NAGS and SNAGS Flashcards
What does NAGS mean?
Natural Apophyseal Glides
Definition: oscillatory weight-bearing mobilizations which can be applied to facet joints between C2 and T3; gliding a facet on its neighbor
NAGS
NAGS are (passive/active) accessory movements.
passive
What does SNAGS mean?
Sustained natural apophyseal glides
definition: Glides that are used for treatment on ALL spinal segments, rib cage, and SI joints
SNAGS
definition: The patient ACTIVELY moves through the previously painful or restricted ROM while an accessory glide is performed
SNAGS
What does MWMS mean?
mobilizations with movements
definition: a combination of SUSTAINED accessory mobilizations with physiologic movement used with the ribs, SI joint, and extremities
MWMS
(true/false) MWMS are used with the spine.
FALSE
What does SMWLMS mean?
Spinal mobilizations with limb movements
definition: SUSTAINED transverse glide to the spinous process of a vertebra is applied while the restricted peripheral joint is mobilized actively OR passively.
SMWLMS
definition: indication of a disturbed proprioceptor being misinterpreted by an agitated CNS and made worse by ACTIVE movement
mild resting aches
Painful restrictions of spinal and peripheral joint mobility is sometimes accompanied by ____ and ____.
weakness and tracking problems
What does SINS factor stand for?
Severity
Irritability
Nature of Presenting condition
Stage
What are indications for mulligan techniques?
- mild resting aches
- painful or restricted joint mobility
- orthopedic conditions (lateral epicondylitis)
- SINS factor
What are contraindications for using the mulligan techniques?
- hypermobility
- degenerative joint disease
- RA
- osteoporosis
- pregnancy
- excessive pain
- infection
- neoplasm
- recent Fx
In what situations are the mulligan concept techniques not effective?
They are not effective with chronically adaptive shortened tissues or where serious pathology exists
What are the physiological effects of mobilizations?
- mobilization induced analgesia
- recruitment of downward inhibitory modulation
What are the mechanical effects of mobilizations?
- increased pain-free ROM including increased joint mobility
- proper/improved joint tracking
Mulligan concept techniques have (immediate/non-immediate) results.
immediate
(true/false) Techniques of the mulligan concept are pain-free and safe.
true
What are the cons of the mulligan concept techniques?
- does not identify anatomic cause of impairment
- may not adhere to the biomechanics of a joint
What does it mean if symptoms remain or become worsened when using mulligan techniques?
- The glide may be in the wrong direction
- The problem is unsuitable for the technique chosen
Perform ___ reps of the _____ movement
10 reps, asymptomatic
What part of ROM are NAGS performed in?
mid to end range
oscillatory accessory glides in NAGS are done in a ___ to ___ direction.
posterior to anterior
NAGS are used to treat problems originating from segments __-__.
C2-T3
SNAGS should not be performed for more than ___ SUCCESSFUL repetitions in the cervical spine
3
What patient position is recommended when performing lumbar SNAGS?
seated
Where should you exert pressure while performing SNAGS?
spinous processes ot unilaterally on articular pillars
When doing reverse NAGS, pain in the neck/upper trap indicates a ___ problem.
upper cervical spine
When doing reverse NAGS, pain in the neck and down to the shoulder indicates a ___ problem.
lower cervical spine
SNAGS are a ____ range mobilization
End of range
NAGS or SNAGS? Which is least likely to provoke a latent pain?
NAGS
NAGS or SNAGS? Preferred if MULTIPLE joints of the cervical spine are involved.
NAGS
NAGS or SNAGS? Preferred if only ONE joint is involved or if symptoms are present at ONLY the END RANGE.
SNAGS
When are MWMS mobilizations indicated?
- When a patient presents with a history that is appropriate for manual therapy
- When there is only complain of symptoms when moving
The direction of the accessory technique of MWMS must follow the _____ line.
joint line
Perform hinge joint mobilizations for ___-___ reps.
3-4 reps
