1. Bill green

2. Joint mobilization

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

4. 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

5. 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.

6. 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

7. Elbow mobilization

8. hip

9. knee

10. shoulder

11. Gleno humeral mobilization
GH AnterioPosterioly
GH longitudinal

12. GH PosterioAnterioly

13. GH Compression
GH lateral and medial glide

14. 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

15. Joint manipulation

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

17. 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

18. 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.

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

20. Principal of passive manual mobilization and manipulations

21. 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.

22. 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..

23. Principal of giving control sustained stretching of tightened structures

24. 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

25. Effect and uses of control sustain stretching

26. 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.)

27. Hemiplegic

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

29. 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.

30. Thank you