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What are 3 indications for joint mob?
- reversible jt hypomobility
What is a passive mvmt performed by the therapist that is slow enough for the patient to stop at any time (intended to decrease pain or increase mobility)?
can be oscillatory or with a sustained stretch
physiologic or accessory mvmts
What are a physiologic mvmts?
- mvmts that the pt can do voluntarily
- (classic or traditional mvmts such as flex, abd, rot)
What are accessory mvmts?
mvmts within the jt and surrounding tissue that are necessary for normal ROM but the pt cannot actively be performed by the pt
upward rotation of the scapula and clavicle that occurs with shoulder flexion
What is another name for accessory movements?
What describes the motions that occur between the 2 jt surfaces, as well as the "give" in the jt capsule, which allows the bones to move?
What is manipulation?
a passive mvmt using physiologic or accessory motions, which may be applied with a thrust or when the pt is under anesthesia
What influences the type of motion occuring between bony partners within a joint?
shape of the joint surface
What type of joint has one surface concave and one convex?
ovoid-ball and socket (glenohumeral jt)
What is a saddle joint shape?
one surface is concave in one directions and convex in the other, with the opposing surface convex and concave
What type of mvmt is what you see the bony lever doing? (classically described as flex, ext, abd, add, and rotation)
What do accessory motions allow for?
greater angulation (ROM) of the bone as it swings
What is a roll?
- one bone rolling on another
- *ALWAYS occurs in the same direction as the angulating bone motion, whether the surface is concave or convex
What happens if rolling occurs alone?
causes compression of the surfaces on the side to which the bone is angulating and separation on the other side
What is a slide?
- one bone sliding over another
- *the same point on one surface comes in contact with new points on the opposing surface
What doe the direction of sliding depend on?
whether the surface is concave or convex
When sliding is occuring in the opposite direction of the angular mvmt of the bone, the moving surface is what?
When sliding is occuring in the same direction as the angular mvmt of the bone, the moving surface is what?
The more congruent the jt surfaces are, the more what occurs?
The less congruent the jt surfaces are, the more what occurs?
What type of component does joint mob use to restore jt play and reverse jt hypomobility?
What is a spin?
- one bone spinning on another
- same point on the moving surface creates an arc of a circle as the bone spins
shoulder flex/ext, hip flex/ext
What uses the bony lever to stretch a tight joint capsule and may cause increased pain or jt trauma?
pssive angular stretching
What uses the translatoric slide component of the bones to stretch a tight capsule?
- joint glide (mobilization) stretching
- *safer and more selective bc of decreased jt compressive forces
What is the decrease in space between bony partners?
compression - normally occurs in extremity and spinal joints when weight bearing (or when one bone rolls onto another)
normal compressive loads help move synovial fluid and maintain cartilage health; abnormally high loads may lead to articular cartilage changes/deterioration
What is traction?
distraction/separation of jt surfaces
How does jt motion stimulate biological activity?
by moving synovial fluid
Joint motion maintains what for articular and periarticular tissues?
extensibility and tensile strength
Immobilization causes what?
What transmits info to the CNS and provides awareness of position and motion?
afferent nerve impulses
What are neurophysiologic effects of jt mob?
sm amp oscillatory and distraction mvmts stimulate mechanoreceptors that may inhibit the transmission of nociceptive stimuli at th spinal cord or brain stem
What are mechanical effects of jt mob?
sm amp distraction or gliding mvmts of the jt are used to cause synovial fluid motion which helps maintain nutrient exhange and prevent painful and degenerating effects of stasis
When a pt has a functional immobility, what should you use to maintain available joint play and prevent degeneration?
nonstretch gliding or distraction
What are the 3 contraindications to STRETCHING techniques?
- jt effusion
What to gentle oscillating motions with no stretch help do?
block the transmission of a pain stimulus
What are the contraindications for nonstretch techniques?
What is a grade 1 oscillatory technique?
sm amp of mvmts that are performed at the beginning of the range...fast
What is a grade 2 oscillatory technique?
lg amp os slow mvmt that is performed within the range, but not reaching the limit
What is a grade 3 oscillatory technique?
lg amp of slow mvmt performed up to the limit of available range, and then into stretch
What is a grade 4 oscillatory technique?
sm amp performed while at the end of the range, then repeatedly stretched..fast
What is a grade 5 oscillatory technique?
sm amp, high velocity, thrust technique
What oscillatory grades are used to treat pain?
1 and 2
What oscillatory grades are used to treat hypomobility and stiffness?
3 and 4
What is a grade 1 (loosen) sustained translatory technique?
sm amp distraction is applied where no stress is placed on capsule
What is a grade 2 (tighten) sustained translatory technique?
enough distraction or glide is applied to tighten the tissues...no stretch
What is a grade 3 (stretch) sustained translatory technique?
distraction or glide is applied with an amplitude large enough to place a stretch on the jt capsule
What grade of distraction is normally used for the initial eval treatment?
What grades of sustained distraction is used for pain relief?
grade 2 and a gentle grade 2
What sustained distraction grade is used to stretch joints structures and increase joint play?
What position should the joints be placed in for jt mob?
Jt traction techniques are applied in what direction to the treatment plane?
look at the "cave" bone
In what direction are gliding techniques applied to the treatment plane?
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