Joint Mobilization

Question 1

Characteristics of mobilization

Answer 1

-skilled passive movement
-low velocity
-does not go beyond end range
-can be graded I-III or I-IV

Question 2

Characteristics of manipulation

Answer 2

-low amplitude
-high velocity
-thrust
-intentionally moves joint beyond end range

Question 3

Describe Grade 1-4 for Maitland

Answer 3

Grade 1: before R1, small and fast oscillations

Grade 2: up to R1, big and slow oscillations (push, relax)

Grade 3: between R1 and R2, big and slow oscillations

Grade 4: up to R2, small and fast oscillations

Question 4

Types of Kalltenborn joint mobs

Answer 4

Compression, traction, translatoric (gliding)

Question 5

Describe the 3 grades of motion for Kalltenborn

Answer 5

Grade I: there’s still loose slack

Grade II: tissue slack taken up, surrounding joint tissue tightened (assess tissue and subjective response)

Grade III: tissue deformation, moving beyond R1

Question 6

What is the purpose of Grade II for Kalltenborn? Grade III?

Answer 6

Grade II - pain relief, assess joint play/reactivity
Grade III: increase mobility

Question 7

What are the different end feels through Nordic System/Kalltenborn?

Answer 7

Soft - soft tissue approximation or muscle stx
Firm - capsular or ligamentous
Hard - bone or cartilage

Question 8

What are the quantity grades for Nordic System/Kalltenborn?

Answer 8

0 = ankyloses (joint has no motion)
1-2 = hypo mobile (do joint mobs)
3 = normal
4-5 = hyper mobile
6 = unstable

Question 9

Indications for passive joint motion

Answer 9

-pain relief and muscle guarding
-increase joint mobility in presence of stiffness

Question 10

Examples of hypermobility/instability contraindications for passive motion

Answer 10

Recent fracture, ligamentous sprains, RA, osteoporosis

Question 11

What is compression used for?

Answer 11

Recreating symptoms

Question 12

What are the grades of traction for Kalltenborn?

Answer 12

Grade I: relieve pain and muscle guarding, move joint fluid

Grade II: relieve pain and assess joint play/reactivity

Grade III: increase mobility

Question 13

What does Grade II and III do per Kalltenborn?

Answer 13

Grade II: pain relief, assess joint play and reactivity
Grade III: improve mobility

Question 14

What are Maitland Grade I-IV used for?

Answer 14

Grade I and II to reduce pain
Grade III and IV to increase mobility

Question 15

What position are initial Maitland mobilization techniques performed in?

Answer 15

Loose-packed

Question 16

What direction are the roll and glide for convex-concave?

Answer 16

Convex moving on concave = opposite
Concave moving on convex = same

Question 17

What are the steps for any joint mob?

Answer 17

1. Figure out which way joints move (convex on concave vice versa)
2. Assess ROM
3. Joint play
4. Compression
5. Choose technique
6. Reassess

Question 18

What are the 4 neurophysiological benefits to passive joint mobilization?

Answer 18

-type I receptors (postural)
-type II (dynamic)
-type III (inhibitive)
-type IV (nociceptive)

Question 19

Type I receptors (postural) characteristics

Answer 19

-found in joint capsules
-small diameter, myelinated fibers
-static and dynamic firing mechanoreceptors
-promote body awareness in space

Question 20

Neurophysiological benefits to passive joint mob in type II (dynamic) receptors and characteristics

Answer 20

-“where are we going in space”
-low threshold, fast adapting movement and direction

Question 21

Neurophysiological benefits to passive joint mob for type III (inhibitive)

Answer 21

Involves GTO; firing leads to reflex inhibition to surrounding muscle

Question 22

Type IV (nociceptive) characteristics

Answer 22

-pain receptors
-found in most joint structures
-lattice like, unmyelinated fibers and free nerve endings

Question 23

Contraindications to use passive motion

Answer 23

-hypermobility/instability
-active disease process (flu, infection, malignancies)
-conditions of acuity, substantial inflammation, reactivity (swelling, warmth, muscle guarding)