MOD 3 Intro to Manual Therapy and Joint Mobilization

Question 1

What is manual therapy?

Answer 1

skilled hand movements intended to produce any or all the following: improve tissue extensibility, increase ROM of joint complex, mobilize or manipulate soft tissues and joints; induce relaxation

Question 2

What is joint manipulation?

Answer 2

passive, high velocity, low amplitude thrust applied to a joint complex within its anatomical limit

Question 3

What is joint mobilization?

Answer 3

manual therapy technique comprising a continuum of skilled passive movements to the joint complex that are applied at varying speeds and amplitudes

Question 4

What is the difference between thrust and non-thrust manipulation?

Answer 4

thrust = joint manipulation

non-thrust = joint mobilization

Question 5

What are the indications for using joint mobilization?

Answer 5

• pain
• muscle guarding
• reversible hypo mobility
• positional faults/subluxations
• progressive limitation
• functional immobility

Question 6

What are the contraindications of joint mobilization?

Answer 6

• hyper mobility
• joint effusion
• inflammation
• conditions requiring special precautions for stretching: malignancy, bone disease, unhealed fracture, etc

Question 7

What is the definition of R1,2 and P1,2?

Answer 7

R1: initial resistance
R2: end resistance

P1: onset of pain
P2: limit of pain

Question 8

What is grade 1 mobilization?

Answer 8

small amplitude non thrust movement at beginning of ROM

use for pain

Question 9

What is grade 2 mobilization?

Answer 9

large amplitude non thrust movement between beginning of mid range of movement

decrease pain

Question 10

What is grade 3 mobilization?

Answer 10

large amplitude non thrust movement reaching limit of range

increase ROM and decrease stiffness

Question 11

What is grade 4 mobilization?

Answer 11

small amplitude non thrust movement at end of available range

increase ROM and decrease stiffness

Question 12

What is grade 5 mobilization?

Answer 12

high velocity thrusting movement beyond end range of motion, but not past anatomic limit

Question 13

What does Baby Big Big Baby mean?

Answer 13

baby: grade 1

big: grade 2

big: grade 3

baby: grade 4

Question 14

How would you treat someone with pain with mobilization?

Answer 14

• start in open packed
• grade 1: before R1, small amp
• grade 2: before R1, large amp

Question 15

How would you treat someone with stiffness using mobilization?

Answer 15

• grade 3: between R1 and R2, large amp
• grade 4: at end near R2, small amp
• grade 5: manipulation: small amp, high speed, thrust

Question 16

How would you treat someone with pain and stiffness using mobilization?

Answer 16

• start with grade 1-2 progress to 3-4
• start with 4 follow with 1-2 to chase pain away

Question 17

What is the dosing of non thirst oscillatory techniques (grade 1-4)?

Answer 17

• 3 to 4 bout of 30-90 seconds

Question 18

What is the dosing of non thrust sustained techniques with small amp at the end range (grade 1-3)?

Answer 18

repeated cycles of 7-10 seconds

Question 19

How do you dose thrust manipulation/high velocity?

Answer 19

• one rep and repeat if no cavitation

Question 20

What do you document for joint mobilization?

Answer 20

1. rate of application of force
2. location in the range of available movement
3. direction of force as applied
4. target of force
5. relative structural movement
6. patient position