Principle of Joint Mobilization

Question 1

Neurophysiological mechanisms of analgesic (pain) effects

Answer 1

• diffuse noxious inhibitory control (DNIC) is the process by which afferent noxious signals are inhibited from the PNS
• beta endorphin & endogenous opioids (EO) appear to be a main contributor to this inhibition
• EO has a comparable analgesic effect to morphine

Question 2

Describe synovial fluid viscosity

Answer 2

• proteoglycans make up 22-38% of the dry weight of cartilage

Question 3

Define classical movements

Answer 3

• active motion (rotating movements of bones)
• passive motion (translatoric movements of bones)

Question 4

Define accessory movements

Answer 4

• component motion
• joint play (Mennell): slack of “the possibility of passive translatoric movement of the bone”

Question 5

Define roll and glide

Answer 5

• Glide: one point on one surface will always be in contact with a new point on the other surface & occurs parallel to the joint plane
• Roll: a new point on one surface will always be in contact with a new point on the other surface

Question 6

Difference between pure and impure movements of the anatomical axis (swing osteokinematics)

Answer 6

• Pure: shortest distance between two points (flat plane)
• Impure: longer distance between two point (curved plane)

Question 7

Difference between cardinal and arcuate movements of the mechanical axis (swing arthrokinematics)

Answer 7

• Cardinal: shortest distance between two points (flat plane)
• Arcuate: longer distance between two points (curved plane)

Question 8

Define the position of reference/zero starting position

Answer 8

• the internationally accepted position from which we can objectively measure the restriction in motion

Question 9

Define the resting position

Answer 9

• position where the surrounding tissue is as relaxed as possible
• the intracapsular space is as larger as possible

Question 10

Define the closed packed position

Answer 10

• position where the surrounding tissue is as tight as possible
• the intracapsular space is as small as possible
• never articulate in the closed packed position

Question 11

What direction is roll and glide for a concave on convex

Answer 11

• same direction

Question 12

What direction is roll and glide for a convex on concave

Answer 12

• opposite direction

Question 13

Describe joint distraction

Answer 13

• force occurs perpendicular to the joint plane which is always in the joint cavity

Question 14

Describe the grades of mobilization (Maitland Grade)

Answer 14

• Grade I: oscillating in the beginning of range
• Grade II: oscillating in the mid range
• Grade III: oscillating into the end range and backing off back into the mid range (get some stretch)
• Grade IV: oscillating in the end range (get some stretch)