Joint Mobilization (Week 1) Flashcards

Question

What are Uses of Mobilization?

Answer 1

• grade I distraction: prior to glides (when possible) • grade II distraction: initial Ax to determine joint sensitivity & available movement • grade I and II oscillatory: decrease pain, increase nutrition • grade I and II sustained: decrease pain • grade II oscillatory and sustained: <-> ROM • grade III sustained/III & IV oscillatory: increase ROM, reduce positional faults/subluxations

Answer 2

• pain, muscle guarding, & spasm can be treated with low grade oscillatory mobilizations • reversible joint hypomobility can be treated with ‘progressively vigorous’ mobilizations • positional faults/subluxations can be corrected with higher grade mobilizations (esp. with movement) • conditions that limit ROM: mobilizations can maintain ROM & possibly slow progression • immobilization: mobilization can help maintain ROM & offset degenerative/restrictive effects

Answer 3

• alter disease processes (e.g., RA) • alter inflammatory process

Answer 4

• create/exacerbate hypermobility • traumatize joints/joint surfaces • initiate spasm/muscle guarding

Answer 5

• any undiagnosed lesion • joint ankylosis • high grade mobilizations only • hypermobility, ligamentous rupture, instability • joint effusion • inflammation • malignancy • osteoporosis • osteomyelitis • recent fracture • herniated discs with nerve compression

Answer 6

• be careful & if in doubt, don’t mobilize • osteoarthritis • unhealed fracture (also note hand positioning) • hypermobility • total joint replacements • conditions that weaken CT (e.g., RA, advanced diabetes) • pregnancy (esp. lumbar spine & pelvis) • internal derangement

Answer 7

• don’t mobilize in close-pack position • communicate • assess (grade II distraction) before treating • distract before mobilizing when possible • joint tissues must be prepped prior to mobilizing (high grade only) • high velocity low amplitude (HVLA) thrust mobilizations are not applied to spine

Answer 8

• prepare surrounding tissue prior to higher-grade mobilizations • make sure patient is comfortable, stable, & body segment being mobilized is supported • make sure your hand contact & any other means of stabilization is comfortable • when possible, your hands must be as close to joint as possible • assess joint movement with grade II distraction prior to mobilization • when possible, apply grade I distraction prior to any glide mobilization • your body & mobilizing segment should be moving as one (i.e., use your body effectively & efficiently) • mobilize one joint, in one direction, at one time • never mobilize through pain • never mobilize in close-pack position

Answer 9

• mobilizing in resting/loose-pack position is safest from which to start but not the most effective position in which to treat • to progress treatment, position joint at or near end of available & PAIN-FREE ROM prior to mobilizing – this will place restricting tissue in its most tensioned position where stretch force can be more specific & effective

Answer 10

• grade III & IV mobilizations can cause post-treatment soreness (but should not cause pain) • if patient experiences pain, soreness lasting more than 24 hours, worsening symptoms, swelling, or spasm, your treatment was likely too aggressive • between treatments, the patient should perform ROM into any newly gained range • mobilization (including self-mobilizations) should be applied every other day

Answer 11

• these techniques use active contraction of muscles that attach near joint to correct joint misalignment • contractions are applied at the ‘barrier’ & progressed • usual precautions apply but also note any localized muscle pain/strains

Answer 12

• contractions are isometric & gentle/submaximal • contract for 5-10 seconds • wait for the muscle to completely relax (usually about 3-5 seconds) • reposition to the next barrier/point of joint restriction • repeat 3-5x

Joint Mobilization (Week 1) Flashcards

(36 cards)