Peripheral Joint Mobilization / Manipulation

These flashcards cover key concepts related to peripheral joint mobilization and manipulation, as outlined in the lecture notes.

How does the APTA define the scope of joint mobilization and manipulation?

According to APTA, spinal and peripheral joint mobilization/manipulation and dry needling are components of manual therapy performed exclusively by physical therapists.

What is joint mobilization?

Joint mobilization is a passive manual therapy technique using variable amplitude and velocity movements to reduce pain and improve joint mechanics by addressing altered arthrokinematics.

What is osteokinematics?

Osteokinematics describes the gross angular motion of bones during movement, including flexion, extension, abduction, adduction, and rotation.

What is arthrokinematics and why does it matter?

Arthrokinematics refers to roll, slide, and spin motions at joint surfaces, which are critical for normal osteokinematic motion and treating stiffness.

What is the concave–convex rule?

The concave–convex rule guides mobilization direction, with convex moving on concave rolling and sliding opposite and concave moving on convex rolling and sliding in the same direction.

What is the loose-packed position?

The loose-packed position is the resting position where joint surfaces are least congruent, making it ideal for initial mobilization.

What are Maitland grades I–IV used for?

Grades I–II address pain while Grades III–IV address stiffness and mobility at end range.

What accessory motions influence joint mechanics?

Accessory motions include traction, distraction, and compression, which influence pain and mobility.

What are Kaltenborn traction grades?

Grade I reduces compression, Grade II takes up slack, and Grade III stretches periarticular tissues.

What limits the use of joint mobilization?

Contraindications include fracture, infection, malignancy, inflammatory arthritis, osteoporosis, and hypermobility.

What are the primary clinical indications for peripheral joint mobilization?

Indications include joint hypomobility, pain limiting motion, capsular restrictions, post-immobilization stiffness, and functional movement limitations.

What are the primary goals of joint mobilization from a functional standpoint?

The goals include decreasing pain, improving joint mobility, restoring normal arthrokinematics, and enabling improved functional performance.

How does joint mobilization help reduce pain from a neurophysiological perspective?

Low-grade oscillatory mobilizations stimulate joint mechanoreceptors, inhibiting nociceptive input and reducing pain perception.

How do higher-grade mobilizations improve joint mobility mechanically?

They stretch the joint capsule and periarticular connective tissues, restoring accessory motion necessary for full osteokinematic movement.

What is joint play and why is it assessed before mobilization?

Joint play refers to passive accessory movements available within a joint, and assessing it helps identify hypomobility and determine the direction of restriction.

What are common joint end feels and their clinical significance?

Capsular end feel suggests tightness; empty end feel may indicate pain; bony end feel suggests bone-to-bone contact; muscle spasm indicates guarding.

What dosage variables are considered when prescribing joint mobilization?

Dosage variables include mobilization grade, amplitude, frequency, duration, sets, rest intervals, and patient irritability.

How does irritability influence grade selection?

Highly irritable joints receive low-grade mobilizations for pain relief, while less irritable, stiff joints may tolerate higher-grade mobilizations.

Why is patient positioning important during joint mobilization?

Proper positioning ensures patient comfort, safety, and accurate application of accessory motion.

Why is stabilization critical during mobilization?

Stabilization isolates the intended joint surface motion and prevents substitution from adjacent segments.

What safety factors must be screened before performing joint mobilization?

Screen for acute inflammation, joint effusion, fracture, infection, severe osteoporosis, and other conditions that may compromise safety.

What is the PTA’s role in joint mobilization interventions?

The PTA may perform joint mobilization techniques under PT delegation and facility policy.

What techniques are outside the PTA scope of practice?

Grade V thrust manipulations, independent evaluation, and unsupervised progression of manual techniques are outside the PTA scope.

How does an inferior glide of the humeral head improve shoulder abduction?

The convex humeral head rolls superiorly and glides inferiorly on the concave glenoid, facilitating abduction.

How does a posterior talar glide improve ankle dorsiflexion?

During dorsiflexion, the convex talus rolls anteriorly and glides posteriorly, so a posterior glide improves range.