Manual Therapy Terminology

Question 1

Physiological movements

Answer 1

Motion that you can see
Osteokinematics
Movement done voluntarily
Motion of the bones
Can be found out the amount of motion
Can be visualized
Can be measured

Question 2

Accessory

Answer 2

Motion you feel
Arthrokinematics
Movement occurs inside the joint
Responsible for improving physiological movement
Restrictions in accessory motion results in decrease of physiological movement

Question 3

Contractile structure

Answer 3

Muscle tendon and its attachment
We use resisted movement

Question 4

Non contractile

Answer 4

Joint capsule
Ligaments
Fasciae
Bursae
Dura mater
Dural sheat
Nerve
We use passive movement

Question 5

Passive movement

Answer 5

Patient relaxes her limb
Pt move it for her
Evaluation for intert structure
Inert structure are stretched at the joint extreme of range
If the patient feel any pain inert structure are faults

Question 6

Resisted movement

Answer 6

Both patients and pt are active
Give resistance in the mid range position so that non contractile structures should not be stretched
Evaluation for contractile structure - muscles tendons bone attachment

Question 7

Passive range of motion

Answer 7

Amount of range of motion
End feel
Pain = if positive it’s non contractile inert soft tissue lesion
Quality of resistance at end range

Question 8

End feel

Answer 8

Soft = soft tissue approximation, feel at the end of the normal range
Firm springy= passive elastic tension of the muscles capsule ligaments
Hard= bone contracting bone

Question 9

Abnormal end feel

Answer 9

Soft= edema synovit, ligaments stability and you can feel before ROM is completed
Firm springy = movement is stopped due to soft tissue tension. You can feel before ROM is completed. Increased tonus tension in capsules , connective tissues of muscle
Hard= movement is stopped due to bone contacting bone. Fracture, osteoarthritis, loose body

Question 10

Resistive movement

Answer 10

Performed in the mid range position to minimize stress to the joint and not to stretch non contractile
Isometric muscles testing is performed = no motion
Pain and weakness are evaluated together

Question 11

Result of resistive movement

Answer 11

Stronger and painless: normal soft tissue
Strong and painful; minor contractile lesion is present
Weak and painless: nerve problems
Weak and painful: severe conditions such as fracture

Question 12

Treatment for resistive movement pain

Answer 12

Deep friction massage
Myofascial release
Soft tissue mobilization
Ischemic compression

Question 13

Deep friction massage

Answer 13

Perpendicular to the tissue fibers for muscle and tendons
6-12 sessions
For acute 3-5 minute
For chronic 20 minute

Question 14

Myofascial release

Answer 14

Parallel to fiber
relax if there’s pain
Structure; limitations of the end at the range
Functional: limitations of the soft tissue

Question 15

Arthrokinematic

Answer 15

Roll
Glide
Spine
Compression
Distraction

Question 16

Roll

Answer 16

Rotatory movement
One joint surface rolling on another
New point on one joint surface with new point on the other joint

Question 17

Glide

Answer 17

Occurs when joint surface are congruent
Defined as a single point on one joint surface repeatedly contacting new points on the other joint surface

Question 18

Spin

Answer 18

Is rotary movement
One joint surface spinning on another

Question 19

Traction/ distribution

Answer 19

Pulling the joint surface apart from each other

Question 20

Compression

Answer 20

Joint surface are pushed closer together

Question 21

Arthrokinematic movement rule

Answer 21

Combined roll-gliding occurs within all joint during movement
If the joint is congruent glide occurs more
If the joint is incongruent roll occurs more

Question 22

Concave- convex

Answer 22

Concave = hollowed or rounded inward
Convex = curved or rounded outward

Question 23

Concave - convex rule kalrenborn

Answer 23

Is that when concave joints surface moves on fixed convex surface, the glide or mobilization should be performed in the same direction as the joint movement
When convex joints surface move on fixed concave surface, the glide or mobilization should be performed in the opposite direction of the joint movement

This rule principle that concave joints is more mobile and convex is more stable

Question 24

Closed packed position

Answer 24

Max contact area  the joint surface maximally congruent
Min mobility
Max stability
Tissues around the joint are under max tension
Min intercapsular space
The joint become losked  no further movement is possible

Question 25

Loosed packed positions

Answer 25

Joint surfaces and tissues around the joint are most relax
Contact between the joint surfaces are lesser
More intercapsular space is available
Treatment position
Most vascularity
Rest position

Question 26

Mobilization

Answer 26

Mobilization:
passive joint movement for increasing ROM or decreasing pain
Used physiologic or accessory motion
Force is light enough that patient’s can stop the movement
Single or multiple application

Question 27

Manipulation

Answer 27

Manipulation:
passive joint movement for increasing joint mobility
Sudden forceful thrust that is beyond the patient’s beyond
Usually a single application

Question 28

Self mobilization ( automobilization

Answer 28

Self stretching techniques that specifically use joint traction or glides

Question 29

Mobilization with movement

Answer 29

Applied in a pain free direction

Question 30

Mobilization grade

Answer 30

Grade1: small amplitude movement at beginning of the available ROM
Grade2: large amplitude movement at within the available ROM
Grade3: large amplitude movement that reaches the end ROM
Grade4: small amplitude movement at the very end range of motion
Grade5: high velocity thrust of small amplitude at the end of the available range and within it anatomical range (manipulations)

Grade1 and 2 it’s control the pain and edema
Grade3 and 4 it’s for stretch the capsules

Question 31

Mobilization treatment principles

Answer 31

Oscillation: 60-120min , l-5 set of 5-60 seconds, generally used to treat pain
Prolonged hold: 5-30second , 1-5 rep, tropically applied at the end range to treat stiffness
You can do all the grades

Question 32

Absolute contraindications

Answer 32

Malignancy in area of the treatment
Infection arthritis
Fractures or ligaments rupture

Question 33

Relative contraindications

Answer 33

Pregnancy
Hyper mobility
Excessive pain or swelling
Spondylolisthesis