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Orthopedics > Lecture 4: Introduction to Joint Mobilization > Flashcards

Lecture 4: Introduction to Joint Mobilization Flashcards

1
Q

What are the 3 types of accessory motions

A

roll
slide (glide)
spin

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2
Q

convex on concave rule

A

When a convex surface moves on a concave surface, the gliding movement occurs in the opposite direction to the bone movement and the roll occurs in the same direction

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3
Q

Concave on convex rule

A

When the concave surface is moving on a stationary convex surface, the gliding and rolling motion is in the bone movement

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4
Q

How do we increase the osteokinematic motion

A

change the arthrokinematics

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5
Q

How do we increase the arthrokinematic motion

A

Joint mobilization

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6
Q

Joint mobilization should be done in the direction of the roll or glide

A

the joint glide

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7
Q

The direction of force to increase motion should be at what angle

A

The angle is the plane of the joint. If your force is not in the plane of the joint than you are not doing an effective mobilization

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8
Q

Describe the open packed position of a joint (5 parts)

A
  • slackening of major ligaments and capsule
  • minimal surface congruity
  • minimal joint surface contract
  • minimal stability of a joint
  • maximal joint volume (best position for joint mobilization)
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9
Q

Describe the closed packed position of a joint

A
  • maximal tautness of major ligaments and capsule
  • maximal surface congruity and compression
  • maximal stability of a joint
  • Minimal joint volume
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10
Q

Loose packed position for the shoulder

A

55 abd, 30 horizontal add

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11
Q

Closed packed position for shoulder

A

Full abd, ER

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12
Q

A torn meniscus in the knee would have what type of end feel

A

abnormal, springy block

This would feel like a rebound at the end range often accompanied by pain

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13
Q

What is an empty end feel

A

motion limited by pain, no block felt

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14
Q

what is a loose end feel

A

hypermobility with no resistance at end-feel

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15
Q

Is a capsular end feel normal

A

analogous to normal tissue stretch, but the elastic resistance is encountered before normal end ROM; capsular restriction

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16
Q

Name 6 contraindications to doing accessory testing

A
  • cancer
  • fracture
  • acute rheumatoid condition
  • non-mechanical pain
  • infection/septic condition
  • ankylosed joint
17
Q

Name 6 precautions to do accessory testing

A
  • joint effusion
  • pregnancy
  • neurologic signs (impaired sensation)
  • hypermobility
  • osteoporosis
  • steroid use
18
Q

Grading Joint Mobility

A 
4 point system
0- no movement/ankylosed
1-stiff/ hypomobile
2- normal
3- excessive/hypermobile
19
Q

How to determine if a pt has a positional fault

A

Decreased ROM

Static palpation my show a joint not sitting in the right place

20
Q

How does a PT treat muscular vs. capsular causes of shortness?

A

Muscle - stretches

Capsular - mobilzations

21
Q

How can you tell if muscle is short or if there is a spasm

A
  • Spasms: have muscle activation with joint movement (reacts with motion)
  • Reduces with PNF

-Shortness: would have not reaction with motion and no change with PNF

22
Q

Treatment: Muscle shortness vs muscle spasm

A

shortness- prolong stretching

Spasm- Modalities, PNF

23
Q

What are the 3 types of PNF stretches

A
  • Contract relax (autogenic inhibition)
  • Agonist contraction (reciprocal inhibition)
  • CR-AC
24
Q

What are the clinical uses of PNF AC?

A

Good to use where the patient is guarding or there are ms spasms

Re educate into new range

25
Q

If a pt has decreased ROM and the issue capsular, what would the end feel be and what would happen with the accessory motion of the joint

A

end feel would be capsular

accessory motion would be decreased

26
Q

If a pt has decreased ROM and the issue is muscular, what would the end feel be and what would happen with the accessory motion

A

End feel would be springy

normal accessory motion

27
Q

What are some goals of joint mobilization

A
  • restore accessory motions
  • reduce pain
  • correct positional fault
  • improve joint nutrition
28
Q

Maitland Mobilization grade 1

amplitude and %

A

small oscillation
small amp.
first 25% of available ROM

29
Q

Maitland Mobilization grade 2 amplitude and %

A

Larger amp

first 50% of ROM

30
Q

Maitland Mobilization grade 3 amplitude and %

A

Large amp

Last 50% - do not release from 50%

31
Q

Maitland Mobilization grade 4 amplitude and %

A

small oscillation

at end of available range (last 25%)

32
Q

Maitland Mobilization grade 5 amplitude and %

A

High velocity thrust, small amplitude at the end ROM
@ 100
Do not release from 100%

33
Q

What is the purpose of a grade 5 Maitland Mobilization

A

joint restrictions - where you get resistance

increase strength

Pain - change tone and break up adhesion

34
Q

What is the purpose of a grade 1 Maitland Mobilization

A

pain and relaxation

35
Q

What is the purpose of a grade 2 Maitland Mobilization

A

Pain and relaxation

36
Q

What is the purpose of a grade 3 Maitland Mobilization

A

treat joint restricitons

37
Q

What is the purpose of a grade 4 Maitland Mobilization

A

Treat joint restrictions

38
Q

What rate is a mobilization done for pain

A

Grade 1 and 2

oscillations at a rate of 2/s

39
Q

What grade and rate is a mobilization for treating joint restrictions

A

Grade 3 and 4

20-60 seconds, 4 to 5 times

Orthopedics (12 decks)

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