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Biomechanics > mobilization vs manipulation > Flashcards

mobilization vs manipulation Flashcards

1
Q

are mobilization and manipulation active or passive

A

Passive joint movement

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2
Q

What is mobilization

A

Passive joint movement to increase range or motion or decrease pain

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3
Q

What is manipulation

A

Passive joint motion to increase joint mobility and reduce pain

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4
Q

what is the main differences beween mobilization and manipulation?

A

Mobilization - varies speed and depth and can be resisted and it only goes to the elastic barrier, Manipulation is fast thrust that patient cant resist, going into the paraphysiological space

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5
Q

can mobilization of manipulation be controled by the patient?

A

mobilization , a patient can stop the movement

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6
Q

which one goes further?

A

manipulation goes to the pariphysiological space

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7
Q

what part of vertebrae plays major role in controling passive joint movement?

A

fascet joints, they resist torsion.

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8
Q

orientatio nof cervical fascets

A

45-parallel

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9
Q

direction of thorasic fascets

A

60 - 2o

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10
Q

direction of lumbar facets

A

90 - 90

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11
Q

what are the broad effects of mobilization?

A

Neurophysiological, Nutritional, mechanical,

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12
Q

Nutritional mobilization?

A

synovial fluid nurishing

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13
Q

mechanical mobilization

A

losens adhesions

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14
Q

neurophysiological mobilization?

A

stimulate proprioception inhibit nociception

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15
Q

goal of mobilization?

A

stimulate neurophysiological, nutritional and mechanical effects.

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16
Q

what are the 5 motions of mobilization?

A

roll, spin, slide, glide, distract/traction and compression

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17
Q

Rationale for mobilization

A

can break tissue adhesions, stretch tissue to help cause permanent changes in the plastic range

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18
Q

what is the type of movement for mobilization?

A

slow, small amplitude oscillations/traction

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19
Q

what is the roll and glide for convex on concave

A

glide occurs opposite that of roll so bone end stays in one place while rotating.

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20
Q

what is the roll and glide for concave on convex?

A

glide occurs in same diretion as roll, so bone sort of rolls around end

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21
Q

when saying convex on concave, what one is stationary?

A

the second one is stationary.

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22
Q

what joint mobilizations do not follow the convex-concave rule?

A

none, they all follow rule

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23
Q

what direction is joint restriction in convex on concave movement?

A

mobilization is in the same direction as restriction - slide tword tight capsule

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24
Q

what direction is joint restriction in the concave on convex

A

direction of restriction is opposite that of the direction its sliding/rolling

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25
Q

what are the rules?

A

Everyone relaxed with a stabalizing hand,

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26
Q

what must operator concider

A

direction of movement, velocity, and amplitude.

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27
Q

how many movements and joints are done at once?

A

only one at a time.

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28
Q

what bone is stabalized during manipulation?

A

the proximal one.

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29
Q

how should joint be positioned?

A

loose packed, open position, lax

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30
Q

How many maitland grades of oscillations?

A

five grades of oscilations.

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31
Q

what is grade 5 miatland?

A

small amp, high velocity thrust beyond end range - to decrease stiffnese.

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32
Q

what would grade II be used for?

A

to manage pain and spasm - mid range movement

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33
Q

what maitland grade levels go past tissue resistance, stretch?

A

three through 5

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34
Q

What type of movement is maitland?

A

oscillations

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35
Q

what grade maitland does cavitation and joint lube

A

grade 5

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36
Q

what should be treated first, pain or tightnes?

A

Pain should be treated first

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37
Q

how many oscilations per treatment? Maitland

A

2-3 oscilation 3-6 sets for 20-60 seconds

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38
Q

is tightness or pain treated more often?

A

Pain is treated daily while tighness is 3-4 times a week

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39
Q

what are small amplitude oscilations used for?

A

stimulate mechanoreceptors and limit pain perception

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40
Q

what does kaltenbord do?

A

combine traction with mobilization

41
Q

what is kaltenborn used for?

A

decrease pain or reduce joint hypomobility

42
Q

How many kaltenborn grades of traction?

A

three grades

43
Q

Kaltenborn grade one?

A

loosen - pain relieve by reducing compression

44
Q

Kaltenborn grade II?

A

tighten - eliminate play, to determine joint sensitivity

45
Q

Kaltenborn grade III?

A

stretch - increase mobility

46
Q

what kalten born grades are in available joint play

A

Kaltenborn I and II are in joint play, II goes into tissue resistantce and stretch.

47
Q

How is kaltenborn applied, directionally

A

Traction is perpendindicular while gliding is parallel to treatment plane

48
Q

how long do kaltenborn for pain or tightness?

A

pain: 1-2 minutes, tightness for 20-60 seconds

49
Q

what kaltenborn do you used first to limit painful reaction?

A

grade I traction, then alternate with grade II.

50
Q

what sort of things are contraindicated for mobilization?

A

malignancy, fractures or bone disease, inflammation that is acute, acute arthritis, vertebral artery disease, cauda equina lesions, nerve root involve, congenital abnormalities. Seroid use.

51
Q

principles of gait analysis

A

feet upwards, patient should walk at normal speed. Follow up with other procedures.

52
Q

what is gaits purpose?

A

to get from A to B efficiently while maintining equilibrium and bareing bodies weight.

53
Q

what can effect gait pattern?

A

speed of gait

54
Q

walking slowly

A

spread feet, less swing, shorter step, side to side body

55
Q

walking fast

A

close feet, large swing, ling step, body foreward

56
Q

what are the two main phases of gait?

A

stance 60% and swing at 40%

57
Q

what are the 5 parts of stance phase?

A

Heel strike, foot flat, midstance, push off, heel off, and toe off

58
Q

what are the 3 parts of swing phase?

A

acceleration, mid-swing and deceleration

59
Q

how long is the gait cycle?

A

from the time the foot touches the grount till it touches it again

60
Q

what is mid stance?

A

when body passes directly over the reference leg.

61
Q

push off is made of what movements?

A

Heel off: where heel leaves the ground and Toe off: where only the toe is left in contact with ground

62
Q

when does swing phase begin?

A

as soon as toe leaves ground

63
Q

what happens to pelvis on side of swing leg>

A

Pelvis drops 5 degrees

64
Q

how far does pelvis rotate?

A

it rotates 4 degress forward on side of swing leg

65
Q

which way does pelvis shift laterally during walking?

A

Pelvis shifts laterally tword side of stance leg.

66
Q

how far apart are the feet during walking?

A

2-4 inches between big toes

67
Q

referred pain

A

percieved at site adjacent or distand from site of orgin

68
Q

radiating pain

A

pain moves from original area outwarts to another part of body

69
Q

radicular pain

A

pain along dermatomal distribution due to inflammation etc of nerve root

70
Q

radiculopathy

A

spinal nerve root irritiation along distribution of a that leads to pain, numbness or muscle weakenss, muscle atrophy.

71
Q

what can help diffierentiat the difference between musculoskeletal and visceral pain?

A

location, how patiet points to pain was there an injury, how did it start

72
Q

how would a patient point to pain that may indicate visceral?

A

broad flat hand over large area rather than pointing with a finger.

73
Q

is referred pain visceral or somatic?

A

either,

74
Q

is musculoskeletal or visceral pain more likely to have identifiable mechanism?

A

musculoskeltal is more likely to have an identifiable mechanism.

75
Q

what would and insidious onset of pain indicate>

A

degenerative or chronic

76
Q

what would a sudden onset of pain indicate?

A

infectious

77
Q

what ususally releaves musculoskeletal pain?

A

rest, specific positions, heat, cold massage etc.

78
Q

what ususally aggrivates visceral pain?

A

related to stressing involved organ.

79
Q

if pain was poorly localized, dull and assiociated with nausa and anxiety, what type would you expect it to be?

A

visceral pain, patology

80
Q

what type of pain ususally has autonomic components?

A

somatic pain.

81
Q

what could indicate injured muscle

A

pain with isometric contraction, contraction without movement

82
Q

what could indicate injured ligament, muscel or tendon

A

pain with passibe stretch

83
Q

pain with direct pressure?

A

muscle strain, trigger point

84
Q

what would indicate ligamentous injury

A

pain with distraction

85
Q

pain with compression?

A

cartilagenous injury

86
Q

Painless crepitis indicates

A

degenerative joint disease or defomity

87
Q

Painful drepitus

A

Degenerative joint disease

88
Q

tenter areas with referred pain

A

trigger points

89
Q

what is pain at rest along meridian at alarm point

A

deficient chi

90
Q

tentderness along merician at alarm during palp

A

excessive chi

91
Q

pain on either side of spinous process

A

joint dysfuncion

92
Q

musculoskeletal diagnosis depends on what 4 things?

A

anatomy knowledge, history, observation and exam.

93
Q

howwould you avoid overlooking anything ?

A

sequential approach to patient evaluation

94
Q

what should you avoid doing while taking patient history

A

leading patient

95
Q

why is asking age pertient

A

because speciifice diseases or impingments

96
Q

what are the pertinent questions

A

age, occupation, hobbies, complaints mechanism of injury, predisposing factors, onset, timing, provokers, relievers., exact location

97
Q

why does entire joint complex need examination with trauma?

A

injury to one side can lead to injury to another.

98
Q

what sometimes makes chronic inflammation better?

A

activity

Biomechanics (12 decks)

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