Mobilisation

Question 1

what factors affect normal joint movement

Answer 1

ligaments
joint capsule
cartilage
tendons
fascia
synovium
muscles

Question 2

what are 3 examples of abnormal joint movement

Answer 2

-reduced ROM (reduced range of passive motion, stiffness)

-hypermobility (increased ROM, may be desirable like in gymnasts, pathological or incidental,, without sufficient muscle control can lead to joint instability)

• insufficient neurological control (abnormal muscle tone or control around joints, usually pathological)

Question 3

what determines joint range of movement

Answer 3

-the structure of the joint itself- arthrology
- resistance within the joint itself
- the properties of each joint structure e.g intra and extra- articular structures like cartilage, capsule etc
- how external forces are transmitted by the articular soft tissue
- varying concentrations of elastin, collagen, water etc

Question 4

what 2 main components make up connective tissue

Answer 4

cells and the extra-cellular matrix

Question 5

what cells make up connective tissue

Answer 5

fibroblasts - chondroblasts and chondrocytes

Question 6

what makes up the extra-cellular matrix

Answer 6

fibres and ground substance

Question 7

what fibres make up the extra-cellular matrix

Answer 7

elastin, collagen, reticulin

Question 8

what makes up the ground substance

Answer 8

proteoglycans, water, GAGs

Question 9

describe the mechanical properties of articular connective tissues

Answer 9

very strong
organised
resistant to tensile strength
strongly resistant against lines of stress

Question 10

what are the 3 main categories of causes of reduced range of movement

Answer 10

trauma, immobility, chronic disease

Question 11

give some examples of trauma which will cause reduced range of movement

Answer 11

fractures
muscle strains
sprains

Question 12

examples of immobility which will cause reduced range of movement

Answer 12

plaster cast
bed rest
hospital
older persons
nursing homes

Question 13

give some examples of chronic disease which may cause reduced range of movement

Answer 13

osteoarthritis
rheumatoid arthritis

Question 14

what are the effects of reduced range of motion

Answer 14

reduced function - for upper limb there will be reduced independence with functional tasks like getting dressed,, for lower limb there will be poor gait and increases falls risk
pain
muscle weakness
vicious cycle of inactivity ( reduced function, body starts to decondition, making things harder to do, so loss of motivation, leading to decreased activity)

Question 15

describe the physiological changes that occur to connective tissue due to immobility

Answer 15

fibres become disorganised- some fibres become perpendicular instead of parallel
weaker overall structure
weakly resistant in all directions

Question 16

describe the physiological changes of intra articular structures (cartilage and synovium) due to immobility

Answer 16

CARTILAGE
- decreased water content
-decreased nutrients from synovial fluid
-thinning of extra-cellular matrix

SYNOVIUM
- decreased number of synoviocytes
-decreased synovial fluid volume
-decreased synovial fluid movement
-reduced lubricin- reduced lubrication

Question 17

physiological changes of immobility to bone and muscle

Answer 17

BONE
- increased resorption of cancellous and compact bone
-decreased bone mineral density
-decreased ability to withstand stress
-increased risk of fracture with excessive force

MUSCLE
- atrophy
sarcomeres lost from myofibrils - shortening