Joint mobilization: Difference between revisions

Joint mobilization
Joint mobilization
Specialty	Physical therapy
	[edit on Wikidata]

Browse history interactively

← Previous edit

Content deleted Content added

VisualWikitext

Inline

Latest revision as of 17:50, 30 August 2024

Joint mobilization is a manual therapy intervention, a type of straight-lined, passive movement of a skeletal joint that addresses arthrokinematic joint motion (joint gliding) rather than osteokinematic joint motion. It is usually aimed at a 'target' synovial joint with the aim of achieving a therapeutic effect. These techniques are used by a variety of health care professionals with specific training in manual therapy assessment and treatment techniques.

The International Federation of Orthopaedic Manipulative Physical Therapists defines joint mobilization as "a manual therapy technique comprising a continuum of skilled passive movements that are applied at varying speeds and amplitudes to joints, muscles or nerves with the intent to restore optimal motion, function, and/or to reduce pain."^[1]

The APTA Guide to Physical Therapist Practice defines mobilization/manipulation as "a manual therapy technique comprised of a continuum of skilled passive movements that are applied at varying speeds and amplitudes, including a small amplitude/high velocity therapeutic movement."^[2]

Classification and mechanisms

Joint mobilization is classified by the Australian physiotherapist Geoffrey Douglas Maitland into five 'grades' of motion, each of which describes the range of motion of the target joint during the procedure.^[3] They are generally divided into five grades. The different grades of manipulation are known to produce selective activation of different mechanoreceptors in the joint.

Grade I – Low amplitude, rhythmically oscillating joint glide near the resting position of the available arthrokinematic joint play. Activates Type I mechanoreceptors that inhibit nociception and provide information regarding joint position. They have a low threshold and respond to a few grams of tension.

Activates mechanoreceptors in the superficial layer of the joint capsule – Bulbous corpuscles.

Grade II – Relatively large amplitude, rhythmically oscillating joint glide that carries well into the available arthrokinematic joint play. Activates Type II mechanoreceptors that inhibit nociception and provide information about joint acceleration. They also have a low threshold and respond to a few grams of tension.

Activates mechanoreceptors in the deep layer of the joint capsule – Pacinian Corpuscles.

Grade III – Relatively large amplitude, rhythmically oscillating joint glide that carries to the end of the available arthrokinematic joint play.

Designed to physically stretch the joint capsule.

Grade IV – Low amplitude, rhythmically oscillating joint glide that is performed at the end of the available arthrokinematic joint play.

Designed to physically stretch the joint capsule.

Grade V – This grade refers to the use of a single high-velocity, low-amplitude thrust performed at the end of the available joint play.

Activates Golgi tendon organ-like endings that inhibit muscle tone and monitor the direction of joint motion. They have a higher threshold and respond to forces on the order of kilograms – Golgi tendon organs.

References

^ "Educational Standards In Orthopaedic Manipulative Therapy" (PDF). International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) INC. Archived (PDF) from the original on 17 November 2023. Retrieved 6 July 2024.
^ Guide to Physical Therapist Practice 3.0. Alexandria, VA: American Physical Therapy Association; 2014.
^ Maitland, G.D. Peripheral Manipulation 2nd ed. Butterworths, London, 1977. Maitland, G.D. Vertebral Manipulation 5th ed. Butterworths, London, 1986.

[1] "Educational Standards In Orthopaedic Manipulative Therapy" (PDF). International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) INC. Archived (PDF) from the original on 17 November 2023. Retrieved 6 July 2024.

[2] Guide to Physical Therapist Practice 3.0. Alexandria, VA: American Physical Therapy Association; 2014.

[3] Maitland, G.D. Peripheral Manipulation 2nd ed. Butterworths, London, 1977. Maitland, G.D. Vertebral Manipulation 5th ed. Butterworths, London, 1986.
Parts of this article (those related to ISBN 9780702040665) need to be updated. Please help update this article to reflect recent events or newly available information. (February 2015)

[1]

[2]

[3]

@@ Line 1: / Line 1: @@
+{{short description|Type of passive movement of a skeletal joint}}
 {{See also |Joint manipulation}}
+{{Infobox medical intervention
+| name         = Joint mobilization
+| synonym      =
+| image        =
+| caption      =
+| alt          =
+| pronounce    =
+| specialty    =physical therapy
+| synonyms     =
+| ICD10        =
+| ICD9         =
+| ICD9unlinked =
+| CPT          =
+| MeshID       =
+| LOINC        =
+| other_codes  =
+| MedlinePlus  =
+| eMedicine    =
+}}
+'''Joint mobilization '''is a [[manual therapy]] intervention, a type of straight-lined, passive movement of a skeletal joint that addresses arthrokinematic joint motion (joint gliding) rather than osteokinematic joint motion. It is usually aimed at a 'target' [[synovial joint]] with the aim of achieving a [[therapeutic]] effect. These techniques are used by a variety of health care professionals with specific training in manual therapy assessment and treatment techniques.
+The International Federation of Orthopaedic Manipulative Physical Therapists defines joint mobilization as "a manual therapy technique comprising a continuum of skilled passive movements that are applied at varying speeds and amplitudes to joints, muscles or nerves with the intent to restore optimal motion, function, and/or to reduce pain."<ref>{{cite web |title=Educational Standards In Orthopaedic Manipulative Therapy |url=https://www.ifompt.org/site/ifompt/IFOMPT%20Standards%20Document%20definitive%202016.pdf |website=International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) INC |access-date=6 July 2024 |archive-date=17 November 2023 |archive-url=https://web.archive.org/web/20231117033651/https://www.ifompt.org/site/ifompt/IFOMPT%20Standards%20Document%20definitive%202016.pdf |url-status=live }}</ref>
-'''Joint mobilization '''is a [[manual therapy]] intervention, a type of passive movement of a skeletal joint. It is usually aimed at a 'target' [[synovial joint]] with the aim of achieving a [[therapeutic]] effect. When applied to the spine, it is known as [[spinal mobilization]]. These techniques are often used by [[Chiropractic|chiropractors]], [[Osteopathy|osteopaths]], [[occupational therapists]], and [[Physical therapy|physical therapists]].
+The APTA Guide to Physical Therapist Practice defines mobilization/manipulation as "a manual therapy technique {{sic|comprised |hide=y|of}} a continuum of skilled passive movements that are applied at varying speeds and amplitudes, including a small amplitude/high velocity therapeutic movement."<ref>Guide to Physical Therapist Practice 3.0. Alexandria, VA: American Physical Therapy Association; 2014.
-== Classification and mechanisms of action ==
+</ref>
+__TOC__
-Joint mobilization is classified by Geoffrey Douglas Maitland into five 'grades' of motion, each of which describes the [[range of motion]] of the target joint during the procedure.<ref>Maitland, G.D. ''Peripheral Manipulation'' 2nd ed. Butterworths, London, 1977.
+== Classification and mechanisms ==
+Joint mobilization is classified by the Australian physiotherapist Geoffrey Douglas Maitland into five 'grades' of motion, each of which describes the [[range of motion]] of the target joint during the procedure.<ref>Maitland, G.D. ''Peripheral Manipulation'' 2nd ed. Butterworths, London, 1977.
-Maitland, G.D. ''Vertebral Manipulation'' 5th ed. Butterworths, London, 1986.{{update|ISBN 9780702040665|date=February 2015}}</ref> They are generally called Grade I through Grade V. The different grades of mobilization are believed to produce selective activation of different [[mechanoreceptors]] in the joint.<ref>[http://hkjo.lib.hku.hk/archive/files/b6a0216ae4024e1a3c831ab4a498aca0.pdf How Manipulation Works] {{medrs|date=February 2015}}</ref>
+Maitland, G.D. ''Vertebral Manipulation'' 5th ed. Butterworths, London, 1986.{{update|{{ISBN|9780702040665}}|date=February 2015}}</ref> They are generally divided into five grades. The different grades of manipulation are known to produce selective activation of different [[mechanoreceptors]] in the joint.
-* Grade I - Activates Type I mechanoreceptors with a low threshold and which respond to very small increments of tension.
+* Grade I – Low amplitude, rhythmically oscillating joint glide near the resting position of the available arthrokinematic joint play. Activates Type I mechanoreceptors that inhibit nociception and provide information regarding joint position. They have a low threshold and respond to a few grams of tension.
-: Activates cutaneous mechanoreceptors.
+: Activates mechanoreceptors in the superficial layer of the joint capsule – [[Bulbous corpuscle]]s.
+* Grade II – Relatively large amplitude, rhythmically oscillating joint glide that carries well into the available arthrokinematic joint play. Activates Type II mechanoreceptors that inhibit nociception and provide information about joint acceleration. They also have a low threshold and respond to a few grams of tension.
-: Oscillatory motion will selectively activate the dynamic, rapidly adapting receptors, i.e., [[Meissner's corpuscle|Meissner's]] and [[Pacinian corpuscle|Pacinian Corpuscles]]. The former respond to the rate of skin indentation and the latter respond to the acceleration and retraction of that indentation.
+: Activates mechanoreceptors in the deep layer of the joint capsule – [[Pacinian corpuscle|Pacinian Corpuscles]].
+* Grade III – Relatively large amplitude, rhythmically oscillating joint glide that carries to the end of the available arthrokinematic joint play.
-* Grade II - Similar effect as Grade I.
+: Designed to physically stretch the joint capsule.
-* Grade III - Similar to Grade II.
+* Grade IV – Low amplitude, rhythmically oscillating joint glide that is performed at the end of the available arthrokinematic joint play.
+: Designed to physically stretch the joint capsule.
-: Selectively activates more of the muscle and joint mechanoreceptors as it goes into resistance, and less of the cutaneous ones as the slack of the subcutaneous tissues is taken up.
+* Grade V – This grade refers to the use of a single high-velocity, low-amplitude thrust performed at the end of the available joint play.
+: Activates Golgi tendon organ-like endings that inhibit muscle tone and monitor the direction of joint motion. They have a higher threshold and respond to forces on the order of kilograms – [[Golgi tendon organ]]s.
-* Grade IV - Similar to Grade III.
-: With its more sustained movement at the end of range will activate the static, slow adapting, Type I mechanoreceptors, whose resting discharge rises in proportion to the degree of change in joint capsule tension.
-* Grade V - This is the same as [[joint manipulation]]. Use of the term 'Grade V' is only valid if the joint is positioned near to its end range of motion during mobilization. Evans and Breen<ref>{{cite journal |vauthors=Evans DW, Breen AC | title = A biomechanical model for mechanically efficient cavitation production during spinal manipulation: prethrust position and the neutral zone. | journal = J Manipulative Physiol Ther | volume = 29 | issue = 1 | pages = 72–82 | year = 2006 | pmid = 16396734 | doi = 10.1016/j.jmpt.2005.11.011}}</ref> recently contested this assumption, in fact arguing that an individual synovial joint should be positioned near to its resting, neutral position. hey
 == See also ==
+* [[Natural apophyseal glides]]
 * [[Orthopedic medicine]]
+* [[Passive accessory intervertebral movements]]
-* [[Osteopathic Manipulative Medicine]]
+* [[Passive physiological intervertebral movements]]
-* [[Physical therapy]]
-*[[Occupational therapy|Occupational Therapy]]
 == References ==
+{{reflist}}
-<references />
 [[Category:Manual therapy]]
-[[Category:Chiropractic treatment techniques]]
+[[Category:Osteopathic techniques]]
-[[Category:Osteopathy]]
 [[Category:Physical therapy]]
-[[Category:Osteopathic manipulative medicine]]