What is joint mobilization in physical therapy?
Joint Mobilization Joint mobilization is a gentle type of manual therapy as the sustained rhythmic passive accessory movements are performed to patient tolerance, with the patient always able to stop the movement. From: Physical Rehabilitation, 2007
Why orthotics for Neurorehabilitation?
The focus on function in neurorehabilitation necessarily means complex interventions are used to address body structure, activity, participation and environmental issues that may arise. Orthotics, like any tool used in the treatment of a complex and chronic condition, can target all levels of health at once.
What is manual therapy for pain?
Abstract Manual therapy (MT) is a passive, skilled movement applied by clinicians that directly or indirectly targets a variety of anatomical structures or systems, which is utilized with the intent to create beneficial changes in some aspect of the patient pain experience.
Does manual therapy reduce pain sensitivity to kinesiology?
Kinesiol.2012;22(5):752–767. [PMC free article][PubMed] [Google Scholar]• This analysis when taken together with [42] indicates that both joint and muscle-biased manual therapy (MT) reduce pain sensitivity; and the parameters of the intervention determine the magnitude of the hypoalgesia. 36.
What is the Rood approach to neuroplasticity?
Facilitation and enhancement of muscle activity to achieve improved motor control are the key tenants to many of the techniques used in neurological rehabilitation, many of which also utilise neuroplasticity. The Rood Approach, theoretically based on the Reflex and Hierarchical Model of Motor Control, developed by Margaret Rood in the 1950s, provides the origin for many of the facilitation techniques used today in neurological rehabilitation today. Rood developed a system of therapeutic exercises enhanced by cutaneous stimulation for patients with neuromuscular dysfunctions. In addition to proprioceptive maneuvres such as positioning, joint compression, joint distraction and the general use of reflexes, stretch, and resistance, the greatest emphasis is given on exteroceptive applications such as stroking, brushing, icing, warmth, pressure, and vibration in order to achieve optimal muscular action.
What type of stretching is used for facilitation?
The types of stretching used include; When we look at the use of stretch for facilitation we employ a fast/quick stretch. The fast/quick stretch produces a relatively short-lived contraction of the agonist's muscle and short-lived inhibition of the antagonist muscle which facilitates a muscle contraction.
Why do we use vibrations in our muscles?
Muscle vibration has been used as a technique to reduce muscle tone and spasticity in individuals with neurological conditions . Vibrations of the muscle are thought to increase corticospinal excitability as well as inhibitory neuronal activity in the antagonistic muscle.
How does joint compression affect motor control?
Joint awareness may be improved by joint compression which will lead to enhancing motor control. Receptors in joints and muscles are involved with the awareness of joint position and movement which are stimulated by joint compression. Joint compression can have both facilitatory and inhibitory effects.
Why do people use ice?
Ice can be used to facilitate a muscle response, which uses a combination of coolness and pain sensation to produce the desired response. If playback doesn't begin shortly, try restarting your device. Videos you watch may be added to the TV's watch history and influence TV recommendations.
How are robotics used in rehabilitation?
Rehabilitation robotics includes development of robotic devices tailored for assisting different sensorimotor functions (e.g. arm, hand, leg, ankle, development of different schemes of assisting therapeutic training, and assessment of sensorimotor performance (ability to move) of patient; here, robots are used mainly as therapy aids instead of assistive devices. Rehabilitation using robotics is generally well tolerated by patients, and has been found to be an effective adjunct to therapy in individuals suffering from motor impairments, especially due to stroke.
How does ice help with spasticity?
Efferent and afferent neurotransmission is reduced through prolonged use of ice, which is effective for the reduction of spasticity. In order to achieve this, the muscle spindles need to be cooled requiring that ice is applied until there is no longer an excessive reflex response to stretching. Effects can last from 1-2 hours which provide a window of opportunity to work on stretches or exercises that may provide a more long lasting effect. The most common method of prolonged icing that is used is local immersion, which is particularly useful in reducing hand flexor tone.
Why is joint mobilization important?
Joint mobilization is essential to maintain its long-term function and mobility. Exercises can be taught by the treating physician but in difficult cases or when cooperation is not achieved it is essential to refer the patient to a professional physiotherapist.
When performing a joint mobilization technique, should the practitioner maintain close approximation to the joint being mobilized
When performing a joint mobilization technique, the practitioner should maintain close approximation to the joint being mobilized and also use the legs and body to transfer weight and provide the force needed for the mobilization.
How does the clinician support the athlete's head?
The athlete is placed in a supine position and the clinician supports the athlete's head with one hand cupping the occiput. The other hand is placed under the athlete's chin to provide positioning so that no force is translated to the chin (see Fig. 16-24 ). By shifting body weight back the clinician introduces a traction force.
What is translatoric accessory mobilization?
Translatoric accessory joint mobilization techniques are well established and form the basis of much of the curriculum of both entry level and post-graduate manual therapy training programmes. Originally developed by contributors such as Kaltenborn and Evjenth from Norway (Kaltenborn et al 2002 ), Orthopaedic Manual Therapy (OMT) utilizes a clinical reasoning paradigm based on the manual therapist's perception of joint restriction as revealed by passive movement examination and the application of the concave-convex rule. Passive translatoric accessory mobilizations are performed parallel or perpendicular to the treatment plane as determined by the specific orientation of the joint surfaces. Mobilizations are graded in their range and sustained for specific durations according to their intended therapeutic goal (s) including pain relief and improving joint mobility.
How can the cervical spine be mobilized?
The cervical spine can be mobilized with motions other than those described earlier by applying arthrokinematic principles to the cervical joints. Other techniques can also be used, depending on the joint mobilization school of thought adhered to by the rehabilitation specialist.
What is joint mobilization?
Joint mobilization is a gentle type of manual therapy as the sustained rhythmic passive accessory movements are performed to patient tolerance, with the patient always able to stop the movement.
Which finger is placed on the inferior articular process of C4?
The clinician supports the athlete's head in a neutral position, identifies the superior articular process of C5, and uses the left index finger to fixate the transverse process of C5 while the right index finger is placed on inferior articular process of C4.
Scope
Quotes
Medical uses
- Stretch may be applied in a number of ways during neurological rehabilitation to achieve different effects. The types of stretching used include;
Benefits
- Joint awareness may be improved by joint compression which will lead to enhancing motor control. Receptors in joints and muscles are involved with the awareness of joint position and movement which are stimulated by joint compression. Joint compression can have both facilitatory and inhibitory effects.
Variations
- Heavy Compression: Compression is greater than that applied by body weight which is thought to facilitate cocontraction at the joint undergoing compression
Research
- Muscle vibration has been used as a technique to reduce muscle tone and spasticity in individuals with neurological conditions. Vibrations of the muscle are thought to increase corticospinal excitability as well as inhibitory neuronal activity in the antagonistic muscle. Studies in Mice show that a stretch of 30 mins daily will prevent the loss of ...
Effects
- Bishop et al (1974) identified three motor effects achieved through muscle vibration: The presence of increased tone can ultimately lead to joint contracture and changes in muscle length. When we look at the use of stretch to normalise tone and maintain soft tissue length we employ a slow, prolonged stretch to maintain or prevent lofss of range of motion. While the effects are no…
Function
- Muscle Vibration is generally applied to directly to the chosen muscle or tendon and may be applied in two ways; High and Low Frequency. The high frequency vibration is driven from a vibrator that optimally operates at a frequency of 100 - 200 Hz and at amplitude of 1 2 mA. This type of vibration produce facilitation of muscle contraction through what is known as tonic vibra…
Risks
- While Vibration has the potential as a good treatment technique there is still limited evidence on its effectiveness the therapist must be aware of the precautions that must be considered when using it as a treatment option which include:
Introduction
- Whole body vibration is a relatively new modality which involves the use of vibration through standing on a vibrating platform and has been utilised to improve balance and gait.
Future
- Further studies are needed in the future well-designed trials with bigger sample size to determine the most effective frequency, amplitude and duration of vibration application in the neurorehabilitation.
Management
- Vestibular stimulation is not widely used in neurological rehabilitation. The management of vestibular dysfunction is recognised as a specialist area within physiotherapy.
Symptoms
- Muscle immobilised short position = Loss of Sacromeres and Increased Stiffness related to increase in connective tissue Muscle immobilised in lengthened position = Increase Sacromeres
Treatment
- Passive stretching may be achieved through a number of methods which include; The duration of stretch to reduce both spasticity and to prevent contracture are not yet clear from teh research and require further research to determine the most appropriate technique and duration to produce the required effect. Patients should be given individualised positioning and early mobilisation m…
Mechanism of action
- It is one of the most common methods used to inhibit postural tone and muscle activity. Neutral warmth acts through stimulating the thermo receptors and activating of parasympathetic responses. Usually 10-20 minutes are sufficient period to produce effect. The application may be by wrapping body part with towels, hot packs, tepid baths and air splints.
Mechanism
- Massage uses pressure to direct venous and lymphatic flow back towards the heart. It is therefore important that the movement is always in this direction so that there is no undue pressure on the closed valves in the veins. These valves prevent backflow of blood by only allowing blood to move in one direction (i.e. toward the heart). As the pressure from the heart pu…
Resources
- For more detailed information about Massage read the Physiopedia Page; For more detailed information about Hydrotherapy read the Physiopedia Page;