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Clinical Prac II > Joint Mobilizations > Flashcards

Joint Mobilizations Flashcards

1
Q

Injury to a joint or structures surround a joint will often lead to…

A
  • pain
  • loss of motion
  • excessive motion
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2
Q

3 roles of the joint capsule

A
  • seals joint space
  • provides stability by limiting movements
  • provides active stability via its proprioceptive nerve endings
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3
Q

What position should you perform an assessment?

A

-open-packed/resting position

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4
Q

glenohumeral open-packed position

A
  • 55 deg abduction
  • 30 deg horizontal adduction
  • slight ER
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5
Q

zygapophyseal (spine)

A
  • midway b/t flexion and extension
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6
Q

temporomandibular

A
  • mouth slightly open
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7
Q

acromioclavicular

A
  • arm resting by side
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8
Q

sternoclavicular

A
  • arm resting by side
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9
Q

ulnohumeral

A
  • 70 deg flexion

- 10 deg supination

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10
Q

radiohumeral

A
  • full extension

- full supination

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11
Q

proximal radioulnar

A
  • 70 deg flexion

- 35 deg supination

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12
Q

distal radioulnar

A
  • 10 deg supination
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13
Q

radiocarpal (wrist)

A
  • slight flexion and ulnar deviation
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14
Q

carpometacarpal

A
  • midway b/t abduction-adduction and flexion-extension
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15
Q

metacarpophalangeal

A
  • slight flexion
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16
Q

interphalangeal

A
  • slight flexion
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17
Q

hip

A
  • about 30 deg flexion & 30 deg abduction

- 0-5 deg ER

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18
Q

tibiofemoral

A
  • 25 deg flexion
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19
Q

patellofemoral

A
  • full extension
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20
Q

talocrural (ankle)

A
  • 10 deg plantar flexion

- midway b/t extremes of inversion and eversion

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21
Q

subatlar

A
  • midway b/t extremes of ROM
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22
Q

midtarsal

A
  • midway b/t extremes of ROM
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23
Q

tarsometatarsal

A
  • midway b/t extremes of ROM
24
Q

metatarsophalangeal

A
  • neutral
25
Q

interphalangeal

A
  • slight flexion
26
Q

3 types of gross quantity of movement

A
  • hypomobile
  • normal
  • hypermobile
27
Q

3 types of end feel (quality of movement)

A
  • firm
  • hard
  • empty
28
Q

Provocation

A
  • painful

- painless

29
Q

hypomobile

A
  • motion stops short of anatomical limit at pathological point of limitation (pain, spasm, adhesion, inflammation)
30
Q

hypermobile

A
  • joint moves beyond its anatomical limit because of laxity of surrounding structures
31
Q

manual therapy techniques involving movement of articulating surfaces with intention of:

A
  • regaining normal ROM
  • improving joint capsule extensibility
  • regaining normal distribution of forces and stresses on a joint
  • reducing pain
  • lubricating joint surfaces
  • providing nutrition to joint structures
32
Q

absolute contraindications of joint mobilizations

A
  • malignancy in area of treatment
  • active inflammation and/or infectious joint
  • ankylosis of joint
  • fracture at the joint
  • practitioner lack of ability
  • neurological deterioration
  • diseases with affect integrity of ligaments
  • arterial insufficiency
33
Q

relative contraindications (take caution and be selective on treatments)

A
  • excessive pain or swelling
  • arthroplasty
  • hypermobility
  • metabolic bone disease
  • pregnancy
  • spondylolisthesis
34
Q

biomechanical mechanisms

A
  • motion improvement
  • positional improvement
  • increase joint capsule extensibility
35
Q

nutritional effects

A
  • synovial fluid movement

- improve nutrient exchange

36
Q

neurophysiological

A
  • stimulates mechanoreceptors to inhibit pain impulses
  • gate control theory
  • descending pathway inhibition theory
  • peripheral inflammatory modulation
37
Q

gate control theory

A
  • pain signals sent to the brain, stimulating different nerves during treatment to close doors so brain can not follow the continued pain
38
Q

compression

A
  • approximation of joint surfaces; force perpendicular to joint plane
39
Q

traction/distraction

A
  • separation of joint surfaces; force perpendicular to the joint plane
40
Q

gliding

A
  • force direction parallel to joint surface
41
Q

Grade I distraction

A
  • toe region on stress-strain curve
  • very minimal amplitude of traction force, minimal stress on the joint capsule
  • reduces compression forces on articular surfaces
  • pain reduction, used with gliding mobilizations
42
Q

Grade II distraction

A
  • “take up the slack” elastic region on stress-strain curve
  • slack in joint capsule and surrounding tissues is taken up
  • can help to determine the sensitivity of the joint
  • used to alleviate pain, assess joint play, and/or reduce muscle guarding
43
Q

Grade III distraction

A
  • stretch / plastic region on stress-strain curve
  • designated to stretch joint capsule and soft tissues surrounding the joint to increase mobility
  • used to assess end feel or increase movement
  • general mobility
44
Q

Grade I Joint Mob

A
  • small amplitude technique performed at beginning of available ROM (0-25%)
  • GOAL- reduce pain and muscle guarding, improve joint lubrication/nutrition
45
Q

Grade II Joint Mob

A
  • large amplitude technique performed in middle of available ROM (25-75%)
  • GOAL- reduce pain and muscle guarding, improve joint lubrication/nutrition
46
Q

Grade’s I & II joint mob

A
  • pain relief and muscle guarding
  • no direct mechanical effect on restrictions
  • influences mechanical nociception
  • often used before and after grade III and IV mobes
  • *** stimulating nerves
47
Q

Grade III joint mob

A
  • large amplitude technique performed at end range of available ROM (50-100%) - feel joint capsule push against you
  • GOAL- stretching joint capsule and associated structures (ligaments, muscles attaching in the area)
48
Q

Grade IV joint mob

A
  • small amplitude technique performed at end of available ROM (75-100%)
  • GOAL- stretching joint capsule and associated structures (ligaments, muscles attaching in the area)
49
Q

Grade III & IV joint mob

A
  • primarily stretching techniques
  • mechanical and neurophysiological effect
  • may activate inhibitory joint and muscle spindle receptors to aid in reducing restriction of movement
50
Q

Grade V joint mob

A
  • high velocity thrust of small amplitude at end of available range but within its anatomical range
  • movement that exceeds the resistance barrier
  • commonly referred to as high velocity thrust technique or joint manipulation
  • GOAL- decrease pain and muscle guarding
51
Q

types of joint mobilizations

A
  • distractions
  • oscillation mobilizations
  • sustained hold mobilizations
  • manipulations
52
Q

oscillation

A
  • target impairments: guarding, pain, joint hypomobility

- address extensibility

53
Q

sustained hold mobilizations

A
  • target impairments: joint mobility, pain
  • pain: beginning range to mid range
  • joint mobility- end range
54
Q

oscillations timing

A
  • 1-3 sec

- 1-5 sets for 15-60 sec each

55
Q

sustained holds timing

A
  • 1-5 sets for 5-30 sec each

- more commonly used to treat ROM

56
Q

Golden rule of mobilization with movement

A
  • PAINLESS

Clinical Prac II (1 decks)

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