PeripheralJoint mobilization Flashcards
Which of the following describes an inappropriate procedure for safe and effective application of joint mobilization techniques?
Select one:
A. Combine a grade III distraction with a grade III sustained glide
B. Initiate joint mobilization procedures with the joint in the resting position of the joint
C. Combine a grade I distraction with a grade III sustained glide
D. Stabilize one of the articulating bones while applying the mobilization force close to the joint
A. Combine a grade III distraction with a grade III sustained glide
How to achieve maximum elongation of the long head of the biceps brachii during passive stretching
Extend the elbow with the forearm in pronation and then extend the shoulder.
Multiple potential benefits and outcomes are speculated to result from stretching programs. Which of the following is strongly supported by evidence and research?
Improved flexibility and increased ROM by restoring extensibility of the muscle-tendon unit with specific stretching techniques
To determine the point of tissue resistance and how sensitive a joint is, you would use which of the following grades of sustained mobilization?
Grade II
A long-axis distraction of the humerus provides which direction of gliding?
Inferior
Moving the proximal row of carpals on the radius in a volar direction increases which wrist motion?
Flexion
Of the following choices, which is the most appropriate application of the hold–relax (contract–relax) method of muscle inhibition and elongation of the gastrocnemius muscle? Extend the patient’s knee, stabilize the lower leg, and:
Select one:
a. Place the patient’s ankle in as much dorsiflexion as is comfortable; have the patient isometrically contract the plantar flexors against resistance for 6 to 10 seconds. Then have the patient relax as you passively dorsiflex the ankle.
b. Place the patient’s ankle in as much dorsiflexion as possible; have the patient isometrically contract the dorsiflexors against resistance for 6 to 10 seconds. Then have the patient relax as you passively dorsiflex the ankle.
b. Place the patient’s ankle in as much dorsiflexion as possible; have the patient isometrically contract the dorsiflexors against resistance for 6 to 10 seconds. Then have the patient relax as you passively dorsiflex the ankle.
Connective tissue fatigue occurs when:
a. When there is a buildup of metabolites in connective tissue as the result of active stretching procedures.
b. When a muscle is not allowed adequate time to recover from exhaustion after exercise.
c. When a submaximal stress load is applied repeatedly and causes tissue failure as in a stress fracture or overuse syndrome
c. When a submaximal stress load is applied repeatedly and causes tissue failure as in a stress fracture or overuse syndrome
All of the following gliding techniques match except:
Select one:
a. Long axis traction of femur—distracts weight-bearing surface in acetabulum.
b. Posterior glide tibia on femur—knee flexion.
a. Long axis traction of femur—distracts weight-bearing surface in acetabulum.
Each of the following is a true statement about self-stretching procedures except:
Select one:
a. A portion of body weight is often the source of the stretch force when the distal segment is fixed.
b. Self-stretching is effective only when the distal segment is stabilized and the proximal segment moves.
c. Proper stabilization of one segment sometimes can be achieved intrinsically
b. Self-stretching is effective only when the distal segment is stabilized and the proximal segment moves.
To increase flexion of the shoulder, position the patient in the supine position, stabilize the scapula, and:
Select one:
a. Place the glenohumeral joint in the resting position and apply a posterior glide of the humeral head.
b. Place the shoulder in 90° flexion and apply an inferior glide of the humeral head.
a. Place the glenohumeral joint in the resting position and apply a posterior glide of the humeral head.
a. Glide the base of the first metacarpal in an ulnar direction on the trapezium.
Mobilization techniques direct forces specific to the involved capsular and ligamentous tissues without causing compressive damage to the articular cartilage.
To increase radial adduction of the carpometacarpal joint of the thumb:
Select one:
a. Glide the base of the first metacarpal in an ulnar direction on the trapezium.
b. Glide the base of the first metacarpal dorsally on the trapezium.
c. Glide the base of the first metacarpal radially on the trapezium.
a. Glide the base of the first metacarpal in an ulnar direction on the trapezium.
If a patient exhibits signs of joint hypermobility or joint effusion/inflammation, which of the following mobilization techniques is contraindicated?
Select one:
Sustained grade I
Sustained grade II
Sustained grade III
Oscillation grade II
Sustained grade III
A posterior glide of the head of the femur on the surface of the acetabulum increases which of the following hip motions?
Flexion and internal rotation
Indications for Thrust manipulation/High Velocity Thrust
To alter positional relationships
Snap adhesions
Stimulate joint receptors
Mobilizations to increase extension of the wrist include all the following except:
Select one:
a. Stabilize the radius and volar glide the lunate.
b. Stabilize the scaphoid and volar glide the radius
b. Stabilize the scaphoid and volar glide the radius
n what way does mobilization with movement (MWM) differ from passive mobilization techniques? MWM:
Select one:
a. Is appropriate for hypomobile or hypermobile joints
b. Integrates active movements by the patient during the mobilization procedure to reduce/eliminate the barrier of pain during the techniques
b. Integrates active movements by the patient during the mobilization procedure to reduce/eliminate the barrier of pain during the techniques
Each of the following is true about joint mobilization/manipulation techniques except:
Select one:
a. Techniques can be applied using gliding or oscillation techniques that involve low or high amplitudes and velocities.
b. Techniques involve the application of accessory joint movements but not physiological movements.
c. They are appropriate to use if a joint is painful or inflamed to decrease or inhibit the perception of pain.
c. They are appropriate to use if a joint is painful or inflamed to decrease or inhibit the perception of pain.
It involves self-stretching techniques that specifically use joint traction or glides that direct the stretch force to the joint capsule.
Self-Mobilization
Concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end-range applied by the patient.
Self-Mobilization
movements that patients can do voluntarily
classical/ traditional movements s/c as flex-extend, abd-add, IR-ER, dorsiflex-plantarflex
follows osteokinematics (movement of bones)
Physiological Movements
movements that patients cannot do voluntarily
necessary to have a full ROM
e.g: the physiological movements is shoulder flexion while the accessory movement is the upward rotation of scapula
this is what the PT manipulates (passively)
Accessory Movements
2 TYPES OF ACCESSORY MOTION:
What are their definition
Component Motions: accompany active motions but are not under voluntary control
Joint Play: movements that occur between/ within joint surfaces, thus following arthrokinematics
movements of the bony lever about an axis of motion (physiological movement of bone within its axis of motion)
Swing
Motion that always occur in the same direction of the swinging bone regardless of concave-convex rule ⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️
Roll
Motion that moves same point on one surface comes in contact with new points on the opposing surface
Slide/ Translation
rotation of a segment about a stationary mechanical axis
same point on the moving surface creates an arc of a circle as the bone spins
SPIN
PASSIVE-ANGULAR STRETCHING VS. JOINT-GLIDE STRETCHING
Passive-angular stretching may cause increased pain or joint trauma .
Joint-glide is safer and more selective
it is the decrease in joint space between bony partners (it normally occurs occasionally in the extremities in the spinal joints, especially in weight bearing)
Compression
It is okay and helps move synovial fluids and joint cartilage health.
Intermittent compressive loads:
It can lead to a damage of the articular cartilage and lead to the deterioration of the joint
Abnormally high compressive loads
T or F
Traction: Longitudinal Pull
TRUE
Separation of Joint Surfaces (PJM as initial dosage)
Joint traction or joint separation
kaltenborn
Distraction
Pain before tissue limitation → assume that patients are in ___ of healing,
Pain before tissue limitation → assume that patients are in acute stage of healing,
Manual therapy techniques that are used to modulate pain and treat joint impairments that limit ROM by specifically addressing the altered mechanics of the joint that limit mobility.
PERIPHERAL JOINT MOBILIZATION
Passive, skilled manual therapy techniques applied to joints and related soft tissues at varying speeds and amplitudes using physiological or accessory motions for therapeutic purposes
MOBILZATION AND MANIPULATION
A normal accessory joint movement that occurs with roll is:
Sliding.
Physiologic vs Accessory motions
Physiologic - voluntary natural swing (flexion, extend, etc.
Accessory motions - accompanies movements, involuntary and cannot be facilitated
Difference of stretching and manipulation
For stretching, we try to mimic physiological movements (e.g. to improve flexion, we stretch toward flexion)
For manipulation, the direction of the treatment is toward the joints and the related soft tissues.
PARAMETERS for Kaltenborn
Grade I
7-10 seconds with rest
full release
10 repetitions or 1 minute
Grade II
7-10 seconds with rest
full release
10 repetitions or 1 minute
Di pwede mag ROM
Grade III
Maximum stretch 6 seconds
partial release
repeat with 3-4 second interval
10 reps
