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What is physiologic motion (osteokinematics)?

movement between 2 bones: flexion, extenion, abduction, adduction,etc, often limited by muscle length or fascia

what is accessory motion (arthrokinematics)?

movement between 2 joint surfaces: spinning, rolling and gliding (translation), limited by ligaments or joint capsules

Describe the Convex-Concave Rule

the relationship between osteokinematics and arthrokinematics,

when a convex surface is moving, gliding occurs in the ___________ direction of bone movement.

opposite

when the concave surface is moving, gliding occurs in the_________ direction as bone movement

same

list the indications for joint mobilization

Increasing accessory motion available at the joint, increasing joint nutrition to the articular surfaces, and pain control via counterirratant theory, stimulation of mechanoreceptors causes release of endorphins in the spinal cord that inhibit pain signal transmission to the brain

general rule for performing joint mobs

patient must be relaxed, (positioning for comfort and support, temperature)

general rule for performing joint mobs

therapist must be relaxed, (good body mechanics and let gravity help)

general rule for performing joint mobs

hondholds should be firm but comfortable

general rule for performing joint mobs

do not move into pain, there is a difference between discomfort of soft tissues stretch and pain with muscle gaurding

general rule for performing joint mobs

both the stabilizing force and the mobilizing fore should be as close to the joint surface as possible for good control

general rule for performing joint mobs

motion should be assessed by comparing it to the corresponding joint on the other side of the body when possible

general rule for performing joint mobs

assess joint movement in the loose-packed postion when possible

general rule for performing joint mobs

each technique is used both evaluation and treatment

general rule for performing joint mobs

never mobilize a joint in the close-packed positon

close-packed position of GH joint

full ABD and ER

loose packed position of GH joint

55-70 degrees ABD, 30 degrees HADD, 0 degrees ROT

close-packed postion of Humeroulnar joint

full EXT & SUP

loose packed position of Humeroulnar joint

70 degrees FLEX, 10 degrees SUP

close packed position of Humeroradial joint

90 degrees FLEX, 5 degrees SUP

loose packed position of Humeroradial joint

full EXT,& SUP

close packed postion of Prox. Radioulnar joint

5 degrees SUP, full EXt

loose packed postion of Prox. Radioulnar joint

70 degrees FLEX, 35 degrees SUP

close packed positon of Distal Radioulnar joint

5 degrees SUP

loose packed postion of Distal Radioulnar joint

10 degrees of SUP

close packed position of Radiocarpal joint

full EXT & radial deviation

loose packed postion of Radiocarpal joint

neutral with slight ulnar deviation

close packed postion of 1st MCP joint

full EXT

loose packe postion of 1st MCP joint

slight FLEX

close packed postion of 2nd-5th MCP joint

full FLEX

loose packed postion of 2nd-5th MCP joint

slight FLEX

close packed postion of IP ( hand)

full EXT

loose packed postion of IP (hand)

slight FLEX

close packed postion of Hip Ligamentous

full EXT, ABD,&IR

loose packed postion of Hip LIgamentous

30 degrees FLEX, 30 degrees ABD, slight ER

closed packed postion of Hip bony joint

90 degrees FLEX, slight ABD & ER

loose packed postion of Hip bony joint

30 degrees FLEX, 30 degrees ABD, slight ER

close packed postion of Patellofemoral joint

full FLEX

loose packe postion of Patellofemoral joint

full EXt

close packed postion of Tibiofemoral joint

full FLEX & ER

loose packed postion of Tibiofemoral joint

25 degrees FLEX

close packed postion of Talocrural joint

full dorsiflexion

loose packed postion of Talocrural joint

10 degrees plantarflexion

closed packed postion of MTP;s joint

full EXt

loose packed postion of MTP's joint

neutral

close packed postion of IP (foot) joint

full EXT

loose packe postion of IP (foot) joint

slight FLEX

Close-Packed:__________ contact between joint surfaces

maximal

Loose-packed /Resting postion: ____________ joint surfaces contact, and joint capsule is relaxed/slackened; postion of ___________ accessory motion available

minimal, maximal

Absolute contraindications for performing joint mobilization

any undiagnosed lesion, joint ankylosis(frozen), and joint hypermobility, if the technique pushes into resistance

relative contraindication

an infection in the area being treated

relative contraindication

malignancy in the area being treated

relative contraindication

an unhealed fx in the area being treated

relative contraindication

inflammatory arthritis in th area being treated, esp. if in a state of exacerbation

relative contraindication

metabolic bone diseases, such as osteoporosis, Paget's disease, and tuberculosis

relative contraindication

RA

relative contraindication

considerable joint effusion in the area, since it is difficult to obtain an accurate assessement of joint extensibility when swelling has taken up the slack in the joint capsule

relative contraindication

considerable joint irritability

relative contraindication

protective muscle spasm to the extent that the clinician is unable to assess mobility

0 grading of accessory joint motion

Ankylosed

1= grading of accessory joint motion

considerable hypomobility

2= grading of accessory joint motion

slight hypomobility

3= grading of accessory joint motion

Normal

4= grading of accessory joint motion

slight hypermobility

5= grading of accessory joint motion

considerable hypermobility

6= grading of accessory joint motion

unstable

grading of treatment techniques =1

Small amplitude oscillation, beginning of the range (no resistance)

grading of treatment techniques =2

Large amplitude oscillation midrange (no resistance)

grading of treatment techniques =3

Large amplitudes oscillation , into resistance

grading of treatment techniques =4

Small amplitude oscilation, to end of passive range

grading of treatment techniques=5

High velocity manipulation past the end of passive range

grades 1 and 2 can be used for

pain reduction and increased joint nutrituon

grades 3 and 4 are used to

increase joint accessory motion

GH distal moving bone is ________ and the shape is _________ gliding in ______ direction

humerus, convex, opposite

Humeroradial distal moving bone is_________ shape is _______ gliding direction is _________

radius, concave, same

Humeroulnar distal moving bone is __________ shape is __________ gliding direction is________________

ulnar, concave, same

Prox. Radioulnar distal moving bone is_________ shape is ________ gliding direction is ________

radius, convex, oppostie

Distal Radioulnar distal moving bone is ___________ shape is _________________ gliding direction is______________________

radius, concave, same

Radiocarpal distal moving bone is __________ shape is ____________ gliding direction is _________

carpal, convex, oppostie

Metacarpophalangeal distal moving bone is _____________ shape is _________ gliding direction is _________

prox. phalanx, concave, smame

Prox. Interphal distal moving bone is_________ shape is __________ gliding direction is____________

IP , concave, same

Distal Interphal distal moving bone is _________ shape is ________ gliding direction is________

DIP , concave, same

Hip distal moving bone is _______ shape is ________ gliding direction is_________

femur, convex, oppostie

Tibiofemoral distal moving bone is__________ shape is___________ gliding direction is__________

Tibia, concave, same

Talocrural distal moving bone is ________ shape is ________ gliding direction is_______

Talus, convex, opposite

Metatarsophalangeal distal moving bone is______________ shape is ____________ gliding direction is ________

Prox. phalanx, concave, same

IP (foot) distal moving bone is______ shape is_______ gliding direction is__________

distal phalanx, concave, same

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