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MSK Rehabilitation > Joint Mobilisation > Flashcards

Joint Mobilisation Flashcards

1
Q

What are the two main types of passive joint mobilisation?

A
  • passive physiological mobilisations
  • passive accessory mobilisations
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2
Q

What are the different types of end feel?

A
  • soft: from soft tissue apposition
  • hard: from a bony block
  • elastic: from stretching capsule and ligaments
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3
Q

what are active physiological movements?

A

movement that someone can consciously perform themselves

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4
Q

what are passive physiological movements?

A

movement performed by another person or device

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5
Q

what can passive physiological movements be used for? (Assessment and treatment)

A

Assess:
-ROM
-End feel
-Symptoms

Treatment:
-Increase ROM
-Relieve pain

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6
Q

What is Maitland grade I?

A

small amplitude movement performed at beginning of range. Gets nowhere near to the end of range. Used to treat pain.

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7
Q

What is Maitland grade II?

A

large amplitude of movement performed within the resistance free range. Used to treat pain.

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8
Q

What is Maitland grade III?

A

large amplitude movement performed into resistance or up to limit of range. Used to treat stiffness and decreased ROM.

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9
Q

What is Maitland grade IV?

A

small amplitude movement performed into resistance or up to limit of range. Used to treat stiffness and decreased ROM.

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10
Q

Speed/Rhythm of movements

A

can be abrupt or slow. Movement can be held for as long as 5 seconds before reversing movement

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11
Q

How do passive physiological movements work?

A

-By stretching soft tissues and adhesions to restore ability of joint for normal ROM
- By a synovial sweep which aids lubrication and thus movement

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12
Q

Explain the pain gate theory

A

A ‘gate’ exists in the dorsal horn of spinal grey matter. This determines which information is received by the brain.
Open gate: painful stimuli are free to travel to the brain
Closed gate: messages about pain are being reduced

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13
Q

what is descending inhibition in the pain gate theory?

A

this reduces pain by: closing the gate directly and by the secretion of opioids

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14
Q

What are accessory movements (+examples)

A

small movements that occur between joint surfaces to maintain congruence (cannot be performed consciously)
- Roll
- Slide/Glide
- Spin

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15
Q

What is the concave-convex rule?

A

-If the convex surface of a joint is moving then roll and slide occur in opposite directions
-If the concave surface is moving then roll and slide occur in the same direction

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16
Q

Which Maitland grades reduce pain?

A

I and II

17
Q

Which Maitland grades improve ROM?

A

III and IV

18
Q

What are the automatic accessory movements?

A

Slide, spin, roll

19
Q

What are the passive accessory mobilisations? (Physio-induced)

A

slide, spin, compression and distraction (pulling apart of joint surfaces)

20
Q

Which accessory mobilisation should you use for pain?

A

The movement that produces the pain

21
Q

Which accessory mobilisation should you use for increasing movement?

A

the accessory movement involved in the physiological movement you want to improve. Use concave-convex rule as a guide.

22
Q

Do you use passive accessory or passive physiological mobilisations for pain?

A

Accessory (grades I and II)

23
Q

Do you use passive accessory or passive physiological mobilisations for increasing movement?

A

combination of accessory and physiological mobilisations (grade III and IV)

24
Q

Technique for applying passive mobilisations

A
  • Patient relaxed (lying) and comfortable
  • Physio comfortable. Grip should not be tighter than required and should make full mechanical advantage of levers
  • Stabilise above the joint
  • Assess patient symptoms and range before, during and after
  • If patient is improved, continue
  • If unimproved or worse, change technique or grade.
25
Q

What are some contraindications for joint mobilisations?

A
  • Osteoporosis
  • Anticoagulants within last 6/52
  • Long term steroid use
  • Hypermobilty
  • Inflammatory arthritis
  • Malignancy (local)
  • Recent radiotherapy (local)
  • Tuberculosis
  • Ligamentous rupture (local)
  • Herniated discs with nerve compression
  • Cauda equina lesion
  • Central stenosis/ cord pressure
  • Recent bone fracture (local)
  • Congenital bone deformities
  • Vascular disorders
  • Spondylolithesis
  • Patients unable to give consent
  • Bone disease
  • Neurological involvement
26
Q

What are some precautions for joint mobilisations?

A
  • Osteoarthritis (Acute phase)
  • Pregnancy
  • Children
  • Total joint replacement
  • Severe scoliosis
  • Poor general health
  • Patient’s inability to relax
  • Downs Syndrome

MSK Rehabilitation (17 decks)

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