Week 2 - Mobilisation - mobilising theory

Question 1

What is the main key feature of a mobilising programme?

Answer 1

Should always include through-range mobilisation
(exercises/techniques that take joint through full available range)

e..g active exercise/active assisted/passive physiological movements

BENEFITS OF THIS MAINLY INTRA-ARTCULAR

Question 2

Effects of through-range mobilsation for synovial fluid?

Answer 2

Stimulation of synoviocytes
↑ synovial fluid volume
↑ synovial flid movement (sweep + squeeze)
↑ lubricin (joint lubrication proteoglycan)

REDUCES FRICTION AND RESISTANCE TO MOVEMENT

Question 3

Effects of through-range mobilisation on cartilage?

Answer 3

↑ synovial fluid to cartilage

↑ water content
↑ GAGs
↑ normalised extra-cellular matrix

REDUCES FRICTION AND RESISTANCE TO MOVEMENT

Question 4

Neural effects of end-range mobilisation?

Answer 4

• increased stretch tolerance
• reduced antagonist muscle activity
• pain modulation

Question 5

Structural effects of end-range mobilisation?

Answer 5

Stress collagen tissues
- stimulates collagen synthesis (tensile stress - stretching sitmulates this)
- collagen laid down parallel to lines of stress = strong in “right” direction
- creep and stress relaxation occur with sustained stretch
- plastic deformation may occur in “window of opportunity”

Question 6

Effects of static stretching?

Answer 6

• regular static stretching increases maximum joint ROM
• mechanism is debateable
• increased stretch tolerance
• little/no change in tensile properties of muscle tissue

Question 7

Effects of dynamic stretching?

Answer 7

• similar effects to static stretching
• not recommended in patient population due to risk of reinjury

Question 8

Effects of proprioceptive neuromuscular facilitation (PNF)?

Answer 8

• contract/relax technique of the antagonist
• maximal relaxation follows a maximal contraction
• increases the maximum joint ROM
• increased stretch tolerance
• little/no changes in tensile properties of muscle tissue
• similar or slightly more effective than static stretching techniques

Question 9

What should be involved in designing a mobilising programme?

Answer 9

Through - range
End - range
Sustained holds
Frequent - needs to be done regularly by patient
Easy to move in that plane :gravity-assisted, minimise inertia, maximise momentum, minimise friction