Lecture #1 Flashcards
What is an open-packed (loose) position?
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)
What is a closed-packed position?
When there is hardly any seperation–only slight separation can occur with traction.
What is a zero position?
Anatomical position
Where do we take ROM measurements from?
From zero positoin.
What is the actual resting position?
Whatever position we refer to relax in
What is the physiological end feel?
Characteristic feeling at the end of ROM of a joint
How many types of end feels are there? What are they?
3:
Soft: tissue approximation or soft tissue stretch
Firm: capsular or ligamentous stretching
Hard: bony or cartilaginous block
What is an example of a soft end feel?
Muscle interphase
What is an example of a firm end feel?
Most joints & ligaments
What is an example of a hard end feel?
Bony contact (as during elbow extension)
How do we grade joint motion?
0-6 scale
On the scale of joint motion, which numbers do 0-2 represent?
Hypomobility
0= no movement
1= considerably decreased movement
2= slightly decreased movement
On the scale of joint motion, what does a 3 represent?
Normal motion
On the scale of joint motion, what does 4-6 represent?
Hypermobility
4= slightly increased movement
5= considerably increased movement
6= complete instability
What is the purpose of joint mobs?
To try and decrease pain or increase mobility
When do we not use joint mobs?
If the joint is already hypermobile
What is the use of hands-on techniques to evaluate, treat, and improve the status of neuromuscular conditions?
Manual therapy
True or false:
The patient can stop the motion during a joint mob
True
What is joint mobilization?
Passive movement of a joint to relieve pain or restore mobility using physiological or accessory movements
What is a joint 5 mob?
A manipulation–this is outside the scope of our practice.
What are they two types of joint motion?
Physiological and accessory
What type of joint motion is accessory?
Arthrokinematic
What type of joint motion is physiological?
Osteokinematic (bone motion)
What is movement that can be performed voluntarily by the patient?
Osteokinematic (flexion, extension, abductinon, etc.)
What are movements that are not voluntary or controlled but necessary for normal joint movements?
Arthrokinematics (joint play-laxity, gliding, translation, etc.)
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?
Distraction; compression
What does distraction of a joint do?
Decrease pain
What does compression of a joint do?
Add stability
What is the convex-concave rule?
Convex= opposite Concave= same
What is the swing of a joint?
The bone movement (the moving limb)
Where is the treatment plane?
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
True or false:
The treatment plane moves with the convex segment?
False–it moves with the concave segment
In terms of treatment plane, where should joint mobs occur?
Parallel or perpendicular to the treatment plane
What type of motion occurs perpendicular to the treatment plane?
Distraction
What type of motion occur parallel to the treatment plane?
Gliding (translation)
What are some indication for joint mobs? (x5)
Joint hypomobility Abnormal arthrokinematic motion Pain Muscle spasm/guarding Testing/evaluation
What are the contraindications for joint mobs? (x 8)
Undiagnosed lesion Joint hypermobility Joint ankylosis Unhealed fracture Inflammatory arthritis Osteoporosis Joint effusion Considerable pain
What are neurophysiologial effects of joint mobs? (x3)
Stimulate mechanoreceptors (decrease pain)
Stimulate inhibition of nociception (increase relaxation)
Affect muscle spasm/guarding
What are the nutritional effects of joint mobs?
Moves synovial fluid (replenish joint surfaces)
Movement improves nutritional exchange
What are the mechanical effects of joint mobs?
Improve mobility in restricted joints (plastic changes)
Break or loosen adhesions
True or false:
Repeaded cracking of a joint can cause a thickening of the joint capsule and reduce ROM
True
How many grades of joint mobs are there for sustained?
3
How many grades of joint mobs are there for oscillation?
4
Describe the grades of sustained mobs.
1= traction/loosening 2= traction and gliding (tightening) 3= traction and gliding (stretching)
Which of the grades of mobs are done for pain? For restriction?
Pain= 1 and 2
Restriction=3 and (4 just oscillation)
Describe the grades of oscillation mobs.
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
What phenonmeon does sustained mobs use?
Creep
What is creep?
Low load, long duration
How long do you hold a sustained mob?
30-60 sec for 3-6 sets
What phenomenon does oscillation mobs use?
Hysteresis
What is hysteresis?
Repeated low load, short duration
How long do you do oscillations for?
3-6 sets of 20-60 secs each at a rate of 1-3 oscillations per second
