Your SlideShare is downloading. ×
  • Like
Mobility Intro Lect I
Upcoming SlideShare
Loading in...5

Thanks for flagging this SlideShare!

Oops! An error has occurred.


Now you can save presentations on your phone or tablet

Available for both IPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Mobility Intro Lect I



Published in Spiritual , Technology
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
No Downloads


Total Views
On SlideShare
From Embeds
Number of Embeds



Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

    No notes for slide


  • 1. Manual Mobilization Of The Extremity Joint Introduction
  • 2. Manipulation vs. Mobilization
  • 3. Manipulation
    • Orthopedic Sec. APTA
      • Any manual procedure used for the purpose of examination , correction or modification of an articular or soft tissue dysfunction.
    • Paris
      • The skilled passive movement to a joint, either within or beyond its active limited motion.
    • Maitland
      • A sudden small amplitude thrust delivered at a speed which renders the patient powerless to prevent it
  • 4.
    • Defined APTA
      • The act of imparting movement, either actively or passively, to joints or soft tissue structures.
    • Maitland
      • Passive oscillatory movements or sustained stretch at the limit of range using graded amplitude movements.
    • Kaltenborn
      • Component of MT referring to any procedure that increases the mobility of joints or ST structures
  • 5. History & School Of Thought
    • James Cyriax
    • John Mennell
    • Freddie Kaltenborn
    • Geoffrey Maitalnd
    • Stanley Paris
  • 6. James Cyraix
    • Concept of end feel
    • Examination by selective tissue tension
    • Friction Massage
  • 7. John Mennell
    • Concept of joint dysfunction
      • loss of accessory or joint play movement
    • Jt. dysfunction as pain- producing entity, causing loss of movement
    • Jt dysfunction is detected by passive movement. Normal passive movement is pain free.
  • 8. Freddy Kaltenborn
    • Norwegian School- biomechanical model
    • Applied the works of MacConnell to joint mobilization
      • Concave /Convex rule
      • Open/ Closed Pack Position
    • Focus is on movement taking place within the joint capsule
  • 9. Freddy Kaltenborn
    • Brought into play the arthrokinematic and osteokinematic relationship of joint movement.
    • The osteokinematic and arthrokinematic at a specific joint may be the same, opposite direction.
      • eg. Shoulder abduction
  • 10. Geoffrey Maitland
    • Deviated from biomechanical model
      • Advocating treatment of painful joints by oscillating passive movement that provide
        • Neurophysiological therapeutic
        • Mechanical therapeutic
    • Implemented the grading system
  • 11. Stanley Paris
    • Focus is on Hypomobility
    • Define joint dysfunction as “ a state of altered mechanics either increased or decreased from the expected normal motion.
    • Grade scale from 0-7
      • 0 no mobility
      • 3 is normal
      • 6 &7 unstable
  • 12. Terminology
  • 13. Terminology
    • Kinematics:
      • Study of movement
    • Osteokinematic:
      • Overall movement of bone
    • Arthrokinematic
      • Movement of one articular surface in relation to it partner- roll, glide, spin
  • 14. Bone Rotation ( roll-gliding )
    • All bone movements occur around an axis.
    • From a mechanical viewpoint are considered to be rotation or spin
    • In normal joints all active movements produce joint roll-gliding
      • Exception planar joints
  • 15. Roll, Slide , Spin
    • Roll: Movement in which points at interval on the moving JT, surface contacts points at the same intervals on the opposite surface.
    • Slide. Movement in which a single point on the moving surface contacts various points on the opposing surface.
    • Spin. Type of slide that accompanies spin of a bone . 1/2 of the jt surface slides in one direction while the other 1/2 slide the opposite direction.
  • 16. Distraction / Compression
    • Distraction: Separation of joint surfaces
    • Compression: Approximation of joint surfaces- moving toward close pack position.
  • 17. Accessory Movements
    • Those movements which accompany the physiological movements and are necessary for normal function, but not under voluntary neuromuscular control
  • 18. Categories Of Accessory Movements
    • Joint Play
    • Component
  • 19. Joint Play Movement
    • Movement that can be produced passively at a joint but cannot be isolated actively.
    • Spin, roll, glide, compression, & distraction
    • Joint play movements are used when applying specific mobilization techniques to restore accessory movements so that full & painless osteokinematic movement may return. ( eg . Inferior distraction of the shoulder)
  • 20. Component Motion
    • A type of accessory movement that is directly associated with the production of osteokinematic movement or motion that takes place in a joint complex or related joint to facilitate a specific active motion
      • Example: at glenohumeral Jt.
        • Inferior and posterior glide of humeral head to produce flexion of the shoulder (humerus)
  • 21. Closed & Open Pack Positions
    • Closed Pack Criteria:
      • Jt. Maximally congruent
      • Jt caps. & ligs. are twisted
      • Jt becomes locked in position
    • Open Pack Criteria
      • Lig & caps are slack
      • Jt surfaces distracted
      • Movements of roll slide are allowed
  • 22. End Feel
    • Refers to the nature of movement limitation experienced by the examiner
      • Assessment of joint play
    • It is the sensation imparted to the examiner’s hands during passive movement of a joint at end range