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Joint Mobilization. The forgotten tool. Manual therapy for the restoration of joint function Stimulates joint receptors and increases afferent input from large-diameter afferent nerves. Effects of Joint Mobilization. Neurophysiological Stimulates large mechanoreceptors to decrease pain

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joint mobilization

Joint Mobilization

The forgotten tool

slide2
Manual therapy for the restoration of joint function
  • Stimulates joint receptors and increases afferent input from large-diameter afferent nerves
effects of joint mobilization
Effects of Joint Mobilization
  • Neurophysiological
    • Stimulates large mechanoreceptors to decrease pain
      • Gate Control Theory
  • Nutritional
    • Synovial fluid movement  improve nutrient exchange
  • Mechanical
    • Improve the mobility of hypomobile joints due to immobilization or dysfunction (capsular adhesions or scar adhesions)
general principles
General Principles
  • Open Packed Position
    • Joint position where the capsule is most relaxed and therefore has the greatest room and accommodate the most fluid.
      • Least amount of joint contact
      • Greatest amount of joint play
      • See handout Table 6.3
general principles5
General Principles
  • Close Packed Position
    • Joint capsule and ligaments are tight
    • Maximal contact between surfaces
    • See handout Table 6.3
general principles6
General Principles
  • Convex
    • Evenly curved; resembling the segment of a sphere
  • Concave
    • Having a spherically depressed or hollow surface
anatomical planes of reference
Anatomical Planes of Reference
  • Sagittal Plane
    • Right and left halves
  • Frontal Plane
    • Anterior and posterior halves
  • Transverse Plane
    • Upper and lower halves
bone and joint movements
Bone and Joint Movements
  • Kinematics
    • Study of movements in the human body
  • Osteokinematics
    • Study of bone movement
  • Arthrokinematics
    • Study of joint movement
osteokinematics arthrokinematics
Osteokinematics / Arthrokinematics
  • Rolling
  • Gliding
  • Spinning
  • Compression
  • Distraction
  • Roll – Gliding Joint Movement
    • Combination of rolling and gliding movements which is possible only between incongruent, curved surfaces. Since human joint surfaces are not fully congruent, physiological movements can only result in roll-gliding
slide10
Rolling Direction
    • Rolling component of roll-gliding is always in the same direction as bone movement
  • Gliding Direction
    • If concave surface moves, gliding and bone movement are in the same direction
    • If convex surface moves, gliding and bone movement are in opposite directions
slide11
Translation
    • Straight line movement with resultant movements of traction, compression, and gliding
    • Traction
      • Direction of bone movement is perpendicular to and away from treatment plane, and results in separation of joint surfaces
    • Compression
      • Direction of bone movement is perpendicular to and toward the treatment plane, and presses joint surfaces together
    • Gliding
      • Direction of bone movement is parallel to the treatment plane, and results in gliding movement between joint surfaces
convex concave rule
Convex / Concave Rule
  • Convex – Opposite
    • Joint with convex surface moving, mobilize in the opposite direction of restricted bone movement
      • Glenohumeral joint, hip joint
  • Concave – Same
    • Joint with concave surface moving, mobilize in the same direction of restricted bone movement
      • Knee
capsular pattern
Capsular Pattern
  • All joints have an expected and normal range of motion / If loss of motion is associated with tightness in the capsule motion loss will follow the capsular pattern
    • See handout Table 6.2
grades of movement
Grades of Movement
  • Maitland
    • 5 grades of movement
      • Grade I - small amplitude, beginning ROM
      • Grade II – large amplitude, tissue reistance
      • Grade III – large amplitude, pathological limit
      • Grade IV – small amplitude, end ROM
      • Grade V - manipulation
slide15
Kaltenborn
    • Grade I – small amplitude, beginning ROM
    • Grade II – large amplitude, up to resistance
    • Grade III – large amplitude, into resistance