Joint Mobs

Question 1

Indications for jt mobs

Answer 1

1) Test and measure - detection of jt restrictions
2) Promote healing process - synovial fluid motion for nutrient exchange
3) Pain, guarding, spasm - amplitude, oscillatory, and distraction movements may stimulate mechanoreceptors to inhibit painful transmission
4) reversible jt hypomobility - elongate hypomobile ligamentous and capsular tissue
5) positional faults/subluxations - can occur with trauma, periods of immobility, mm imbalance
6) functional immobility - treatment with non-stretch gliding or distraction to maintain available jt play and limit the effects of immobility

Question 2

Movement of joint surfaces

Answer 2

Breakdown of intra-articular barriers
Nourishment of articular surfaces/cartilage

Question 3

Stretching of joint capsules and surrounding soft tissue

Answer 3

Breaking of adhesions
Collagen remodeling

Question 4

Two major (theoretical) reasons for jt mobs - there’s some overlap between the lists for each

Answer 4

Facilitation of healing
- increase circulation
- normalization of joint nutrition
- increase H2O
- therapeutic stresses to soft tissues

Prevention of complications associated with immobility
- maintains distance, mobility, and lubrication between collagen fibers
- provides low levels of stress to limit atrophy of tissues
- delivery of nutrients

Question 5

Direction of jt mob: traction/distraction

Answer 5

Perpendicular to treatment plane (parallel line drawn along opposite articulating surface), parallel to line drawn from axis of rotation of moving segment to opposite articulating surface

Question 6

Direction of jt mob: glide

Answer 6

Perpendicular to line drawn from axis of rotation to treatment plane (surface of opposite articulating surface), parallel with treatment plane

Question 7

Parameters/ guidelines for dosage of jt mobs

Answer 7

3-6 sets of oscillations, each lasting about 20-60s

Question 8

Joint traction grades

Answer 8

I: beginning of range, neutralize joint pressure without separation at joint
II: take up all slack in joint, limits of joint play within capsule
III: stretching of soft tissues

Question 9

Contraindications to joint mobs (9)

Answer 9

1) Acute inflammation
2) Active/flare up of disease (e.g. rheumatoid arthritis)
3) Malignancy
4) Advanced osteoporosis
5) Joint hypermobility
6) fracture
7) muscle guarding
8) vertebral artery compromise
9) congenital bone deformities

Question 10

Documentation for joint mobs (6)

Answer 10

1) rate of application of force
2) location in range of available movement
3) direction of force applied by the PT
4) target of force
5) relative structural movement
6) position of pt