Peripheral Joint Mobilization

Question 1

Clinical Indication: Pain or muscle guarding (which grades?)

Answer 1

Grades 1 & 2 – low intensity, no stretch force against capsule
(Vary speed of oscillations for different effects, such as low amplitude and high speed, to inhibit pain or slow speed to relax muscle guarding.)

Question 2

Clinical Indication: Mobility (which grades?)

Answer 2

Grades 3 & 4 – stretch force at the limit of motion

Question 3

Contraindications/Precautions for joint mobilization

Answer 3

Hypermobility, joint effusion, inflammation

Question 4

Traction vs. Distraction

Answer 4

Traction is a longitudinal pull or pulling on the long axis of a bone. Distraction is a separation, or pulling apart. Distraction is generally applied at right angles to the joint surface (i.e. glenoid fossa).

Question 5

Oscillation Techniques: Dosage and Rate of Application

Answer 5

GRADE I. Small-amplitude rhythmic oscillations; beginning of the range; rapid.
GRADE II. Large-amplitude rhythmic oscillations; within range, not reaching limit; 2 or 3 per second for 1 to 2 minutes.
GRADE III. Large-amplitude rhythmic oscillations; up to limit of available motion and stressed into tissue resistance; 2 or 3 per second for 1 to 2 minutes.
GRADE IV. Small-amplitude rhythmic oscillations; at the limit of motion and stressed into tissue resistance; rapid.

Question 6

Sustained Joint-Play Techniques: Dosages and Rate of Application

Answer 6

GRADE I (Loosen). Small-amplitude distraction; no stress place on capsule; equalizes cohesive forces, muscle tension, and atmospheric pressure acting on joint; within available joint play.
GRADE II (Tighten). Enough distraction or glide applied to tighten the tissues around joint "taking up the slack"; to tissue resistance.
GRADE III (Stretch). Distraction or glide applied with an amplitude large enough to place stretch on joint capsule and surrounding periarticular structures.

Question 7

Inferior/Caudal glide at GH Joint increases what motion?

Answer 7

Abduction

Question 8

Posterior glide at GH joint increases _______.

Answer 8

Flexion, IR

Question 9

Anterior glide at GH joint increases ________.

Answer 9

Extension, ER

Question 10

Distraction progression at GH joint increases _______.

Answer 10

ER

Question 11

Anterior glide at AC Joint increases ________.

Answer 11

General mobility

Question 12

SC Joint Posterior glide increases _______.

Answer 12

Retraction

clavicle - concave ant to post

Question 13

SC Joint Anterior glide increases _______.

Answer 13

Protraction

clavicle - concave ant to post

Question 14

SC Joint Superior glide increases ________.

Answer 14

Depression

clavicle - convex sup to inf

Question 15

SC Joint Caudal glide increases ________.

Answer 15

Elevation

clavicle - convex sup to inf

Question 16

Which glides increase ER at the shoulder?

Answer 16

Anterior glide, Distraction Progression, general distraction

Question 17

Which glides increase IR at the shoulder?

Answer 17

Posterior glide, general distraction

Question 18

Which glides increase Flexion at the shoulder?

Answer 18

Posterior glide (GH), distraction (GH), and caudal glide (SC), Anterior glide (AC), Upward rotation (ST)

Question 19

Which glides increase Abduction at the shoulder?

Answer 19

Inferior/Caudal glide (GH), distraction (GH), caudal glide (SC), Anterior glide (AC), upward rotation (ST)

Question 20

Distraction at HU joint increases ____.

Answer 20

Flexion or Extension

Question 21

Distal glide (scoop) at HU joint increases ______.

Answer 21

Flexion (concave olecrannon; convex trochlea)

Question 22

Dorsal glide at HR joint increases ________.

Answer 22

Extension (concave radial head; convex capitulum)

Question 23

Volar glide at HR joint increases ______.

Answer 23

Flexion (concave radial head; convex capitulum)

Question 24

Which glides increase elbow flexion?

Answer 24

Distraction (HU), distal glide or scoop (HU), volar glide (HR)

Question 25

Which glides increase elbow extension?

Answer 25

Distraction (HU), doral glide (HR)

Question 26

Dorsal glide at proximal RU joint increases ___.

Answer 26

Pronation (convex radial head; concave radial notch of ulna)

Question 27

Volar glide at proximal RU joint increases _____.

Answer 27

Supination (convex radial head; concave radial notch of ulna)

Question 28

Dorsal glide at distal RU joint increases _____.

Answer 28

Supination (concave ulnar notch of radius; convex head of ulna)

Question 29

Volar glide at distal RU joint increases ______.

Answer 29

Pronation (concave ulnar notch of radius; convex head of ulna)

Question 30

Which glides increase pronation of forearm?

Answer 30

dorsal glide (proximal RU joint) and volar glide (distal RU joint)

Question 31

Which glides increase supination of forearm?

Answer 31

volar glide (proximal RU joint) and dorsal glide (distal RU joint)

Question 32

Dorsal glide at RC joint increases

Answer 32

Flexion

Question 33

Volar glide at RC joint increases

Answer 33

Extension

Question 34

Ulnar glide at RC joint increases

Answer 34

RD

Question 35

Radial glide at RC joint increases

Answer 35

UD

Question 36

Carpal mobilizations to increase wrist extension

Answer 36

stabilize concave bone and mobilize dorsum of convex bone (capitate on stabilized lunate)

Question 37

Carpal mobilizations to increase wrist flexion

Answer 37

stabilize convex bone and mobilize dorsum of concave bone (distal radius on stabilized lunate)

Question 38

Volar glide at CMC joints increases

Answer 38

mobility of the arch of the hand

Question 39

Ulnar glide at Thumb CMC increases

Answer 39

Flexion (prox MC concave on convex trapezium for flex/ext)

Question 40

Radial glide at Thumb CMC increases

Answer 40

Extension (prox MC concave on convex trapezium for flex/ext)

Question 41

Dorsal glide at Thumb CMC increases

Answer 41

Abduction (prox MC convex on concave trapezium for abd/add)

Question 42

Volar glide at Thumb CMC increases

Answer 42

Adduction (prox MC convex on concave trapezium for abd/add)

Question 43

Volar glide at MCP/IP increases

Answer 43

Flexion (concave distal surface; convex proximal surface)

Question 44

Dorsal glide at MCP/IP increases

Answer 44

Extension (concave distal surface; convex proximal surface)

Question 45

Radial glide at MCP/IP increases

Answer 45

Abduction (concave distal surface; convex proximal surface)

Question 46

Ulnar glide at MCP/IP increases

Answer 46

Adduction (concave distal surface; convex proximal surface)

Question 47

Posterior glide at hip joint increases

Answer 47

Flexion, IR (convex femoral head on concave acetabulum)

Question 48

Anterior glide at hip joint increases

Answer 48

Extension, ER

Question 49

Posterior glide at Tibiofemoral joint increases

Answer 49

Flexion (concave tibial plateaus; convex femoral condyles)

Question 50

Anterior glide at Tibiofemoral joint increases

Answer 50

Extension

Question 51

Distal glide at Patellofemoral joint increases

Answer 51

Flexion

Question 52

Superior glide at Patellofemoral joint increases

Answer 52

Extension

Question 53

Which glides increase knee flexion?

Answer 53

posterior glide (tibiofemoral), distal glide (patellofemoral)

Question 54

Which glides increase knee extension?

Answer 54

anterior glide (tibiofemoral), distal glide (patellofemoral)

Question 55

Anterior glide at proximal tib-fib joint increases

Answer 55

mobility of fibular head

Question 56

Anterior or posterior glide at distal tib-fib joint increases

Answer 56

mortise mobility and improve DF

Question 57

Posterior glide at Talocrural joint increases

Answer 57

Dorsiflexion (convex talus; concave mortise)

Question 58

Anterior glide at Talocrural joint increases

Answer 58

Plantarflexion

Question 59

Medial glide at subtalar joint increases

Answer 59

Eversion (convex calcaneus; concave talus)

Question 60

Lateral glide at subtalar joint increases

Answer 60

Inversion

Question 61

Plantar glide at Intertarsal/TMT joint increases

Answer 61

PF/Flexion

Question 62

Dorsal glide at Intertarsal/TMT joint increases

Answer 62

DF, pronation

Question 63

Dorsal glide at 1st MCP increases

Answer 63

Extension

Question 64

Which glides increase DF?

Answer 64

posterior glide (talocrural), dorsal glide (intertarsal/TMT), anterior or posterior glide (distal tib-fib)