Manipulation and Mobilization: Assessment Flashcards
Biomechanical Approaches: Static or Dynamic?
A. Changes in motion of adj bones; muscles and ligaments contribute
B. Alterations in position of adjacent bones
C. Function is often more significant than structure
D. Structure determines function
A. Dynamic
B. Static
C. Dynamic
D. Static
Biomechanical Approaches: Static or Dynamic?
A. Dxd by palpation, posture/gait, & motion x-rays
B. Dxd by palpation, markings on x rays, instruments
C. “malposition of a bone”
D. “restriction of joint movement”
A. Dynamic
B. Static
C. Static
D. Dynamic
What are advantages and limitations of Static assessment?
Limitations: incorrect due to bony abnormalities, good static alignment with faulty joint movement, joints may be compensating for problem elsewhere
Advantages: used in acute conditions when moving body would be too painful, can be used w limited motion
What are advantages and limitations of Dynamic assessment?
Limitations: Lack of consistency in assessment, less used w acute/pain/limited motion, may overlook postural stresses, doesn’t take coexisting disease into account.
Advantages: IDs components that become dysfunctional.
Joint Dysfunction, Fixation, or Restriction?
A. Limitation of movement
B. Temporarily immobilized in normal position of mvmt
C. Disturb. of function w/o structural or position change
D. Produces subtle change in quality & range of motion
A. Dysfunction
B. Fixation
C. Restriction
D. Dysfunction
Causes of Jt. Dysfunction: Mech, Chem or Psychological?
A. Microtrauma, macrotrauma, postural
B. Psycho-somato-visceral reflexes
C. Reflex interaction (somato-visceral, viscera-somatic, viscera-visceral)
A. Mechanical
B. Chemical
C. Psychological
Identifying Joint Dysfunction
What does the acronym PARTS stand for?
P = Pain or tenderness produced by palpation/pressure A = Asymmetry of joint components IDd by static palp R = ROM (active, passive, or accessory movements) T = Tone texture and temp changes IDd by palp S = Special tests or procedures (orthopedic)
How is joint dysfunction assessed?
Inspection/observation
Palpation (static, motion)
ROM (global - osteokinematics; articular - arthrokinematics)
End feel
What are the things you would look for when observing/inspecting a person for joint dysfunction?
Superficial (size, shape, skin, cuts, bruises, swelling, scars, moles)
Posture
Gait
What would you include in your palpation assessment for a person with possible joint dysfunction?
Static = assessment of soft tissues in neutral state Motion = assessment of passive/active ROM incl. quality, quantity, joint play, end-feel, symptoms
Name the instruments used to measure global ROM
A. Standard instrument used for spinal measurements
B. Instrument limited to extremity joints
A. Inclinometer
B. Goniometer
What is the paraphysiological space?
Area of increased movement beyond the elastic barrier up to the anatomical limit.
End-Feel: Capsular Ligament Soft Tissue Muscular Bony?
A. Firmer quality; occurs normally w knee extension
B. Firm but giving, resistance builds with lengthening, stiff
C. Giving, squeezing quality, from approximation
D. Hard, non-giving, abrupt stop
A. Ligamentous
B. Capsular
C. Soft Tissue
D. Bony
End-Feel: Capsular Ligament Soft Tissue Muscular Bony?
A. Firm but giving, builds with elongation, not stiff
B. Occurs normally w hip flexion
C. Occurs normally at elbow extension
D. Occurs normally at elbow flexion
A. Muscular
B. Muscular
C. Bony
D. Soft Tissue
End-Feel: Muscle Spasm, Interarticular, Empty?
A. Normal end-feel resistance is missing; hyper-mobility
B. Bouncy springy quality; found w meniscal tear
C. Guarding, resist, can’t be assessed b/c pain/guarding
A. Empty
B. Interarticular
C. Muscle Spasm
