Mobility Intro Lect I
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Transcript

  • 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
    Mobilization
  • 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