Therapeutic Exercise I Chapter 5

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Presentation transcript:

Therapeutic Exercise I Chapter 5 Peripheral Joint Mobilization

What is Joint Mobilization? (manipulation) Joint mobilizations are to be done by the supervising PT and PTA, but PTA’s can perform only grades I & II It is a passive traction and or gliding movement applied to joint surfaces that maintain or restore the joint play normally allowed by the capsule, so the normal roll-slide joint mechanics can occur as a person moves. The speed and amplitude which applied may vary.

Examples of Mobilization!!!!!

Definitions Joint Mobilization/Manipulation Self Mobilization Mobilization with Movement (MWM) Physiological Movements (osteokinematic) Accessory Movements (arthokinematic) Thrust – high velocity, short amplitude Manipulation Under Anesthesia (MUA) Muscle Energy

What Can Alter Joint Mechanics? Pain Muscle guarding Joint effusion Contractures/adhesions of the joint capsules or supporting structures Malalignment/subluxation of the bony surface

---Types of Motion---- Swing Rolling/sliding/spinning Slide/Translation Combined Roll-Slide in a joint Spin

Indications for Joint Mobilization Pain, muscle guarding, and spasm Reversible joint hypomobility Positional faults/subluxations Progressive limitations Functions Immobility Mobilizations cannot change a disease process/inflammation process, but it can minimize pain, maintain joint play, and reduce mechanical limitations

Contraindications Hypermobility Joint Effusion Inflammation

Grade or Dosage of Movement Grade I Grade II Grade III Grade IV Grade V

Peripheral Joint Mobilization Techniques - see handout Closed Pack Position Open Pack Position Capsular Pattern of Restriction

Example of Grade I and V Shoulder (posterior/inferior/anterior glide) Oscillations http://www.bing.com/videos/search?q=shoulder+mobilizations&view=detail&mid=A12A5B8D01186B5562B2A12A5B8D01186B5562B2&first=0&FORM=LKVR14 Ankle (talocrural Joint) Thrust http://www.bing.com/videos/search?q=grades+of+mobilizations&view=detail&mid=48B740EF882B77EF067048B740EF882B77EF0670&first=0&FORM=LKVR2

Things To Remember: Mobilization assist in minimizing pain, maintain joint play, and reduce mechanical limitations Mobilization is to be done by the PT and PTA, but PTA’s can ONLY perform grades I & II

Break for Lab with Lecture on UE Stretching Techniques in Anatomical Planes of Motion LAB ON JOINT MOBILIZATION…..To be reviewed and practiced in week #2 (If time permits may review LE’s)