- 1. Manual Mobilization Of The Extremity Joint Introduction
2. Manipulationvs. Mobilization 3. Manipulation
-
- Any manual procedure used for the purpose of examination ,
correction or modification of an articular or soft tissue
dysfunction.
-
- The skilled passive movement to a joint, either within or
beyond its active limited motion.
-
- A sudden small amplitude thrust delivered at a speed which
renders the patientpowerless to prevent it
4.
-
- The act of imparting movement, either actively or passively, to
joints or soft tissue structures.
-
- Passive oscillatory movements or sustained stretch at the limit
of range using graded amplitude movements.
-
- Component of MT referring to any procedure that increases the
mobility of joints or ST structures
Mobilization 5. History & School Of Thought
6. James Cyraix
- Examination by selective tissue tension
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
-
- 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 arthrokinematicat a specific joint may
be the same, opposite direction.
10. Geoffrey Maitland
- Deviated from biomechanical model
-
- Advocating treatment of painful joints by oscillating passive
movement that provide
-
-
- Neurophysiological therapeutic
- Implemented the grading system
11. Stanley Paris
- Define joint dysfunction as a state of altered mechanics either
increased or decreased from the expected normal motion.
12. Terminology 13. Terminology
-
- 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
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 ofjoint surfaces- movingtoward close
pack position.
17. Accessory Movements
- Those movements which accompany thephysiologicalmovements and
are necessary for normal function, but not undervoluntary
neuromuscularcontrol
18. Categories Of Accessory Movements
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 sothat 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
-
- Jt caps. & ligs. are twisted
-
- Jt becomes locked in position
-
- Movements of roll slide are allowed
22. End Feel
- Refers to the nature of movement limitation experienced by
theexaminer
- It is the sensation imparted to the examiners hands during
passive movement of a joint at end range