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Describe the fundamental task of Maitland joint mobilizations
Examiner feels for abnormal resistance to motion and monitors for any symptoms
Assess and reassess
What type of principles influenced Maitland's philosophy?
Neurophysiologic principles relating to pain
Describe the fundamental task of Kaltenborn joint mobilizations
Examiner feels for abnormal resistance to motion with emphasis on end-feel testing
What type of principles influenced Kaltenborn's philosophies?
Joint based, mechanical approaches
MAIN goals of joint mobilizations (2)
Restore joint play by normalizing roll and glide of movements
Modulate pain to restore normal, painless joint function
Relate the treatment plane for joint mobs with the convex/ concave surface of joints
Treatment plane always relates to concave surface, regardless whether moving joint partner is concave or convex
What numerical system is used to identify Maitland joint mob grades?
Roman numerals
How are Maitland joint mobs applied?
Uses oscillatory movements of different amplitudes applied at different parts of the ROM
Describe the amount of motion delivered in a grade I Maitland joint mob. Do we encounter resistance?
Small amplitude at the beginning of range
No tissue resistance encountered
How do grade I Maitland joint mobs reduce pain and enhance relaxation?
Via neurophysiological effects
Describe the amount of motion applied in a grade II Maitland joint mob. Do we encounter resistance?
Large amplitude oscillation from near beginning to midrange.
If you reach resistance, you have gone too far.
How do grade II Maitland joint mobs reduce pain?
Via neurophysiological effects (same as grade I)
Reasons to use grades I and II Maitland joint mobs (3)
Maintain (not increase) joint mobility
Promote tissue healing
Provide pain relief
How do small oscillatory movements (grades I and II) modify pain signals?
Stimulate mechanoreceptors that modify pain via descending inhibition of nociceptive transmission in SC
Do grades I and II joint mobs excite the system centrally or distally?
Hypothesized to be mediated centrally via brainstem
Should grades I and II joint mobs place a stretch on the reactive tissues?
No
Examples of times when grades I and II would be useful joint mobs (3)
Active inflammation of joint
Post-operatively
When you can't add stretch to an area
What grade is the most common Maitland joint mob to perform?
Grade III
Describe the movements of the grade III Maitland joint mob. Do we encounter resistance?
Large amplitude oscillation from mid -> end range
Hits end range abruptly
Taken into tissue resistance
Describe the movements of the grade IV Maitland joint mob. Do we encounter resistance?
Small amplitude oscillations at end range into tissue resistance
Grades III and IV Maitland joint mobs have this sort of effect on joints
Mechanical effect
What symptoms are grades III and IV joint mobs meant to treat?
Stiffness (III and IV)
Stretching of capsular lesions (III) (disruption of adhesions)
What type of joints receive grades III and IV Maitland joint mobs?
Joints with hypomobility and/or periarticular capsular restrictions
Main goal of grades III and IV Maitland joint mobs
Increase joint mobility
Describe the movement of a grade V Maitland joint mob. What do we feel?
Small amplitude thrust beyond end range
Do grade V Maitland joint mobs use a neurophysiologic or mechanical effect?
Mechanical effect
Primary purpose of grade V Maitland joint mob
Used for stiffness and pain control
Nickname for grade V Maitland joint mobs
Manipulations
