Joint Mobilizations

Question 1

Name the types of joint mobilizations

Answer 1

1. Distractions
2. Oscillation mobilizations
3. Sustained hold mobilizations
4. Mobilization with movement

Question 2

What is the goal of sustained hold mobilizations?

Answer 2

Targets impairments of joint mobility and pain

- addresses tissue extensibility directly to allow motion

Question 3

During sustained hold mobilizations, where is pain targeted?

Answer 3

beginning to mid range

Question 4

During sustained hold mobilizations, where is joint mobility targeted?

Answer 4

end range

Question 5

When should the joint be placed in resting position?

Answer 5

• during assessment
• acute stage
• grade I oscillations
• grade II oscillations

Question 6

When should the joint be placed at end ROM?

Answer 6

when attempting to improve ROM (grades III & IV) IF tolerable

Question 7

How should the PT use their hands for stabilizing and mobilizing?

Answer 7

• half joint should be stabilized while other half is mobilized
• both stabilizing and mobilizing hands should be as close to the joint line as possible
• hands should make maximum contact with the patient’s body

Question 8

When performing oscillations, how long are they typically done?

Answer 8

• 1-3 per second

- typically 1-5 sets for 15-60 seconds each

Question 9

When performing sustained holds, how long are they typically done?

Answer 9

• typically 1-5 sets for 5-30 seconds each

- more commonly used to treat ROM

Question 10

What are the 6 major techniques for joint mobilizations?

Answer 10

1. allow gravity to assist when possible
2. your body should act as one unit with the mobilizing part as much as possible
3. use good body mechanics!
4. your forearm should align with the intended direction of force when possible
5. reassess afterwards
6. stop when a large improvement has been obtained or when improvement ceases

Question 11

What is mobilization with movement?

Answer 11

combined active and passive joint mobilization

Question 12

What is the golden rule of MWM?

Answer 12

it should be painless

Question 13

If pain occurs with MWM, what should be done?

Answer 13

either change direction of force, correct pressure, or do not use MWM

Question 14

What is the theory of MWM?

Answer 14

bony positional faults contribute to painful joint restrictions

Question 15

What are the guidelines of MWM?

Answer 15

• should be pain free
• apply 10 times before reassessing joint motion
• overpressure should be applied at end range of AROM

Question 16

What direction of joint glide would you perform in NWB to improve ROM in ankle DF?

Answer 16

posterior glide

Question 17

What direction of joint glide would you perform in NWB to improve ROM in tibiofemoral flexion?

Answer 17

posterior glide

Question 18

What direction of joint glide would you perform in NWB to improve ROM in radiocarpal extension?

Answer 18

anterior glide

Question 19

What is the PT working to improve if Grade III GH joint distraction is performed?

Answer 19

joint mobility. Stretching the joint capsule and surrounding tissues

Question 20

What direction of joint glide would you perform in NWB to improve ROM in GH IR?

Answer 20

posterior glide

Question 21

What grade(s) of joint mobilization glides would you want to perform for GH hypomobility without pain?

Answer 21

grades III & IV

Question 22

What grade(s) of joint mobilization glides would you want to perform for GH pain without hypomobility?

Answer 22

Grades I & II

Question 23

What grade(s) of joint mobilization glides would you want to perform for GH hypomobility with pain?

Answer 23

Grade V

possibly also grades I & II if grade V is too much muscle guarding

Question 24

What is the PT working to improve if Grade II inferior patellofemoral mobilization is performed?

Answer 24

pain or muscle guarding during knee flexion

Question 25

What is the PT working to improve if Grade III anterior hip mobilizations are performed?

Answer 25

hip extension joint mobility (capsule and associated structures)

Question 26

What is the PT working to improve if Grade III posterior radiohumeral mobilization is performed?

Answer 26

elbow extension joint mobility (capsule and associated structures)

Question 27

What is the primary goal of grades I & II maitland joint mobilizations (glides)?

Answer 27

reduction in pain and muscle guarding

Question 28

What is the primary goal of grades III & IV maitland joint mobilizations (glides)?

Answer 28

stretching joint capsule and associated structures

Question 29

What is the primary goal of grade V maitland joint mobilizations (glides)?

Answer 29

decrease pain and muscle guarding

Question 30

What is the theory behind grades I & II maitland joint mobilizations (glides)?

Answer 30

• reduces pain by improving joint lubrication and circulation to tissues related to the joint
• rhythmic oscillations possibly activate articular and skin mechanoreceptors which play a role in pain reduction

Question 31

What is the theory behind grades III & IV maitland joint mobilizations (glides)?

Answer 31

may activate inhibitory joint and muscle spindle receptors to aid in reducing restriction of movement

Question 32

What are the proposed mechanisms for grades I & II joint mobilizations?

Answer 32

• Nutritional effect

- Neurophysiological effect

Question 33

What are the proposed mechanisms for grades III & IV joint mobilizations?

Answer 33

• Biomechanical effect

- Neurophysiological effect