Manual Therapy

Question 1

define arthrokinematics

Answer 1

accessory or component motions such as rolls and glides necessary for full motion

Question 2

define mobs

Answer 2

passive movement using altho and osteokinematic principles to increase joint mobility

Question 3

what is a ligamentous end feel?

Answer 3

capsular but harder

Question 4

what are the 3 psych effects of mobs/manips

Answer 4

1. confidence through improvement
2. manual contact positivity
3. response to joint sounds

Question 5

what are some examples of joint effusion/synovial inflammation capsular patterns (4)

Answer 5

traumatic arthritis, infectious arthritis, gout, RA

Question 6

what is a spastic end feel?

Answer 6

palpable muscular resistance

Question 7

define capsular pattern

Answer 7

if there is a capsule pathology, there will be a consistent and predictable pattern of limitations of passive movements

Question 8

what are the 4 mechanical effects of mobs/manips

Answer 8

1. stretch joint
2. break adhesions
3. alter position
4. eliminate barriers to normal motion

Question 9

describe the joint play/component motion grading

Answer 9

0 - ankylosed
1-2 - hypo (restricted)
3 - normal
4 - normal slight increase
5 - moderate increase
6 - unstable

Question 10

what are the 3 neurophysiological effects of mobs/manips

Answer 10

1. fire jt mechano/proprioceptors
2. fire cut and muscular receptors
3. alter nociception

Question 11

what are the two categories of capsular patterns?

Answer 11

1. joint effusion or synovial inflammation

2. capsular fibrosis

Question 12

what is a springy end feel?

Answer 12

loose body blockage

Question 13

what if there is a joint limitation, but there isn’t a capsular pattern? examples?

Answer 13

then it is not (just) the capsule: internal derangement, adhesion, strains

Question 14

what are some examples of capsular fibrosis (2)

Answer 14

capsular inflammation and joint immobilization (frozen shoulder)

Question 15

what is a capsular end feel?

Answer 15

stretching leather with gradually increasing resistance

Question 16

do joint mobs utilize physiologic (osteokinematic) or accessory (arthrokinematic) movements

Answer 16

both

Question 17

define osteokinematics

Answer 17

active or passive physiologic movements such as flexion, extension, or abduction

Question 18

what are the 6 absolute contraindications to mobs/manips

Answer 18

1. active inflammation or rheumatoid flare
2. Cauda equina or spinal compression >2 levels
3. malignancy in spine
4. bone disease or fracture
5. VA insufficiency
6. undiagnosed pain

Question 19

define a grade 5 manip

Answer 19

HVLA thrust close to R2