Bill green

Joint mobilization

Defination: These are usually Small Repetitive Rhythmical oscillatory Localized acessory/functional movements Various amplitude In available range Under patient control

Joint mobilization Joint mobilization is a manual therapy intervention, a type of passive movement of a skeletal joint. It is usually aimed at a 'target' synovial joint with the aim of achieving a therapeutic effect. When applied to the spine, it is known as spinal mobilization

Benefits of Mobilization;  Joint mobilisation involves performing a back and forth oscillation of the joint in order to restore motion. Joint mobilisation is helpful in cases where pain and joint tightness limit motion, as in the case of adhesive capsulitis or frozen shoulder Joints of the elbow, wrist and hand, where tightness is present, also benefit from this technique. It is also used to relieve low back pain and re-establish accessory motion in the lumbar segments.

Classification and mechanisms of action: Maitland Joint Mobilization Grading Scale Grade I - Small amplitude rhythmic oscillating mobilization in early range of movement Grade II - Large amplitude rhythmic oscillating mobilization in midrange of movement Grade III - Large amplitude rhythmic oscillating mobilization to point of limitation in range of movement Grade IV - Small amplitude rhythmic oscillating mobilization at endrange of movement Grade V (Thrust Manipulation) - Small amplitude, quick thrust at endrange of movement

Elbow mobilization

hip

knee

shoulder

Gleno humeral mobilization GH AnterioPosterioly GH longitudinal

GH PosterioAnterioly

GH Compression GH lateral and medial glide

How Much Joint Movement is Normal? For full and pain-free movement your joints need to move freely in all directions that they were designed to. If they become locked or restricted in any particular direction, you may experience pain and/or stiffness. Skilled physiotherapist who understands your joints, you can quickly and easily regain full joint range and pain-free movement. To achieve this, your physiotherapist will assess which of your joints are: painful (but normal motion) stiff  painful and stiff hypermobile painful and hypermobile

Joint manipulation

Defination These are accurately localized, single quick decisive movement small magnitude with high velocity complete before the patient stop it..

Joint manipulation passive movement of a skeletal joint. It is usually aimed at one or more 'target' synovial joints with the aim of achieving a therapeutic effect The method of joint manipulation is usually used on synovial joints — which covers most of the types of movable joints in a human — that are causing pain

Clinical effects and mechanisms of action The clinical effects of joint manipulation have been shown to include: Temporary relief of musculoskeletal pain. Shortened time to recover from acute back sprains. Temporary increase in passive range of motion (ROM). Physiological effects upon the central nervous system. No alteration of the position of the sacroiliac joint.

Uses: it’s commonly used for many spinal injuries.

Principal of passive manual mobilization and manipulations

General or local anesthesia General anesthesia allows the patient to “sleep” with the use of anesthesia, completely unaware of the surgery.  Local anesthesia allows the patient to remain awake without feeling pain.

Maximum effort On part of physiotherapist and patient must be exerted after Manipulation to maintain the range of motion of movement gained at each session..

Principal of giving control sustained stretching of tightened structures

Mechanical mean can be use Comfortly supported As relax as possible Appropriate position Sustain stretch to muscles Suitable fixation Mechanical mean can be use TurnBuckle Plaster

Effect and uses of control sustain stretching

Steady and sustain streching Use to overcame plasticity pattern of limb Slow stretch produce the relaxation and lengthening of muscles example Hemiplegic Patient(paralysis of one side of the body.)

Hemiplegic

Steady and prolonged passive strech Over came the resistance of Shortened Ligament Fascia Tendon Fibrous sheath of Muscles

Talipes equinovarus Club foot or clubfoot, also called Congenital Talipes Equinovarus (CTEV), is a congenital deformity involving one foot or both. The affected foot appears to have been rotated internally at the ankle.

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