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UE Accessory Motions

Terms in this set (52)

Accessory motions to increase shoulder flexion
GH lateral distraction, GH inferior glide, GH posterior glide, SC inferior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder extension
GH lateral distraction, GH anterior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder abduction
GH lateral distraction, GH inferior glide, GH anterior glide, SC inferior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder adduction
GH lateral distraction, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder scaption
GH lateral distraction, GH inferior glide, SC inferior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder external rotation
GH lateral distraction, GH anterior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder internal rotation
GH lateral distraction, GH posterior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder horizontal abduction
GH lateral distraction, GH anterior glide, SC posterior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder horizontal adduction
GH lateral distraction, GH posterior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase shoulder retraction
GH lateral distraction, SC posterior glide, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase all shoulder motions
GH lateral distraction, AC anterior/inferior & posterior/superior glide, and scapular distraction/glides
Accessory motions to increase elbow flexion
Humeroulnar joint distraction, radial head anterior glide
Accessory motions to increase elbow extension
Humeroulnar joint distraction, radial head posterior glide, radiohumeral joint distraction
Accessory motions to increase elbow supination > pronation
Humeroulnar joint distraction, radial head anterior glide (ulnomeniscotriquetral volar glide also supports supination)
Accessory motions to increase elbow pronation > supination
Humeroulnar joint distraction, radial head posterior glide
Accessory motions to increase all elbow motions
Humeroulnar joint distraction
Accessory motions to increase wrist flexion
Radiocarpal joint distraction, radiocarpal joint dorsal glide, radiohumeral joint distraction, (also intercarpal dorsal glides)
Accessory motions to increase wrist extension
Radiocarpal joint distraction, radiocarpal joint volar glide, (also intercarpal volar/palmar glides)
Accessory motions to increase wrist radial deviation
Radiocarpal joint distraction, radiocarpal joint ulnar glide
Accessory motions to increase wrist ulnar deviation
Radiocarpal joint distraction, radiocarpal joint radial glide
Accessory motions to increase wrist supination
Radiocarpal joint distraction, ulnomeniscotriquetral volar glide
Accessory motions to increase all wrist motions
Radiocarpal joint distraction
Accessory motions to increase MCP and IP flexion
MCP and IP distraction, MCP and IP volar/palmar glide
Accessory motions to increase MCP and IP extension
MCP and IP distraction, MCP and IP dorsal glide
Accessory motions to increase thumb CMC flexion
Thumb CMC ulnar glide
Accessory motions to increase thumb CMC extension
Thumb CMC radial glide
Accessory motions to increase thumb CMC abduction
Thumb CMC dorsal glide
Accessory motions to increase thumb CMC adduction
Thumb CMC volar glide
0/6 Mobility
Ankylosis / no detectable movement within segment
Treatment: Needs x-ray confirmation. If not, reclassify as 1/6
1/6 Mobility
Considerable restriction in movement (hypomobility)
Treatment: Mobilization, stretching
2/6 Mobility
Slight restriction in movement
Treatment: Mobilization, stretching
3/6 Mobility
Normal - expected range for body range
Treatment: No treatment
4/6 Mobility
Slight increase in motion (hypermobility)
Treatment: Stabilization
5/6 Mobility
Considerable increase in motion
Treatment: Stabilization, treat neighboring hypomobility
6/6 Mobility
Unstable
Treatment: Support, fusion
0/3 Reactivity
No reactivity
1/3 Reactivity
Minimal reactivity - pain with overpressure
2/3 Reactivity
Moderate reactivity - pain comes at point of resistance
3/3 Reactivity
Severe reactivity - pain before onset of resistance
Grade I Mobilization
Slow, small amplitude oscillation at beginning of range (before R1), used to reduce pain
Grade II Mobilization
Slow, large amplitude oscillation at beginning to midrange shy of resistance (just up to R1), used to reduce pain
Grade III Mobilization
Slow, large amplitude oscillation from midrange to end of range into resistance (R1 to R2), used to increase joint mobility
Grade IV Mobilization
Slow, small amplitude oscillation parallel to joint surface at end of range into resistance (R2), used to increase joint mobility
Grade V Mobilization
Fast - high velocity, small amplitude non-oscillatory movement beyond pathological limitation of range, can be performed within physiological range
Mobilization grades for relief of pain
Grades I and II (can be used even with hypermobile joints for pain relief)
Mobilization grades to increase joint mobility/accessory motion
Grades III, IV, and V
Contraindications for Grades I and II mobilizations
None
Contraindications for Grades III, IV, and V mobilizations
Active disease processes like malignancy, metabolic bone disease
Acute inflammatory or infectious process like active rheumatoid arthritis
Acute trauma
Joints that have not ossified
Lack of indications (if the joint doesn't need it don't do it)
Precautions for joint mobilizations
Rheumatoid arthritis (can perform joint mobs if inactive)
Osteoporosis
Ligament weakness (pregnancy or virus)
Hypermobility/instability (Grades I and II ok)
Past history of malignancy
Disc pathology (rotary manipulations)
Current or long term use of anticoagulants or steroids
Neurophysiological effects of joint mobilizations
Gate-controlled theory
Opioid mediated analgesia theory
Non-opioid mediated analgesia theory
Relaxation of hypertonic muscle theory
Muscle inhibition theory
Mechanical effects of joint mobilizations
Movement of synovial fluid
Plastic deformation of collagen fibers
Breaking of intracapsular cross-linkages of collagen fibers
Release of entrapped meniscoid
Psychological effects of joint mobilizations
Power of touching in intelligent, professional, and caring manner
Influence of making improvement in amount of movement
Physiology of joint "pop" or "crack" = cavitation
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