JOINT MOB

80問 • 1年前

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Joint mobilization is also known as

manipulation

Refers to manual therapy techniques that are used to modulate pain and treat joint impairments that limit ROM by specifically addressing the altered mechanics of the joint

Joint mobilization

Applied to joints and related soft tissues at varying speeds and amplitude

passive and skilled manual therapy techniques

Small-amplitude force

Fast velocity

Large-amplitude force

Slow velocity

Is performed at the end of the pathological limit of the joint

Thrust manipulation/HVT

Is intended to alter positional relationships, snap adhesions, or stimulate joint receptors

Thrust manipulation/HVT

Movements the patient can do voluntarily

Physiological movements

Osteokinematics

Physiological movements

Used when these motions of the bones are described

Osteokinematics

Used to describe bone surfaces within joints

Arthrokinematics

Accompany active motion but are not under voluntary control

Component motions

Motions such as upward rotation of the scapula and rotation of the clavicle, which occur with shoulder flexion

Component motions

Movements in the joint and surrounding tissues that are necessary for normal ROM but that cannot be actively performed by the patient

Accessory movements

Motions that occur between the joint surfaces which allows the bones to move

Joint play

Necessary for normal joint funtioning through the ROM and can be demonstrated passively, not actively

Joint play

Arthrokinematics

Joint play

Refers to self-stretching techniques that specifically use joint traction pr glides that direct the stretch force to the joint capsule

Self-mobilization

Is a procedure used to restore full ROM by breaking adhesions around a joint while the patient is anesthesized

Mobilization under anesthesia

Is the concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end-range applied by the patient

Mobilization with movement

Use active contraction of deep muscles that attach near the joint and whose line of pull can cause the desired accessory motion

Muscle energy

This position is typically used for testing joint play and for applying the initial mobilization treatment

Resting position

Terms that describe the position of the joint where the greatest mobility is possible

Resting, Open pack, Loose pack

Surfaces are incogruent

Roll

New points in one surface meet new point on the opposing surface

Roll

Results in angular motion of the bone(swing)

Roll

Always in the same direction as the swinging bone motion

Roll

If it occurs alone, causes compreasion of swing side and separation on the opposite side

Roll

The surfaces must be congruent, wither flat or curved

Slide

The same point on one surface comes into contact with the new points on the opposing surface

Slide

Sliding is in the __________ direction if the moving joint surface is convex

opposite

Sliding is in the ________ direction if the moving surface is concave

same

For combined roll-sliding, the more congruent

more sliding

For combined roll-sliding, the more incongruent,

more rolling

______ component of joint motion is used to restore joint play and reverse joint hypomobility

Sliding

______ is not used to stretch tight joint capsules because it causes joint compression

Rolling

PJM uses ______ instead of _______ which promotes passive-angular stretch

sliding, rolling

There is rotation of a segment about stationary mechanical axis

Spin

The same point on the moving surface creates an arc of a circle

Spin

Rarely occurs alone in joints

Spin

May cause increased pain or joint trauma

Passive angular stretching

Use of lever magnifies the force at the joint

Passive angular stretching

Force causes compression of the joint surfaces in the direction of the rolling bone

Passive angular stretching

The roll without a slide does not replicate normal joint mechanics

Passive angular stretching

Safet and more selective

Joint glide stretching

Force is applied close to the joint surface and controlled

Joint glide stretching

Direction of the force replicates the sliding component of the joint mechanics and does not compress the cartilage

Joint glide stretching

The amplitude of the motion is small yet specific to the restricted structures

Joint glide stretching

Forces are selectively applied to the desired tissue

Joint glide stretching

Longitudinal pull

Traction

Separation, or pulling apart

Distraction

Is the decrease in the joint space between bony partners

Compression

Normally occurs in the extremity and spinal joints when weight bearing

Compression

Normal intermittent compressive loads may lead to articular cartilage changes and detoriaration. Abnormally high compression loads help move synovial fluid and thus help maintain cartilage health.

Both statements are false

Effects of joint motion

Stimulates biological activity by moving synovial fluid, Extensibility and tensile strength of the tissues are maintained, Afferent nerve impulses transmit information to CNS and provide awareness of position and motion

Brings nutrients to the avascular articular cartilage of the joint and intraarticular fibrocartilage of the menisci

Synovial fluid

Indications for use of joint mob

Pain, muscle guarding & spasm, Reversible joint hypomobility, Positional faults or subluxation, Progressive limitation, Functional immobility

Pain, muscle guarding and spasm: stimulate the mechanoreceptors that may inhibit the transmission of nociceptive stimuli at the spinal cord or brain stem levels

Neurological effects

Pain, muscle guarding and spasm: Cause synovial fluid motion

Mechanical effects

Pain, muscle guarding and spasm: maintain nutrient exchange and this prevent the painful and degeneraying effects of stasis

Mechanical

Can be treated wih gentle joint-play techniques

Pain, muscle guarding and spasm

Can be treated with progressively vigorous joint-play stretching techniques to elongate hypomobile capsular and ligamentous connective tissue

Reversible joint hypombolity

Sustained or oscillatory stretch forces are used to distend the shortened tissue mechanically

Reverse joint hypomobility

MWM techniques attempt to realign the bont partners while to person actively moves the joint through its ROM

Positional faults/subluxation

Thrust techniques are used to reposition an obvious subluxation, such as pulled elbow or capitate-lunate

Positional faults/subluxation

Can be treated with joint-play techniques to maintain available motion or retard progressive mechanical restrictions

Progressive limitation

The dosage of distraction or glide is dictated by the patient’s response to treatment and the state of the disease

Progressive limitation

Can be treated with nonstretch gliding or distraction techniques to maintain available joint play and prevent the degenerating and restricting effects of immobility

Functional immobility

Joints can change the disease process of disorders

False

The skill of the therapist affects the outcome

True

Patients with painful hypermobile joints may benefit from gentle joint pkay techniques if kept within the limits if motion

Hypermobility

Stretching is not done

Hypermobility

Gentle oscillatong or distraction motions may temporarily inhibit the pain response

Inflammation

Swelling

effusion

Rapid swelling of a joint usually indicates bleeding in the bone

False

Hemophilia

joint effusion

Do not stretch a swollen joint with mobilization or passive stretching techniques

True

Gentle oscillating motions that do not stress or stretch the capsule

Joint effusion

Precautions

Newly formed or weakened connective tissue (immediately after injury, surgery, or disuse), Malignancy, Bone disease, Unhealed fracture, Excessive pain, Hypermobility in assoc. joints, Total joint replacements, Patient taking corticosteroids, Systemic connective tissue diseases (rheumatoid arthritis), Elderly individuals with weakened connective tissue and diminished circulation

Contraindications

Hypermobility, Joint effusion, Inflammation

ROM

Kyla Rafols · 71問 · 2年前

ROM