joint mobilisations 1- INTRO

Question 1

what is accessory or arthrokinematic movement?

Answer 1

• accessory movement or joint play movement are joint movements which cannot be performed by the individual
• these movements include roll, spin and glide and accompany physiological movements
• they are examined passively - ie by pt to assess range and symptom response in an open packed position of joint

Question 2

what is joint mobilisation?

Answer 2

• a technique performed by the physiotherapist that helps to restore the small and involuntary movement that assists joints to perform to their optimum ROM
• it involves performing a back and forth oscillation of the joint in order to restore motion

Question 3

what are physiological movements?

Answer 3

• the movements which can be achieved and performed** actively** by the individual and can be analysed for quality and symptom response

Question 4

what does the term ‘overpressure’ mean?

Answer 4

• each joint has a passive range of motion which exceeds its available active range
• to achieve this range, a stretch is applied at the end of a normal passive movement - it nearly always has a degree of discomfort

Question 5

what is mobilisation?

Answer 5

• movement back and forth in a regular rhythm of the** joints accessory movements** or its physiological movements or a combination of both

Question 6

what are passive movements?

Answer 6

• physiological movements that are performed by the therapist - at a single joint or at several joints in sequence to maintain joint range and muscle length
• NOT GRADED

Question 7

Describe Kaltenborn’s convex - concave rule

Answer 7

• this rule tells us which part of the joint capsule is stressed when we move an adjacent joint - ie the convex or concave part
• when a convex joint surface eg head of femur is moving , the roll and glide occur in opposite directions
• when a concave joint suface is moving, the roll and glide occur in the same direction

Question 8

what is an anterior posterior glide?

Answer 8

a glide in which the joint is moving from anterior to posterior - ie joint surface is moving in the posterior position

Question 9

what is a posterior anterior glide?

Answer 9

joint is moving towards an anterior position

Question 10

what arthrokinematic glide occurs with hip flexion?

remember - the convex surface is moving

Answer 10

• anterior posterior glide

Question 11

what is a lateral distraction arthrokinematic movement?

Answer 11

• only used for ball and socket joint
• imaging you are trying to pull the ball from the socket

Question 12

what arthrokinematic movement is occuring with hip extension?

Answer 12

posterior anterior

Question 13

what movement can an AP glide help to increase in the hip joint?

Answer 13

• increase flexion and medial rotation of the hip

Question 14

what movement of the hip does a PA glide increase?

Answer 14

• increases extension and lateral rotation of the hip

Question 15

what is a longitudinal caudad arthrokinematic movement?

Answer 15

an inferior glide

Question 16

what kind of arthrokinematic motion occurs with knee flexion?

knee - concave surface is moving

Answer 16

anterior posterior glide

Question 17

what kind of arthrokinematic movements are occuring with knee extension?

remember - concave surface moving

Answer 17

posterior anterior

Question 18

what kind of arthrokinematic movement is occuring with ankle dorsiflexion?

convex moving

Answer 18

• anterior posterior glide

Question 19

what kind of arthrokinematic movement is occuring with ankle plantarflexion?

Answer 19

• posterior anterior glide

Question 20

what does a joint mobilisation exam technique involve?

Answer 20

• apply pressure close to joint line
• EXAMINE UNAFFECTED SIDE FIRST FOR COMPARISON NB
• note movement quality
• range of motion
• pain behaviour throughout range
• resistance - stiffness of the joint
• muscle spasm

Question 21

what can it indicate if the active range of motion is equal to the passive range of motion of a joint during assessment?

Answer 21

• may indicate a joint dysfunction - capsular vs non capsular pattern of restriction
• muscle shortening - restriction of joint movement is due to muscle crossing joint

Question 22

what might it indicate if the passive range of motion is greater than the active range of motion?

Answer 22

• it may indicate contractile unit lesion or rupture in tendon, muscle etc

Question 23

Distinguish between the different grades (I - IV) for mobilisation techniques

Answer 23

• grade I and grade ii are utilised for pain relief
• grade III and IV - deeper mobilisations - more effectuve for decreasing joint stiffness