Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Kaltenborn manual mobilization srs

19,583 views

Published on

Kaltenborn Manual Mobilization

Published in: Education
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (Unlimited) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://shorturl.at/krvUW } ......................................................................................................................... Download Full EPUB Ebook here { http://shorturl.at/krvUW } ......................................................................................................................... Download Full doc Ebook here { http://shorturl.at/krvUW } ......................................................................................................................... Download PDF EBOOK here { http://shorturl.at/krvUW } ......................................................................................................................... Download EPUB Ebook here { http://shorturl.at/krvUW } ......................................................................................................................... Download doc Ebook here { http://shorturl.at/krvUW } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Kaltenborn manual mobilization srs

  1. 1. Kaltenborn Manual Mobilization Sreeraj S R
  2. 2. Kaltenborn – Evjenth Orthopedic Manipulative Therapy (OMT) • Kaltenborn Techniques Kaltenborn’s techniques use a combination of traction and mobilization to reduce pain and mobilize hypomobile joints According to Kaltenborn, all joint mobilizations, when performed correctly should be made parallel, or at right angles Sreeraj S R performed correctly should be made parallel, or at right angles to this plane of motion • Maitland's grades of joint mobilization differ from Kaltenborn's because they are oscillations while Kaltenborn's are sustained. http://quizlet.com/2850456/joint-mobs-maitland-vs-kaltenborn-flash-cards/ 2
  3. 3. Two types of bone movements are important in OMT system: Sreeraj S R Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 1: Extremity Joint Movement: p. 24 3
  4. 4. • A common goal in OMT is to restore the gliding component of roll-gliding to normalize movement mechanics. • Joint rolling movements in the absence of gliding can produce a damaging concentration of forces in a Sreeraj S R produce a damaging concentration of forces in a joint. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 1: Extremity Joint Movement: p. 29 4
  5. 5. The Kaltenborn Treatment Plane • passes through the joint and lies at a right angle to a line running from the axis of rotation in the convex bony Sreeraj S R the convex bony partner, to the deepest aspect of the articulating concave surface. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 32 5
  6. 6. The Kaltenborn Treatment Plane • remains with the concave joint surface whether the moving joint partner is concave or convex. Sreeraj S R • Always test joint play or mobilize a joint by moving the bone parallel to, or at a right angle to, the Kaltenbom Treatment Plane. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 32 6
  7. 7. Translatoric joint play movements • The translatoric joint play movements used in the OMT Kaltenbom-Evjenth System are • Traction, • Compression, and Gliding. Sreeraj S R • Gliding. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 33 7
  8. 8. Traction Compression Gliding Sreeraj S R Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 33-34 8
  9. 9. Determining the direction of restricted gliding • There are two methods of determining the direction of restricted joint gliding: 1. The glide test, and 2. The Kaltenborn convex concave rule . Sreeraj S R Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 34 9
  10. 10. Glide test • It is the direct method • Apply passive translatoric gliding movements in all possible directions and determine in which directions joint gliding is restricted. • The glide test is the preferred method because it Sreeraj S R • The glide test is the preferred method because it gives the most accurate information about the degree and nature of a gliding restriction, including its end-feel. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 34 10
  11. 11. Kaltenborn Convex-Concave Rule • the indirect method Sreeraj S R Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 35 11
  12. 12. Grades of translatoric movement • The translatoric movements of traction and gliding are divided into three grades. • These grades are determined by the amount of joint slack (looseness and resistance) in the joint • The slack is taken up when testing and treating joints with gliding or traction. Sreeraj S R with gliding or traction. • When gliding is performed, the slack is taken up in the direction of joint gliding; • when traction is performed, the slack is taken up in the direction of traction. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 36 12
  13. 13. Normal grades of translatoric movement • In the Grade I and II SZ range the therapist senses little or no resistance. • In the Grade II TZ range the therapist senses gradually increasing resistance. Sreeraj S R increasing resistance. • At the First Stop, the therapist senses marked resistance as the slack is taken up and all tissues become taut. • Stretching occurs beyond this point. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 37-38 13
  14. 14. Pathological grades of translatoric movement Sreeraj S R Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 39 14
  15. 15. Using translatoric grades • Grade I (loosen): relief pain • Grade II (tighten): initial treatment, maintain joint play • Grade III (stretch): stretch joint and increase joint play Sreeraj S R play 1. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006.Chapter 2: Translatoric joint play: p. 40 2. http://sunrise.hk.edu.tw/~stpt/languagetherapy/therapeutic/teacher/Introduction%20of%20manual%20therapy.pdf 15
  16. 16. Tests of function • Tests of function are a key element within the OMT evaluation; • Assessing quantity of movement Assessing quality of movement Sreeraj S R • Assessing quality of movement Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 42-46 16
  17. 17. Quantity of Movement Sreeraj S R Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 42 17
  18. 18. Quality of Movement Sreeraj S R 1. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 45 2. Petersen CM, Hayes KW. Construct Validity of Cyriax's Selective Tension Examination: Association of End-feels With Pain at the Knee and Shoulder. Journal of Orthopaedic & Sports Physical Therapy 2OOO;3O (9) :5 12-527 18
  19. 19. Quality of Movement Normal End Feel • Soft: characteristic of soft tissue approximation. Feels like squeezing two balloons together. e.g., knee flexion. • Firm: indicates that the joint capsular or ligamentous stretching limiting the ROM. Feels like stretching a leather Sreeraj S R stretching limiting the ROM. Feels like stretching a leather belt. A normal ligamentous end-feel > capsular end-feel. • Hard: indicates that bone touching bone is limiting the ROM. Feels like pushing two wooden surfaces together. e.g., elbow extension. 1. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 45 2. http://www.scranton.edu/faculty/kosmahl/courses/gonio/intro/end-feel.shtml 19
  20. 20. Quality of Movement Pathological end-feel • Boggy: intra-articular swelling produces a soft resistance • Springy: For example, a displaced meniscus Empty: Pain Sreeraj S R • Empty: Pain • Firmer, less elastic: scar tissue, shortened connective tissue • More elastic and less soft end-feel: muscle spasm Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 46 20
  21. 21. Elements of function testing • Standard (anatomical) movements • Combined (functional) movements • Painful arc • Capsular pattern Differentiating Contractile lesions from Sreeraj S R • Differentiating Contractile lesions from Non contractile lesions • Differentiating muscle shortening from muscle spasm Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 46-51 21
  22. 22. Differentiating Contractile lesions from Non contractile lesions Contractile Non contractile Muscle with its tendons and attachments Bones, joint capsules, ligaments, bursae, Fasciae, nerve roots Active and passive movements are restricted in opposite directions. Active and passive movements are restricted in the same direction. Sreeraj S R restricted in opposite directions. restricted in the same direction. Passive joint play movements are normal and symptom free. Passive joint play movements produce or increase symptoms and are restricted. Resisted movements produce or increase symptoms. Resisted movements are symptom free. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 50 22
  23. 23. Differentiating muscle shortening from muscle spasm • Based on end-feel testing. • A shortened, tight muscle imparts a firmer, less elastic end-feel • Muscle spasm produces a more elastic and less soft end-feel. Sreeraj S R end-feel. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 51 23
  24. 24. Translatoric joint play tests • Testing the quantity and quality of joint play, including end feel, using • Traction, • Compression, and Gliding Sreeraj S R • Gliding • In all of the translatoric directions in which a joint is capable of moving. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 51-52 24
  25. 25. Traction and compression tests Traction Compression Relieves joint pain Aggravates joint pain If traction tests is positive in the normal resting position, find a position of greater comfort and reevaluate the patient's response to traction. If compression tests are negative, the tests should also be performed in various three-dimensional positions. Sreeraj S R response to traction. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 52 25
  26. 26. Gliding tests • Translatoric gliding primarily tests those structures belonging to the anatomical joint. • Also important for determining the specific directions of joint movement restrictions. Sreeraj S R directions of joint movement restrictions. • Evaluates gliding movement both in the joint's resting and non resting positions. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 52 26
  27. 27. Resisted movements • If compression tests provoke pain, resisted tests are of limited Value. • Resisted tests evaluate • neuromuscular integrity, • contractile elements and • status of associated joints, nerves, and vascular supplies. • Cyriax interprets resisted tests in the following ways: Sreeraj S R Cyriax interprets resisted tests in the following ways: Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 52 Painful and strong : minor lesion of a muscle or tendon Painful and weak : major lesion of a muscle or tendon Painless and weak : neurological lesion or complete rupture of a muscle or tendon Painless and strong : normal 27
  28. 28. Differential diagnosis for pain in a muscle synergy • To identify a specific muscle responsible for a patient's pain, the examiner selectively elicits or prevents contraction of a specific muscle or group of muscles. There are three methods described below. 1. Testing a muscle's secondary function in the Sreeraj S R 1. Testing a muscle's secondary function in the same joint. 2. Testing a muscle's secondary function at an adjacent joint 3. Testing using reciprocal inhibition Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 53-54 28
  29. 29. Testing a muscle's secondary function in the same joint • If one muscle in a joint movement synergy has a secondary function not shared by the other muscles in the synergy, it can be selectively tested. For example, • if resisted knee flexion is painful, further examination of resisted lateral and medial leg rotation may Sreeraj S R of resisted lateral and medial leg rotation may identify the specific muscle causing the pain. If lateral rotation is painful and medial rotation is not, then it is likely that the biceps femoris is injured and not the other knee flexors which medially rotate the leg. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 54 29
  30. 30. Testing a muscle's secondary function at an adjacent joint • A muscle or tendon can be selectively stressed if it is the only muscle in a synergy which functions at another joint. For example, • pain with resisted shoulder flexion can be due to a lesion in one of several muscles in a synergy Sreeraj S R lesion in one of several muscles in a synergy producing this movement. If resisted elbow flexion produces the same pain, then the biceps is implicated as it is the only muscle which can produce both shoulder and elbow flexion. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 54 30
  31. 31. Testing using reciprocal inhibition • This technique uses to prevent a muscle from contracting in synergy with other muscles during a movement by resisting the antagonist of the muscle. For example, Sreeraj S R • To eliminate the wrist extensors and test the finger extensors, the examiner resists palmar flexion at the wrist and finger extension simultaneously; the resisted wrist palmar flexion will inhibit contraction of the wrist extensors. Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 54 31
  32. 32. Indications • Restricted joint play (hypomobility) • An abnormal end-feel Sreeraj S R Kaltenborn FM. The Extremities Volume 1. 6th Edition. Norli, Norway; 2006. Chapter 3: Tests of Function: p. 59 32
  33. 33. Absolute Contraindications • Malignancy in area of treatment • Infectious Arthritis • Metabolic Bone Disease • Neoplastic Disease • Fusion or Ankylosis Sreeraj S R • Fusion or Ankylosis • Osteomyelitis • Fracture or Ligament Rupture • excessive joint play (hypermobility) for grade III mobilization http://www.physio-pedia.com/images/c/c0/Principles_of_Joint_Mobilization.pdf 33
  34. 34. Relative Contraindications • Excessive pain or swelling • Arthroplasty • Pregnancy • Hypermobility Spondylolisthesis Sreeraj S R • Spondylolisthesis • Rheumatoid arthritis • Vertebrobasilar insufficiency http://www.physio-pedia.com/images/c/c0/Principles_of_Joint_Mobilization.pdf 34
  35. 35. THANK YOU Sreeraj S R will be continued @ the Practical…. 35

×