What is the difference between mobilization & manipulation?
Mobilization: the px can voluntarily contract a mm to stop the mvmt
Manipulation: the px cannot stop the mvmt
Define arthrokinematic mvmts
Involuntary mvmts within the jt and surrounding tissues that are necessary for normal ROM
In a normal jt roll occurs with…
Slide or spin
Roll always occurs…
In the direction that the bone is moving
Slide occurs in the ____ direction as roll if the moving surface is concave
- same
Slide occurs in the opposite direction of the roll if the moving surface is ____
- convex
Explain the concave-convex rule
Slide occurs in the same direction as the role if the moving surface is concave and slide, occurs in the opposite direction of the role, if the moving surface is convex 
Define traction
A longitudinal pull/ a pull along the long axis of the bone
Define distraction
A force applied perpendicular to the treatment plane. A separation or pulling apart of the articular surfaces.
Glide is when…
You mobilize a bone in a direction that is parallel to the treatment plane
Grades and uses
Grade l distraction:
Grade ll distraction:
Grade l and ll oscillatory:
Grade l and ll sustained:
Grade ll oscillatory and sustained:
Grade lll sustained/lll & lv oscillatory:
Grade l distraction: prior to glides
Grade ll distraction: initial ax
Grade l and ll oscillatory: ⬇️ P, ⬆️ nutri
Grade l and ll sustained: ⬇️ P
Grade ll oscillatory and sustained: Maint. ROM
Grade lll sustained/lll & lv oscillatory: ⬆️ROM
Pain, mm guarding, and spasm can be treated w/…
low grade oscillatory mobilizations
Reversible joint hypo mobility can be treated w/
- progressively vigorous mobs
Positional faults/subluxations can be corrected w/…
higher grade mobs
What is the CMTO’s conditions for applying sustained grade l or ll or Grade l or ll oscillations jt mobs?
Given that the client’s tx plan indicated a need to maintain jt ROM and/or decrease jt pain
What is the CMTO’s standards for applying sustained grade l or ll or Grade l or ll oscillations jt mobs?
- so that the jt is in a loose-pack position
- so that the jt is taken up to the elastic barrier but not beyond, within the client’s pain tolerance
What is the CMTO’s saftey outline for applying sustained grade l or ll or Grade l or ll oscillations jt mobs?
- so that you assess the joint for pain prior to treatment by using a gentle controlled traction
- So that you treat the client within their agreed-upon pain tolerance
- So that you perform a gentle traction were possible before doing any gliding movements
- So that low-grade joint mobilization is not used or is modified if a contraindication to this technique exist
What is the CMTO’s conditions for applying high-grade jt mobs (sustained Grade ll and or Oscillations lll and lv jt mobs)?
Given that the client’s tx plan indicates a need to increase inert tissue elongation through jt mobilization
What is the CMTO’s standard for applying high-grade jt mobs (sustained Grade ll and or Oscillations lll and lv jt mobs)?
- so that the tissues around the joint is warmed and stretched prior to joint mobilization
So that the directions of mobilization are correct for that specific capsular pattern - So that the joint is in a loose pack position
- So that the joint is taken to the end of its physiological range of motion, and then slightly beyond the physiological range of motion within the clients comfort level
- So the accessory movement and physiological movements may be improved
- so that high velocity, low amplitude thrust techniques are not used to the spine
What is the CMTO’s safety guidelines for applying high-grade jt mobs (sustained Grade ll and or Oscillations lll and lv jt mobs)?
- so that you assess the joint for pain prior to treatment by using a gentle controlled traction
- So that you treat within the clients agreed upon pain tolerance
- So that you take special precaution, based on your assessment with any client who is prone
What is the loose pack position of the hip?
30° of flexion, 30° of abduction, slight external rotation
What is the close pack position of the hip?
Full extension, media rotation, abduction
What are the uses for hip joint distraction?
- To improve general hip mobility
- Pain control
- To increase nutrition to articular structures
What are the uses for posterior glide of the hip?
- Improve hip flexion
- Improve hip internal rotation
