Joint Mobilization
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Joint Mobilization
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. IFOMPT 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." The APTA Guide to Physical Therapist Practice defines mobilization/manipulation as “a manual therapy technique a continuum of skilled passive movements that are applied at varying speeds and amplitudes, including a small amplitude/ high velocity therapeut ...
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Manual Therapy
Manual therapy, or manipulative therapy, is a physical treatment primarily used by physical therapists, physiotherapists, occupational therapists to treat musculoskeletal pain and disability; it mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation. It is also used by Rolfers, massage therapists, athletic trainers, osteopaths, and physicians. A 2011 literature review indicates that placebo is one of likely many potentially relevant mechanisms through which manual therapy improves clinical outcomes related to musculoskeletal pain conditions. Definitions Irvin Korr, J. S. Denslow and colleagues did the original body of research on manual therapy. Korr described it as the "Application of an accurately determined and specifically directed manual force to the body, in order to improve mobility in areas that are restricted; in joints, in connective tissues or in skeletal muscles." According to the ''Orthopaedic Manual Physical Therapy ...
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Synovial Joint
A synovial joint, also known as diarthrosis, joins bones or cartilage with a fibrous joint capsule that is continuous with the periosteum of the joined bones, constitutes the outer boundary of a synovial cavity, and surrounds the bones' articulating surfaces. This joint unites long bones and permits free bone movement and greater mobility. The synovial cavity/joint is filled with synovial fluid. The joint capsule is made up of an outer layer of fibrous membrane, which keeps the bones together structurally, and an inner layer, the synovial membrane, which seals in the synovial fluid. They are the most common and most movable type of joint in the body of a mammal. As with most other joints, synovial joints achieve movement at the point of contact of the articulating bones. Structure Synovial joints contain the following structures: * Synovial cavity: all diarthroses have the characteristic space between the bones that is filled with synovial fluid * Joint capsule: the fibrous ...
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Therapeutic
A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many different types of therapy. Not all therapies are effective. Many therapies can produce unwanted adverse effects. ''Medical treatment'' and ''therapy'' are generally considered synonyms. However, in the context of mental health, the term ''therapy'' may refer specifically to psychotherapy. History Before the creating of therapy as a formal procedure, people told stories to one another to inform and assist about the world. The term "healing through words" was used over 3,500 years ago in Greek and Egyptian writing. The term psychotherapy was invented in the 19th century, and psychoanalysis was founded by Sigmund Freud under a decade later. Semantic field The words ''care'', ''therapy'', ''treatment'', and ''intervention'' overlap in a se ...
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Range Of Motion
Range of motion (or ROM), is the linear or angular distance that a moving object may normally travel while properly attached to another. It is also called range of travel (or ROT), particularly when talking about mechanical devices and in mechanical engineering fields. For example, a sound volume control knob. As used in the biomedical field and by weightlifters, range of motion refers to the distance and direction a joint can move between the flexed position and the extended position. The act of attempting to increase this distance through therapeutic exercises (range of motion therapy—stretching from flexion to extension for physiological gain) is also sometimes called range of motion. Measuring range of motion Each specific joint has a normal range of motion that is expressed in degrees. The reference values for the normal ROM in individuals differ slightly depending on age and gender. For example, as an individual ages, they typically lose a small amount of ROM. Analog ...
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Mechanoreceptors
A mechanoreceptor, also called mechanoceptor, is a sensory receptor that responds to mechanical pressure or distortion. Mechanoreceptors are innervated by sensory neurons that convert mechanical pressure into electrical signals that, in animals, are sent to the central nervous system. Vertebrate mechanoreceptors Cutaneous mechanoreceptors Cutaneous mechanoreceptors respond to mechanical stimuli that result from physical interaction, including pressure and vibration. They are located in the skin, like other cutaneous receptors. They are all innervated by Aβ fibers, except the mechanorecepting free nerve endings, which are innervated by Aδ fibers. Cutaneous mechanoreceptors can be categorized by what kind of sensation they perceive, by the rate of adaptation, and by morphology. Furthermore, each has a different receptive field. By sensation *The Slowly Adapting type 1 (SA1) mechanoreceptor, with the Merkel corpuscle end-organ (also known as Merkel discs) detect sustained pr ...
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Bulbous Corpuscle
The Bulbous corpuscle or Ruffini ending or Ruffini corpuscle is a slowly adapting mechanoreceptor located in the cutaneous tissue between the dermal papillae and the hypodermis. It is named after Angelo Ruffini Angelo Ruffini (Pretare of Arquata del Tronto; 1864–1929) was an Italian histologist and embryologist. He studied medicine at the University of Bologna, where beginning in 1894 he taught classes in histology. In 1903 he attained the chair of e .... Structure Ruffini corpuscles are enlarged dendritic endings with elongated capsules. Function This spindle-shaped receptor is sensitive to skin stretch, and contributes to the kinesthetic sense of and control of finger position and movement. They are at the highest density around the fingernails where they act in monitoring slippage of objects along the surface of the skin, allowing modulation of grip on an object. Ruffini corpuscles respond to sustained pressure and show very little adaptation. Ruffinian endings are lo ...
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Pacinian Corpuscle
Pacinian corpuscle or lamellar corpuscle or Vater-Pacini corpuscle; is one of the four major types of mechanoreceptors (specialized nerve ending with adventitious tissue for mechanical sensation) found in mammalian skin. This type of mechanoreceptor is found in both glabrous (hairless) and hirsute (hairy) skins, viscera, joints and attached to periosteum of bone, primarily responsible for sensitivity to vibration. Few of them are also sensitive to quasi-static or low frequency pressure stimulus. Most of them respond only to sudden disturbances and are especially sensitive to vibration of few hundreds of Hz. The vibrational role may be used for detecting surface texture, e.g., rough vs. smooth. Most of the Pacinian corpuscles act as rapidly adapting mechanoreceptors. Groups of corpuscles respond to pressure changes, e.g. on grasping or releasing an object. Structure Pacinian corpuscles are larger and fewer in number than Meissner's corpuscle, Merkel cells and Ruffini's corpuscl ...
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Golgi Tendon Organ
The Golgi tendon organ (GTO) (also called Golgi organ, tendon organ, neurotendinous organ or neurotendinous spindle) is a proprioceptor – a type of sensory receptor that senses changes in muscle tension. It lies at the interface between a muscle and its tendon known as the musculotendinous junction also known as the myotendinous junction. It provides the sensory component of the Golgi tendon reflex. The Golgi tendon organ is one of several eponymous terms named after the Italian physician Camillo Golgi. Structure The body of the Golgi tendon organ is made up of braided strands of collagen (intrafusal fasciculi) that are less compact than elsewhere in the tendon and are encapsulated. The capsule is connected in series (along a single path) with a group of muscle fibers () at one end, and merge into the tendon proper at the other. Each capsule is about long, has a diameter of about , and is perforated by one or more afferent type Ib sensory nerve fibers ( Aɑ fiber), which ...
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Natural Apophyseal Glides
Natural apophyseal glides (NAGS) refers to a spinal physical therapy treatment technique developed by Brian Mulligan.Brian R. Mulligan (2004). ''Manual therapy: NAGS, SNAGS, MWMS etc.'' (5th Ed). Plane View Services Ltd. Technique NAGS involves a mid to end-range facet joint mobilisation applied anterocranially along the plane of treatment within the desired joint, combined with a small amount of manual traction. The purpose of this treatment is to increase movement within the spine, and decrease symptomatic pain. Sustained natural apophyseal glides Sustained natural apophyseal glides (SNAGS) are a separate technique involving a combination of a sustained facet glide with active motion, which is then followed by overpressure. Clinical evidence A 2010 study concluded that whilst both NAGS and SNAGS showed signs of effectiveness, SNAGS demonstrated greater statistically significant efficacy over NAGS in reducing pain and disability in subjects with chronic neck pain. Another stud ...
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Orthopedic Medicine
Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders. Etymology Nicholas Andry coined the word in French as ', derived from the Ancient Greek words ὀρθός ''orthos'' ("correct", "straight") and παιδίον ''paidion'' ("child"), and published ''Orthopedie'' (translated as ''Orthopædia: Or the Art of Correcting and Preventing Deformities in Children'') in 1741. The word was assimilated into English as ''orthopædics''; the ligature ''æ'' was common in that era for ''ae'' in Greek- and Latin-based words. As the name implies, the discipline was initially developed with attention to children, but the correction of spinal and bone deformities in all stages of life eventuall ...
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Passive Accessory Intervertebral Movements
Passive accessory intervertebral movements (PAIVM) refers to a spinal physical therapy assessment and treatment technique developed by Geoff Maitland. The purpose of PAIVM is to assess the amount and quality of movement at various intervertebral levels, and to treat pain and stiffness of the cervical and lumbar spine.Geoffrey Douglas Maitland, Elly Hengeveld, Kevin Banks, Kay English, (2005). ''Maitland's Vertebral Manipulation, Volume 1.'' Elsevier Butterworth-Heinemann. . Technique During assessment, the aim of PAIVM is to reproduce patient symptoms, and assess the endfeel of cervical movement, quality of resistance, behaviour of pain throughout the range of movement, and observe any muscle spasm. A posterior to anterior force of varying strength is applied by the therapist either centrally onto the spinous process, or unilaterally on either the left or right articular pillar. As a treatment technique, pain is treated by oscillations of small amplitude short of resistance, whi ...
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