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Therapeutic Exercise I Chapter 5

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

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Therapeutic Exercise I Chapter 5

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  1. Therapeutic Exercise IChapter 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 • 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

  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)

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