quiz #1- joint mobs, stretching

  1. What type of thrust is a joint mobilization?
  2. What is the purpose of a joint mobilization?
    passive procedure meant to restore normal joint play and reduce pain
  3. What is joint play?
    straight lined (rectilinear), passive bone movements
  4. What are three types of joint play and what direction do they all need to be to the treatment plane?
    • traction: perpendicular and away
    • compression: perpendicular and toward
    • gliding: parrallel
  5. What is a major indication for joint mobilization?
    reverse hypomobility
  6. What happens if exercise and muscle stretching occurs prior to restoration of normal joint play?
    articular surfaces are compressed further damaging the articular cartilage
  7. What are 2 methods to determine decreased joint play and their differences?
    • direct method: physically feel joint in all directions
    • indirect method: done through observation
  8. Why can't a person be physically examed if they are using the indirect method to determine joint play?
    • severe pain
    • little movement (symphysis)
    • hypermobile
    • examiner doesn't have the expertise to do so
  9. What is more important rolling or gliding?
  10. How do you grade joint play? (general)
    • hypomobile (0-2)
    • normal (3)
    • hypermobile (4-6)
  11. What is the maximum loose packed position?
    • maximum slack
    • joint play is at the greatest
  12. What is the actual resting position?
    similar to loose packed, but the position the patient adopts
  13. What is the closed packed position?
    • maximum tension between joint capsule and muscle
    • maximal congruency between 2 articular surfaces
  14. What position do you perform joint mobilizations in?
    loose packed preferably, but if you can't then actual resting position gradually moving to loose packed position
  15. Where does the treatment plane lie?
    with the concave joint partner whether it is movable or fixed
  16. What direction does rolling occur in?
    always in the direction of the bone movement
  17. What occurs when CONCAVE moves on CONVEX, how do you mobilize?
    • roll and glide in SAME direction
    • mobilize in same direction
  18. What occurs when CONVEX moves on CONCAVE, how do you mobilize?
    • roll and glide in opposite direction
    • mobilize in direction of glide
  19. What are the Kaltenborn grades for Traction?
    • grade I: nullify compressive forces
    • grade II: take up slack
    • grade III: stretch capsule
  20. What are the Kaltenborn grades for gliding?
    • grade II: take up slack
    • grade III: stretch
  21. What are grades I and II used for in traction?
    treatment of pain
  22. What is grade III used for in traction?
    treatment of capsular restriction
  23. What is three dimensional traction?
    • can be very dangerous but effective
    • and that's all i know...
  24. What are the grades for traction and gliding for Maitland oscillations?
    • grade I: 0-25% (small oscillations)
    • grade II: 0-50% (large oscillations)
    • grade III: 50-100% (large oscillations)
    • grade IV: 75-100% (small oscillations)
    • grade V: high velocity thrust
  25. What are Maitlands Rules for oscillations?
    • 2-3 per second for 2 minutes
    • repeat 2-3 times
    • treat pain then stiffness
    • treat in loose/pain free position, moving to stiff/painful position
  26. What the two different "hands" of the PT when treating according to Kaltenborn?
    • fixating hand: fixates one jt partner
    • mobilizing hand: placed as close to jt as possible
  27. How do you treat pain according to Kaltenborn?
    • with traction or oscillation
    • 10 second intervals
    • grades 1 or 2
    • the goal here is NOT to stretch structures
  28. How do you treat hypomobility according to Kaltenborn?
    • traction or gliding held for minimum of 5-7 seconds
    • longer periods up to a minute better
    • grade 1 traction should always be maintained during joint mobilization
    • (15-18 seconds, 3-4 times?)
  29. What are some conditions that cause shortening of soft tissues?
    • prolonged immobilization
    • restricted mobility
    • connective tissue or neuromuscular disease
    • tissue pathology from trauma
    • bony deformities
  30. What are you stretching, while stretching?
    • contractile tissue
    • non-contractile
    • adhesions
    • epimysium
    • endomysium
    • sacrolema
    • muscle fiber
    • origin and insertion
    • nerve
    • associated tendons
  31. What is the purpose of stretching?
    • increase ROM to normal limits
    • decrease pain
    • increase strength
    • improve function
    • reduce injury
  32. Describe the load/stress- relaxation curve
    • the length of muscle is held constant
    • (i don't know how to explain this)
  33. Describe the idea of creep:
    • load is held constant (keep moving into it)
    • 15-18 seconds is when max deformation can occur
  34. What is the optimal number of passive stretch repititions?
    4 (up to 80%)- much more than that deformation doesn't change
  35. What are some little facts about stretching from literature?
    • no warm up required
    • 4-6 reps optimal
    • hold 15-18 seconds
    • no signifcant difference from doing it 1 or 3 times a day
    • retain gains for 2-4 weeks
    • to maintain- stretch 1 time a week
    • acute lasting effects lasts 24 hours
    • effect on injury is inconclusive
    • static stretching most researched
    • 35% compliance
    • intensity/force is very subjective
  36. What should be done before stretching?
    • assess all joints the muscle crosses
    • check muscle length
    • check end feel
    • stretch across larger more stable joints instead of smaller
    • inform and instruct patient
    • choose best method for you and pt
  37. What are different stretching techniques?
    • static stretching
    • hold relax
    • hold relax- agonist contract
    • agonist contract
  38. What do you do to stretch?
    • preposition for protection
    • elicit contraction or static stretch
    • hold 15-30 seconds (avoid compression with grade 1)
    • repeat 3-4 times
    • stimulate antagonists
    • gradual releast
  39. Who controls the direction, intensity, velocity, and duration in static stretching?
    the therapist
  40. What do you do in hold relax?
    • place involved muscle in lengthened position
    • isometrically contract for 10 seconds
    • patient relaxes
    • lengthen passively and hold
    • repeat 4-6 times
  41. What do you do in hold relax- agonist contract?
    • place involved muscle in lengthened position
    • isometrically contract for 10 seconds
    • then contract muscle opposite the tight muscle
  42. What do you do in agonist contract?
    • patient does everything- dynamically contracting the agonist (muscle opposite tight muscle)
    • produces reciprocal inhibition
  43. What is the order of procedures?
    mobilize --> stretch --> exercise --> functional exercise
  44. Why do you do exercises after stretching?
    you have to show the body how to use this newly aquired motion from stretching
  45. What are acute effects of stretching?
    active inhibition works well
  46. What are chronic effects of stretching?
    low prolonged load techniques work well
  47. What are precautions to stretching?
    • recent fracture
    • recent soft tissue repair
    • osteoporosis
    • prolonged immobiliation
    • pain greater than 24 hours post stretch
    • edematous joints and tissue
    • joint position sense or deep pressure dysfunction
  48. What are contraindications to stretching?
    • bone block
    • fracture or non-union
    • acute inflammation or infection
    • sharp pain
    • hematoma
Card Set
quiz #1- joint mobs, stretching
joint mobilizations, stretching