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 n 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 rollslide joint mechanics can occur as a person moves. The speed and amplitude which applied may vary. n

Examples of Mobilization!!!!!

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

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

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

Indications for Joint Mobilization n n 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 n Joint Effusion n Inflammation n

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

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

Example of Grade I and V n Shoulder (posterior/inferior/anterior glide) Oscillations n http: //www. bing. com/videos/search? q=shoulder+mobilizations&view =detail&mid=A 12 A 5 B 8 D 01186 B 5562 B 2 &first=0&FORM=LKVR 14 n Ankle (talocrural Joint) Thrust n http: //www. bing. com/videos/search? q=grades+of+mobilizations&vie w=detail&mid=48 B 740 EF 882 B 77 EF 0670 &first=0&FORM=LKVR 2

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

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)