1. Therapeutic Exercise I Chapter 5
Peripheral Joint Mobilization

2. 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.

3. Examples of Mobilization!!!!!

4. 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

5. 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

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

7. 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

8. Contraindications
Hypermobility
Joint Effusion
Inflammation

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

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

11. Example of Grade I and V
Shoulder (posterior/inferior/anterior glide) Oscillations
Ankle (talocrural Joint) Thrust

12. 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

13. 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)