Mulligan

Question 1

Mulligan - pain

Answer 1

Pain free throughout the entire range and back!

Pain = it does not reproduce the comparable sign

Question 2

Mulligan - pt moves in what direction

Answer 2

Into motion that produces their comparable sign

Question 3

Tx is in what plane

Answer 3

Parallel for spinal joints

Perpendicular for long bones

Question 4

Movement - what range

Answer 4

to end range, if they can then add OP at the end of end range (stay pain free)

Question 5

What position are the tx done in

Answer 5

Weight bearing - this is functional for the joints

Question 6

MWM

Answer 6

mobilization with movement

Question 7

NAG vs. SNAG

Answer 7

Pt does not move with a NAG

Question 8

Mulligan concept

Answer 8

Therapist applied- passive phys mvmtn, passive access mvmnt, combined with active physiological mvmnts by pt
Never cause pain
Follow basic rules of manual therapy

Question 9

7 basic principles

Answer 9

1 Comparable sign
2 Pain free accessory glide (parallel or perpendicular)
3 Continual assessment
4 Pt actively performs comparable sign - should improve
5 If does not improve, incorrect contact point, tx plane, grade, or direction of mobilization, segment, or technique is not indicated
6 Comparable mvmnt repeated by pt while PT maintains accessory glide
7 OP at end range can lead to further gain

Question 10

Theory

Answer 10

Bony positional faults contribute to painful joint restrictions

Question 11

NAG stands for

Answer 11

Natural apophyseal glide

Passive accessory movement

Question 12

SNAG stands for

Answer 12

Sustained apophyseal glide

Passive accessory movement combined with active physiologic movement

Question 13

Basic components

Answer 13

1 Weight bearing
2 End of range
3 Follow tx plane rule
4 Spinal or peripheral joints
5 Sustained
6 Combined with active movements
7 Painless

Question 14

Weight bearing

Answer 14

Sitting
Standing
Functional

Question 15

End of range

Answer 15

Initiated short of end range
Maintained through available range
OP added at end of range
Restriction dramatically reduced

Question 16

Follow tx plane

Answer 16

Glide joint surfaces relative to one another - glide parallel to tx plane
Traction = perpendicular to tx plane, avoid joint compression

Question 17

Spinal or peripheral - Hinge joint =

Answer 17

Sustained glide is at right angle to the glide that usually occurs

Question 18

Spinal or peripheral - Adjacent long bones =

Answer 18

Ex - wrist or ankle

Clinician may need to adjust relative position to allow pain free movement

Question 19

Peripheral joint examples

Answer 19

Hip internal rotation MWM

Ankle DF MWM

Question 20

Spinal tx planes

Answer 20

Upper cervical = horizontal
Mid cervical = 45
Thoracic = nearly vertical
Lumbar = vertical

Question 21

Sustained with active movement

Answer 21

Joint glide taking place is sustained throughout the available range and back to midline
SNAGs are in direction of movement loss or pain

Question 22

Painless

Answer 22

Painless when indicated
Eliminate pain associated with the movement taking place
Contraindicated if painful

Question 23

Guidelines for application

Answer 23

Use other interventions in conjunction
MWM successful in on direction only
Apply OP at end of range
Re assess after 10 reps

Question 24

Self treatment

Answer 24

Pt providing glide component of MWM combined with active comparable movement
Painfree
Improved function during technique application

Question 25

Summary

Answer 25

Manual therapy technique in which we examine pt to find comparable sign and using that movement actively by the pt and passive sustained joint mobilization in order to create pain free movement and improve function