Mobility Intro Lect I
22
Manual Mobilization Of The Extremity Joint Introduction
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Transcript of Mobility Intro Lect I
- 1. Manual Mobilization Of The Extremity Joint Introduction
2. Manipulationvs. Mobilization 3. Manipulation
- Orthopedic Sec. APTA
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- Any manual procedure used for the purpose of examination , correction or modification of an articular or soft tissue dysfunction.
- Paris
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- The skilled passive movement to a joint, either within or beyond its active limited motion.
- Maitland
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- A sudden small amplitude thrust delivered at a speed which renders the patientpowerless to prevent it
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- Defined APTA
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- The act of imparting movement, either actively or passively, to joints or soft tissue structures.
- Maitland
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- Passive oscillatory movements or sustained stretch at the limit of range using graded amplitude movements.
- Kaltenborn
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- Component of MT referring to any procedure that increases the mobility of joints or ST structures
Mobilization 5. History & School Of Thought
- James Cyriax
- John Mennell
- Freddie Kaltenborn
- Geoffrey Maitalnd
- Stanley Paris
6. James Cyraix
- Concept of end feel
- Examination by selective tissue tension
- Friction Massage
7. John Mennell
- Concept of joint dysfunction
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- loss of accessory or joint play movement
- Jt. dysfunction as pain- producing entity, causing loss of movement
- Jt dysfunction is detected by passive movement. Normal passive movement is pain free.
8. Freddy Kaltenborn
- Norwegian School- biomechanical model
- Applied the works of MacConnell to joint mobilization
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- Concave /Convex rule
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- Open/ Closed Pack Position
- Focus is on movement taking place within the joint capsule
9. Freddy Kaltenborn
- Brought into play the arthrokinematic and osteokinematic relationship of joint movement.
- The osteokinematic and arthrokinematicat a specific joint may be the same, opposite direction.
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- eg. Shoulder abduction
10. Geoffrey Maitland
- Deviated from biomechanical model
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- Advocating treatment of painful joints by oscillating passive movement that provide
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- Neurophysiological therapeutic
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- Mechanical therapeutic
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- Implemented the grading system
11. Stanley Paris
- Focus is on Hypomobility
- Define joint dysfunction as a state of altered mechanics either increased or decreased from the expected normal motion.
- Grade scale from 0-7
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- 0 no mobility
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- 3 is normal
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- 6 &7 unstable
12. Terminology 13. Terminology
- Kinematics:
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- Study of movement
- Osteokinematic:
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- Overall movement of bone
- Arthrokinematic
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- Movement of one articular surface in relation to it partner- roll, glide, spin
14. Bone Rotation (roll-gliding )
- All bone movements occur around an axis.
- From a mechanical viewpoint are considered to be rotation or spin
- In normal joints all active movements produce joint roll-gliding
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- Exception planar joints
15. Roll,Slide , Spin
- Roll:Movement in which points at interval on the moving JT, surface contacts points at the same intervals on the opposite surface.
- Slide.Movement in which a single point on the moving surface contacts various points on the opposing surface.
- Spin.Type of slide that accompanies spin of a bone . 1/2 of the jt surface slides in one direction while the other 1/2 slide the opposite direction.
16. Distraction / Compression
- Distraction: Separation of joint surfaces
- Compression: Approximation ofjoint surfaces- movingtoward close pack position.
17. Accessory Movements
- Those movements which accompany thephysiologicalmovements and are necessary for normal function, but not undervoluntary neuromuscularcontrol
18. Categories Of Accessory Movements
- Joint Play
- Component
19. Joint Play Movement
- Movement that can be produced passively at a joint but cannot be isolated actively.
- Spin, roll, glide, compression, & distraction
- Joint play movements are used when applying specific mobilization techniques to restore accessory movements sothat full & painless osteokinematic movement may return.( eg .Inferior distraction of the shoulder)
20. Component Motion
- A type of accessory movement that is directly associated with the production of osteokinematic movement or motion that takes place in a joint complex or related joint to facilitate a specific active motion
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- Example: at glenohumeral Jt.
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- Inferior and posterior glide of humeral head to produce flexion of the shoulder (humerus)
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21. Closed & Open Pack Positions
- Closed Pack Criteria:
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- Jt. Maximally congruent
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- Jt caps. & ligs. are twisted
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- Jt becomes locked in position
- Open Pack Criteria
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- Lig & caps are slack
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- Jt surfaces distracted
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- Movements of roll slide are allowed
22. End Feel
- Refers to the nature of movement limitation experienced by theexaminer
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- Assessment of joint play
- It is the sensation imparted to the examiners hands during passive movement of a joint at end range