for normal joint movements?

Answer 25

Arthrokinematics (joint play-laxity, gliding, translation, etc.)

Question 26

What occurs when the two surfaces of the joint are pulled apart? What about when there is a decrease in the space between the two joint surfaces?

Answer 26

Distraction; compression

Question 27

What does distraction of a joint do?

Answer 27

Decrease pain

Question 28

What does compression of a joint do?

Answer 28

Add stability

Question 29

What is the convex-concave rule?

Answer 29

``` Convex= opposite Concave= same ```

Question 30

What is the swing of a joint?

Answer 30

The bone movement (the moving limb)

Question 31

Where is the treatment plane?

Answer 31

Passes through the joint and lies at a right angle to a line running from the axis of rotation (of convex segment) to the middle of the contacting articular surface

Question 32

True or false: | The treatment plane moves with the convex segment?

Answer 32

False--it moves with the concave segment

Question 33

In terms of treatment plane, where should joint mobs occur?

Answer 33

Parallel or perpendicular to the treatment plane

Question 34

What type of motion occurs perpendicular to the treatment plane?

Answer 34

Distraction

Question 35

What type of motion occur parallel to the treatment plane?

Answer 35

Gliding (translation)

Question 36

What are some indication for joint mobs? (x5)

Answer 36

``` Joint hypomobility Abnormal arthrokinematic motion Pain Muscle spasm/guarding Testing/evaluation ```

Question 37

What are the contraindications for joint mobs? (x 8)

Answer 37

``` Undiagnosed lesion Joint hypermobility Joint ankylosis Unhealed fracture Inflammatory arthritis Osteoporosis Joint effusion Considerable pain ```

Question 38

What are neurophysiologial effects of joint mobs? (x3)

Answer 38

Stimulate mechanoreceptors (decrease pain) Stimulate inhibition of nociception (increase relaxation) Affect muscle spasm/guarding

Question 39

What are the nutritional effects of joint mobs?

Answer 39

Moves synovial fluid (replenish joint surfaces) | Movement improves nutritional exchange

Question 40

What are the mechanical effects of joint mobs?

Answer 40

Improve mobility in restricted joints (plastic changes) | Break or loosen adhesions

Question 41

True or false: | Repeaded cracking of a joint can cause a thickening of the joint capsule and reduce ROM

Answer 41

True

Question 42

How many grades of joint mobs are there for sustained?

Answer 42

3

Question 43

How many grades of joint mobs are there for oscillation?

Answer 43

4

Question 44

Describe the grades of sustained mobs.

Answer 44

``` 1= traction/loosening 2= traction and gliding (tightening) 3= traction and gliding (stretching) ```

Question 45

Which of the grades of mobs are done for pain? For restriction?

Answer 45

Pain= 1 and 2 | Restriction=3 and (4 just oscillation)

Question 46

Describe the grades of oscillation mobs.

Answer 46

1= tugging rhymthm (20-25% of joint range) 2=pulling a little further (from beginning of joint range to middle of joint range) 3=mobing to the restriction (from middle of jointrange to end) 4= small oscillations at the very end of available joint play range

Question 47

What phenonmeon does sustained mobs use?

Answer 47

Creep

Question 48

What is creep?

Answer 48

Low load, long duration

Question 49

How long do you hold a sustained mob?

Answer 49

30-60 sec for 3-6 sets

Question 50

What phenomenon does oscillation mobs use?

Answer 50

Hysteresis

Question 51

What is hysteresis?

Answer 51

Repeated low load, short duration

Question 52

How long do you do oscillations for?

Answer 52

3-6 sets of 20-60 secs each at a rate of 1-3 oscillations per second