PTA145-Unit3-JointMobilization Flashcards
There are two different techniques you can use in joint mobs. What are they?
- Non-thrust Oscillation
- Non-thrust Sustained joint-play
differentiate between the grading systems for Oscillation and Sustained
Oscillation has grades I - IV
Sustained has grades I- III
Oscillation, Grade I
- Small-amplitude rhythmic oscillations are performed at the beginning of the range.
- They are usually rapid oscillations, like manual vibrations.
- Primarily used for treating joints limited by pain or muscle guarding.
Oscillation, Grade II
- Large-amplitude rhythmic oscillations are performed within the range, not reaching the limit.
- They are usually performed at 2 or 3 per second for 1-2 minutes.
- Primarily used for treating joints limited by pain or muscle guarding.
Oscillation, Grade III
- Large-amplitude rhythmic oscillations are performed up to the limit of the available motion and are stressed into the tissue resistance.
- They are usually performed at 2 or 3 per second for 1-2 minutes.
- Primarily used as stretching maneuvers.
Oscillation, Grade IV
- Small-amplitude rhythmic oscillations are performed at the limit of the available motion and stressed into the tissue resistance.
- They are usually rapid oscillations, like manual vibrations.
- Primarily used as stretching maneuvers.
Sustained, Grade I
Grade I (loosen)
• Small amplitude distraction is applied when no stress is placed on the capsule.
• It equalizes cohesive forces, muscle tension, and atmospheric pressure acting on the joint.
• Used with all gliding motions and may be used for relief of pain
• Apply intermittent distraction for 7-10 seconds with a few seconds of rest in between for several cycles
Sustained, Grade II
Grade II (tighten) • Enough distraction or glide is applied to tighten the tissues around the joint. • This is called taking up the slack. • Used for the initial treatment to determine the sensitivity of the joint. Once the joint reaction is known, the treatment dosage is increased or decreased accordingly • Gentle grade II applied intermittently by be used to inhibit pain. Grade II glides may be used to maintain joint play when ROM is not allowed.
Sustained, Grade III
Grade III (stretch) • A distraction or glide is applied with an amplitude large enough to place stretch on the joint capsule and surrounding periarticular structures. • Used to stretch the joint structures and thus increase joint play. • For restricted joints, apply a minimum of a 6-second stretch, then repeat with slow, intermittent stretches at 3- to 4- second intervals.
what is the convex-concave rule?
- if the surface of the moving bone is convex, sliding/gliding is in the direction opposite to that of the angular movement of the bone
- if the surface of the moving bone is concave, sliding/gliding is in the same direction as the angular movement of the bone
list indications for joint mobilization
- Modulation of pain
- Treat muscle guarding / spasm
- Treat joint hypomobility
- Treat positional faults / subluxations
- Maintenance of available joint play during function immobility or diseases the progressively limit motion
list contraindications for joint mobilization
- Hypermobility – may use grade I or II as long as don’t reach tissue limits (NO STRETCHING)
- Joint effusion – grade I or II to help with maintaining joint play, improve fluid flow and block transmission of pain stimulus OR may use stretching techniques if there is MILD effusion/edema
- Inflammation – gentle oscillation or distraction motions may temporarily inhibit the pain response (NO STRETCHING)
list precautions for joint mobilization
- Malignancy – in the area
- Bone disease (osteomyelitis, osteoporosis, etc)
- Unhealed fracture – in the area
- Excessive pain
- Hypermobility in associated joints
- Total joint replacements
- Newly formed or weakened connective tissue
- Systemic connective tissue diseases (RA)
- Elderly individuals with weakened connective tissue and diminished circulation
- So, I and II, not III and IV
Which direction does the patella move with knee flexion?
inferior
Which direction does the patella move with knee extension?
superior
