Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
118 Cards in this Set
- Front
- Back
|
Joint Mobilization
|
the concept of musculoskeletal evaluation and treatment in PT that applies principles of kinesiology, histology, neurophysiology, and pathophysiology to promote the well-being of clients
|
|
|
Joint mobilization
|
manual therapy techniques that are used to modulate pain and treat joint dysfunctions that limit ROM by specifically addressing the altered mechanics of the joint
|
|
|
Manipulation
|
a sudden high velocity technique applied at the end of ROM that cannot be stopped by the patient. This technique is designed to release pathologically shortened or adhered structures. A rapid and forceful technique.
|
|
|
The concept of joint mobilization is used consistently within the scope of treatment strategies along with common interventions of
|
massage, Exercise, client education, traction, and MAR.
|
|
|
Joint Play
|
the motions that occur between the joining surfaces as well as the extensibility or give in the joint capsule, which allows the bones to move.
|
|
|
Joint Congruency
|
the degree to which joint surfaces match
|
|
|
Ovoid Joints
|
joints consisting of two surfaces: one is concave, the other is convex.
|
|
|
Sellar (saddle) Joints
|
joints possessing a convex and a concave surface on each opposing joint surface (Pringles Potato Chips).
|
|
|
With joint mobilizations, PTA's will use two techniques:
|
1) a sustained traction (or distraction) motion that occurs perpendicular to the articulating joint surface, and 2) a slide or glide that occurs parallel to the articulating joint surface.
|
|
|
Indications for mobilization
|
stretch supporting tissues for the restoration of normal accessory motion, to reduce pain, and to reduce muscle guarding per the plan of treatment.
|
|
|
Static Mobilization
|
is a sustained glide or distraction technique held for a brief 10-60 seconds
|
|
|
Dynamic Mobilization
|
consists of an oscillatory motion occurring in a sliding manner for 2-3 seconds
|
|
|
Graded Oscillation Techniques - Grades I-III used by PTA's
Grade I: |
small amplitude, rhythmic oscillations performed at the beginning of the range. Used for the reduction of pain and for muscle guarding. A loosening technique with no stress placed on the joint capsule
|
|
|
Center of Gravity (COG)
|
point in the human body where the sagittal, frontal and transverse planes intersect. It is usually located at midline at the level of and anterior to S2. It is also anterior to the atlanto-occipital joint, medial/lateral malleoli, ankles, and knees and posterior to the hip joint.
|
|
|
C5
|
Lateral Shoulder area
Deltoid Biceps reflex |
|
|
C6
|
Lateral Arm
Thumb Brachioradialis Reflex |
|
|
C7
|
Middle of Arm
Index and Middle Fingers Triceps Reflex |
|
|
C8
|
Medial Arm
Ring and little finger |
|
|
T1, T2
|
Axillary region
Elbow |
|
|
T4
|
Nipple Ares
|
|
|
T6
|
Xiphoid Process
|
|
|
T10
|
Umbilicus
|
|
|
T12
|
Inguinal or groin area
Pubis |
|
|
L1-L4
|
Anterior and inner surfaces of lower extremities
|
|
|
L2
|
Medial Thigh
|
|
|
L3
|
Medial Knee
|
|
|
L4
|
Medial Ankle
Medial side of great toe Patellar reflex |
|
|
L4-S1
|
Foot
|
|
|
L5
|
Dorsum of Foot
|
|
|
L5-S2
|
Posterior and outer surfaces of lower extremities
|
|
|
S1
|
Lateral Margin of foot
Little toe Achilles Tendon reflex |
|
|
S2-S4
|
Perenium
|
|
|
S2
|
Poteriomedial Thigh
|
|
|
S3-S5
|
Perianal area
|
|
|
What grades of Joint Mobilization are used for the reduction of pain
|
Grades I and II
|
|
|
What is Grade I Joint Mob
|
Small Occil at beginning of range, no stress on joint capsule
|
|
|
What is Grade II joint mob?
|
High amp, rythmic occil. within the range but not to the limit of the range. Also tests the sensitivity of joint and and preserves joint play.
|
|
|
What is Grade III Joint mob?
|
High amp occil withing available motion extending to the limits of range
|
|
|
What is grade III used for
|
After pain and gaurding go away it is used for increase tissue mobility, reduce joint limitations.
|
|
|
What is grade IV used For
|
By PT only,
small occil. at limit of range |
|
|
What is Grade V Joint Mob
|
Small amp, high velocity thrust, snaps adhesions at the limit of motion.
|
|
|
What is the timing for Grade II and III Mob?
|
Smooth, Regular
2-3 per second 1-2 minutes |
|
|
What are high speed/low amp oscill for?
|
Inhibit pain
|
|
|
What are slow speed oscill for?
|
relax muscle guarding
|
|
|
What is the timing for Sustained mobilization for painful joints?
|
7-10 second intermittent distractions with a few seconds in between serveral cycles. Note response and continue or not
|
|
|
What is the timing for sustaiined mob for restricted joints?
|
6 second minimum stretch force followed by partial releases (grade I and Ii) then repeat with slow intermittent stretches and 3-4 second intervals
|
|
|
What are the absolute contraindications for Joint Mob?
|
Bacterial Infection
Neoplasm Joint Hypermobility Recent Fracture |
|
|
What are the relative contraindications for joint mob?
|
Joint Effusion
Degenerative Joint disease Rheumatooid Arthritis Osteoperosis Derangement of the joint Pregnancy |
|
|
What is the resing position of the shoulder joint for Mobilization?
|
55 Degree Abduction
30 degree Horizontal Flexion |
|
|
Convex Humeral head ________ in same direction as humerus and _____________ in opposite direction
|
Rolls
Glides |
|
|
What grade of joint mob should you begin with for shoulder joint?
|
Grade II Sustained Mobilizaition
|
|
|
What glide should you use to increase shoulder abduction?
|
Inferior/caudal glide
|
|
|
What glide should you use to increase shoulder flexion/IR?
|
Posterior Glide
|
|
|
What glide should you use to increase shoulder Extention/ER?
|
Anterior Glide
|
|
|
No motion joint (fiberous) - sutures of skull
|
Synarthroidal
|
|
|
Small motion Joint(cartilagenous)
|
Amphiarthroidal
(hyaline or fibrocartilage) |
|
|
Joint with no direct union between bones
|
Diarthroidal
|
|
|
What is a non-axial joint?
|
Movement is not around an axis
linear, angular, stairstep ex carpal bones |
|
|
What is a uniaxial joint?
|
Movement in angular pattern
hinge or pivot around on axis ex. Elbow |
|
|
What is a biaxial joint?
|
Movement around 2 planes/2 axes.
ex. wrist |
|
|
What are the 2 types of biaxial joints?
|
Condyloid - mpc joints
Saddle (sellar)- Ex. thumb |
|
|
What is a triaxial joint?
|
3 planes/axes
Shoulder |
|
|
Prime mover of muscle action
|
Agonist
|
|
|
Assisting mover, not prime, but helps
|
Synergist
|
|
|
performed opposite motion of agonist
|
Antagonist
|
|
|
antagonist and agonist contract at the same time to stablize a joint
|
Co-contractor
ex. pushups |
|
|
Prevents unwanted motion to enable one action
|
Neutralizer
Ex neutralize supination to get true elbow flexion |
|
|
Muslces that hold or support a joint to allow agonist to work more efficiently
|
Stablizer (fixator)
|
|
|
What is stress
|
Magnitude of the force or load
|
|
|
What is strain?
|
amount of deformation in response to stress
|
|
|
What is mechanical failure?
|
ex. bony fracture, skin laceration, ligament sprain, muscle strain
|
|
|
What are the types of mechanical stress?
|
Compression
Approximation Tensile forces Distraction Shear Forces |
|
|
What is compression
|
forces perpendicular to joint surface, PUSHING surfaces together
|
|
|
What is approximation
|
Moves joint surfaces Closer
THerapeutic technique |
|
|
What are Tensile FOrces
|
FOrces perpendicular - PULLING joint surfaces apart
|
|
|
What is Distraction
|
Therapeutic Technique - Separation from opposting joint surfaces
|
|
|
What are shear forces
|
Forces applied PARALLEL to structure, SLIDES one surface over another
|
|
|
What is the time line for Immobilization?
|
3 days up to 4 weeks
|
|
|
How long does it take for ligaments to heal?
|
2-12 months
|
|
|
What is a grade I Ligament damage?
|
Less than 50% damage to fibers with no clinical instability
|
|
|
What is grade II Ligament Damage?
|
Damage to more than 50% of fibers with clinical instability and may or may not need surgery depending on function
|
|
|
What is grade III Ligament damage
|
Complete disruption of supporting structure fibers with pathological instability and usually need surgical repair
|
|
|
What is the time line for bone repair?
|
callus 6-8 weeks
heals in 1 year |
|
|
What are bones made of?
|
Cartilagenous foundation
Calcium crystals |
|
|
What is ossification?
|
Calcium crystals form in a cartilagenous network forming bone
|
|
|
What is endochondral growth
|
New bone deposits are made at the END OF LONG BONES
Growth LOGITUDINALLY |
|
|
What is membraneous growth of bone?
|
New bone deposists are added to INNER MEMBRANEOUS LAYER
Growth CIRCUMFIRALLY |
|
|
What is osteoperosis?
|
reduction of bone mass enough to interfere with mechanical support of the bone
|
|
|
What is wolfes law?
|
remodling of bone in response to physical stress placed on bone.
|
|
|
What is needed for response to exercise for increasing bone mass?
|
Weight bearing
Intense Activity |
|
|
What is the time line for muscle healing?
|
4-8 weeks to 4-6 months
|
|
|
What is the time line for tendon healing?
|
10 days to 6 months.
|
|
|
What does collagen do?
|
Resist Tensile Loads
|
|
|
What do elastin fibers do?
|
provide extensibility and flexibility
|
|
|
What to reticulin fibers do?
|
bulk of the fiber
|
|
|
What are the phases of tissue healing?
|
Acute (inflammation-reaction)
Subacute (fibroplastic-repair-healing) Chronic (maturation and remodling) |
|
|
What happens and low long is Acute stage?
|
Cleansing, restoring blood flow
48-96 hours following injury INFLAMMATION-REACTION |
|
|
What happens and how long is Subacute stage?
|
Production of Collagen and Glycoaminoglycan (GAG), mobile scar
4 Days to 3 Weeks FIBROPLASTIC -REPAIR-HEALING |
|
|
What happens and low long is Chronic Stage of healing?
|
Fits new scar tissue to the surrounding tissue
Inflammation resolved 3 weeks to 3+ months Theraputic interventions applied (mobilization, weight bearing, range of motion) MATURATIN AND REMODLING |
|
|
How long does inflammation last?
|
24-48 hours to two weeks
|
|
|
When does scar tissue start?
|
2-4 days to mature scar 60 to 360 days.
|
|
|
What is the normal soft end feel?
|
between soft tissues
Ex. Knee flexion against post thigh |
|
|
What is the normal firm end feel?
|
stretch of muscle/ligaments
Ex. knee extension touching toes |
|
|
What is the normal Hard end feel?
|
Bone contacs bone
Ex. Elbow flexion |
|
|
What is the Path soft end feel?
|
occurs before end of range
ex. edema |
|
|
What is path firm end feel?
|
before end of range as is spasticity and contractures
|
|
|
What is path hard end feel?
|
before normal end range
ex. chondromalacia and osteoarthritis. |
|
|
What is path empty end feel?
|
before normal end range
ex. joint inflammation, bursitis, and fracture as result of GUARDING due to PAIN |
|
|
Capsular pattern jonit restrictions?
|
specific joint with specific motion
ex. restrictin of elbow flexion compared to elbow extension |
|
|
Non-capsular Pattern?
|
not in joint capsule
Range limitation due to pain may affect only one joint motion |
|
|
closed packed postion
|
maximal joint surface congruency
|
|
|
Loose packed
|
Resting position
joint surfaces non-congruous |
|
|
What are two conditions of concave-convex law?
|
Roll and glide are same when tibia moving (concave moving on convesx
Roll and glide are opposite when femur moving (convex moving on concave) Concave tib moves the same way Convex femur rotates (rolls) opposite of its own shaft. |
|
|
What is overload?
|
overload to produce strength
|
|
|
What is SAID principle?
|
Specific
Adaptation to Imposed Demands |
|
|
Reversibility principle
|
use it or lose it
|
|
|
What are Type I Fibers?
|
Red/Tonic - slow twitch oxidative (SO)
Low level of tension for long time Ex. postural muscles |
|
|
What are Type II Fibers?
|
White -Phasic
Fast Twitch glycolytic (FG) Burst of tension to lift body weight or to lift, lower, push or pull heave load Fatigues quickly |
