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37 Cards in this Set
- Front
- Back
Mobilization/manipulation
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Passive skilled manual therapy techniques applied to joints and related soft tissues at varying speeds and amplitudes using physiological or accessory motions for therapeutic purposes
Manual therapy techniques that are used to modulate pain and treat joint dysfunctions that limit ROM. They specifically address restricted capsular tissue by replicating normal joint mechanics while minimizing abnormal compressive stresses on the articular cartilage in the joint. |
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Self-mobilization (auto-mobilization)
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Self-stretching techniques that specifically use joint traction or glides that direct the stretch force to the joint capsule
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Mobilization with movement
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Therapist provides accessory mobilization while pt performs active physiological movement to end range
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Physiological movements
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Movements pt can do voluntarily
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Accessory movements
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Component motions
Motion that accompany active motion but are not under voluntary control |
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Joint play
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Motions that occur between joint surfaces
“give” of a joint capsule arthrokinematics |
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Give me an example of component motions
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Upward rotation of scapula and rotation of clavicle with shoulder flexion
Rotation of fibula with ankle movement |
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What motions would be included under jt play??
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Distraction, sliding, compression, rolling, spinning
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Thrust
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High-velocity, short amplitude motion
Performed at end range Intended to alter positional relationships, snap adhesions, or stimulate jt receptors |
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Manipulation under anesthesia
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Medical procedure used to restore full ROM by breaking adhesions around a joint while the pt is under anesthesia
May be a rapid thrust or a passive stretch |
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Muscle energy
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Use active contraction of deep muscles that attach near the joint and whose line of pull can cause the desired accessory motion
Specialization courses offered in this |
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Joint Shapes
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Ovoid or sellar
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Ovoid joints are?
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on surface is convex and the other is concave
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Sellar Joints are?
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One surface is concave in one direction and convex in the other, with opposing surface convex and concave.
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Types of motion
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Roll
Slide/translation Combined roll-sliding in a joint Spin |
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Does roll ever occur alone?? Does Slide/translation ever occur alone??
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Rolling, if occur alone, causes compression of the surfaces on the side to which the bone is swinging and separation on the other side.
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Examples of spin:
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Shoulder with flexion/extension
Hip with flexion/extension Radiohumeral jt with pronation/supination |
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Compression
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Decrease in joint space
Occurs with normal WB Good or bad??? Compression is good in that is causes nutrient transfer through synovial fluid. Can be bad if there is abnormally high compression resulting in cartilagenous changes and deterioration |
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Traction
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Longitudinal pull
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Distraction
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Separation or pulling apart
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Indication for Joint mobilizations
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Pain, muscle guarding, and spasm
-Neurophysiological effects = small amplitude oscillatory and distraction movements are used to stimulate mechanoreceptors that may inhibit transmission of pain receptors at the brain or spinal cord level -Mechanical effects = cause synovial fluid motion to bring nutrients to avascular portions of cartilage thereby preventing painful and degenerative effects Positional faults/subluxations = malposition of one bony segment can occur with traumatic injury, after immobility, or with muscle imbalance; would use manipulation with movement; could be used to relocate a dislocation Progressive limitations = use mobilization to maintain what movement they have Functional immobility Reversible joint hypomobility |
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Limitations to Joint Mobilization
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Cannot change disease process
Cannot change inflammatory process Skill of therapist |
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What are some altered joint mechanics may be due to and need joint mobilization?
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Pain and muscle guarding, joint effusion, contractures or adhesions in the joint capsules or supporting ligaments, or malalignment or subluxation of bony surface.
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Contraindiciations and precautions
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Hypermobility
Joint effusion Can use gentle oscillations for pain but want to avoid stretching joint capsule as it is already inflamed Inflammation Same as above |
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Conditions requiring special precautions for stretching
Examples? |
Malignancy
2. bone disease 3. unhealed fx, 4. excessive pain, 5.hypermobility in associated jts, 6. total joint replacements 7. newly formed or weakend connective tissue – i.e. after surgery, injury 8. Systemic connective tissue diseases – i.e. RA 9. Elderly individuals with weakened connective tissue and dimished circulation |
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Contraindiciations and precautions
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Hypermobility
Joint effusion Can use gentle oscillations for pain but want to avoid stretching joint capsule as it is already inflamed Inflammation Same as above |
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Conditions requiring special precautions for stretching
Examples? |
Malignancy
2. bone disease 3. unhealed fx, 4. excessive pain, 5.hypermobility in associated jts, 6. total joint replacements 7. newly formed or weakend connective tissue – i.e. after surgery, injury 8. Systemic connective tissue diseases – i.e. RA 9. Elderly individuals with weakened connective tissue and dimished circulation |
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Grade I Oscillation Technique
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Small-amplitude rhythmic oscillations are performed at the beginning of the range.
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Grade II Oscillation Technique
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Large-amplitude rhythmic oscillations are performed within the range, not reaching the limit
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Grade III Oscillation Technique
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Large-amplitude rhythmic oscillations are performed up to the limit of available motion and are stressed into tissue resistance
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Grade IV Oscillation
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Small-amplitud rhythmic oscillations are performed at the limit of available motion and stressed into tissue resistance.
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Grade I (loosen):
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Small-amplitude distraction is applied where no stress is placed on the capsule. It equalizes cohesive forces, muscle tension, and stmospheric pressure acting on joint.
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Grade II (tighten)
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Enough distraction or glide is applied to tighten the tissues aroudn the joint
"Taking up the slack" |
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Grade III (Stretch)
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A distraction or glide is applied with an amplitude large enough to place stretch on the joint capsule and surrounding periartictular structures.
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When is sustained grade I used?
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Grade I Distraction is used with all gliding motions and may be used to relieve pain.
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When is sustained grade II used?
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Grade II distraction is used for the initial treatment to determine how sensitive the joint is. Once the joint reaction is known, the treatment dosage is increased or decrease accordingly. Inhibit pain and Grade II glide may be used to maintain joint play when ROM is not allowed
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When is sustained grade III used?
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USed to stretch joint structures and thus increase joint play.
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