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msk2 > pjm > Flashcards

pjm Flashcards

1
Q

what is the main rationale for PJM

A

to modulate pain and joint LOM by correcting altered joint mechanics

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2
Q

what are the usual causes for altered joint mechanics

A

pain and MG
jt effusion
capsular adhesions
ligament adhesions
aberrant joint motion

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3
Q

diff PJM stretching from normal stretching

A

PJM addresses capsular tissue restriction by replicating loss arthrokinematics

stretching only stretches muscle and not joint capsule

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4
Q

exp mobilization or manip

A

passive manual therapy at varying speeds and ampli

using physiologic and accessory motions

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5
Q

discus self-mob or automob

A

self-stretching that uses joint traction or glide to stretch capsule

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6
Q

dicuss MWM

A

sustained accessory mob and active movement

able to to passive end range over pressure s pain

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7
Q

when is MWM applicable

A

no contra for manual therapy

(+) local MSK pathology

localized loss of movement or pain c function

(-) pain during and after appli

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8
Q

example of MWM

A

belt on post ankle while PT applies anterior glide to talus while pt dflexes ankle

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9
Q

discuss thrust

A

high velocity short ampli

done and end of pathologic limit

only once

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10
Q

thrust is intended to ______

A

alter pos rela
snap adhesions
stim joint receptors

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11
Q

discuss muscle energy

A

appli of active isometric contraction = desired accessory motion

isometrically contract hams to pull pelvis backward in SI joint dysfunction

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12
Q

what are physiologic movements

A

voluntary - osteokinematics

elbow flex/ext

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13
Q

what are accesorry movements

A

involuntary and has 2 kinds

component - accompanies active motion but not under volu control; shoulder abd and clavicle tilts up

joint play - arthro; necessary for nomal jt function

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14
Q

what is swing

A

angular rot of a lever c roll, slide or spin

elbow flexion

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15
Q

what is roll

A

same direction as the movement of lever

elbow flexion - ant roll

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16
Q

discuss glide/slide/translation

A

convex moving - opposite direction of roll; shoulder abd - sup roll and inf glide

concave moving - same direction of roll; elbow flexion - ant roll and glide

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17
Q

discuss spin

A

rolling + gliding

usually shoulder flex/ext, hip flex/ext, radiohum pron/supin

shoulder flexion - posterior spin

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18
Q

compare joint-glide stretching and passive angular stretching in terms of intensity

A

joint-glide stretching - modulates intensity based on pathology

passive angular stretching - cant be modulated

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19
Q

compare joint-glide stretching and passive angular stretching in terms of effect on joint

A

joint-glide stretching - replicated normal arthro and does not compress

passive angular stretching - causes compress and may inc pain

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19
Q

compare joint-glide stretching and passive angular stretching in terms of effect on pt

A

joint-glide stretching - stretch tight capsule

passive angular stretching - stretch tight muscle

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20
Q

discuss compression

A

dec jt space - during WB or for stab

during rolling, compression on angulating side

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20
Q

compare normal and high load compression

A

normal - helps move synovial fluid and for stab

high - articular cartilage damage; OA

20
Q

discuss traction

A

sep of jt surfaces

21
Q

what is long-axis traction

A

longitudinal pull along long axis of bone

22
Q

what is distraction

A

pulling perpendicular to the treatment plane or concave side

23
Q

effects of joint motion

A

stims bnio activity - move synovial fluid - nutri to articular structures

maintains extensib and tensile strength of articular and peri structures (cartilage and ligaments)

sensory for proprio feedback

24
Q

effects of immob on jt

A

immob - fibrofatty prolif w/in 2-3 days - intra artic adhesions - contractures and ligament weakening

kaya jt mob as early as possible

25
Q

indications for PJM

A

pain, MG and spasm

reverse joint hypomob

positional faults or sublux

progressive limitation

functional immob

26
Q

how does PJM dec pain

A

neurophysiologic - GCT from oscillations

mechanical - stims movement of synovial fluid

27
Q

limitations of PJM

A

cannot change disease process - RA or OA

only alleviate symptoms

28
Q

contraindications of PJM

A

hypermob

joint effusion

inflammation

29
Q

conditions requiring special precautions for PJM

A

gr 3/4

malignancy
bone disease
unhealed fx
excessive pain
hypermob
total jt replacements
new or weak connective tissue
RA or systemic diseases
elderly

30
Q

usual evaluation findings that would warrant the use of PJM

A

capsular pattern

firm capsular end feel

dec joint play

adhered or contracted ligament

sublux or disloc

31
Q

grade 1 oscillatory technique

A

Small-amplitude rhythmic oscillations; beginning of range

32
Q

grade 2 oscillatory technique

A

Large-amplitude rhythmic oscillations; within the range not reaching the limit; 2-3 per second

33
Q

grade 3 oscillatory technique

A

Large-amplitude rhythmic oscillations; up to the limit of available motion

34
Q

grade 4 oscillatory technique

A

Small-amplitude rhythmic oscillations; at the limit of available motion,

35
Q

grade 5 oscillatory technique

A

Small-amplitude, high velocity thrust

36
Q

oscillatory grade for inhib pain and improve nutri

A

grade 1 and 2

37
Q

oscillatory grade for stretch

A

grade 3 and 4

38
Q

oscillatory grade for snap adhesion, reposition of disloc

39
Q

grade 1 sustained translatory technique

A

Small amplitude distraction; no stress

40
Q

grade 2 sustained translatory technique

A

Enough distraction or glide to tighten tissues - taking up slack

41
Q

grade 3 sustained translatory technique

A

large enough to place a stretch on jt. capsule and surrounding periarticular structures

42
Q

use of grade 1 sustained translatory technique

A

pain relief or gliding motions

43
Q

use of grade 2 sustained translatory technique

A

for initial tx

inhib pain and maintain jt play when ROM not allowed

44
Q

use of grade 3 sustained translatory technique

A

stretch jt structures and inc jt play

45
Q

speed, rhythm and duration of oscillations

A

gr 1 and 4 - rapid

gr 2 and 3 - 2-3 cycles per second

grade 5 - once only

gr 1-4 - 1-2 mins total

46
Q

speed, rhythm and duration of sustained translatory JP

A

gr 1 - 7-10 secs and 1-2 sec resr

gr 2-3 - stretch for 6 sec then repeat c slow intermittent stretch for 3-4 secs

total 1-2 mins

47
Q

discuss pos and stab for PJM

A

OPP and relax pt’s muscles

always stab proximal to mob distal - guard belt ot BW

48
Q

discuss direction of force

A

distraction - perpendicular to treatment plane

gliding - parallel to treatment plane

49
Q

discuss initiation and progression

A

start c sustained gr 2 distraction - ask pt to note changes w/in 24 hrs

no pain proceed or inc; yes pain dec to gr 1

good response next grade if not dec grade

50
Q

what can be done prior or during PJM

A

warm tissue around or muscle relaxation techniques

gr 1-2 oscillitatory to inhibit MG

if gr 3-4 gliding only use gr 1 distraction

beging gliding in painless directions

move through available ROM then apply stretch

incorporate MWM

msk2 (42 decks)

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