Mobilizarea Articulară

 end-feel moale:

- stretching

- inhibiţie activă

 end-feel mediu:

- mobilizare articulară

- manipulare articulară.

Ce este Mobilizarea articulară?

Manual therapy technique

Used to modulate pain

Used to increase ROM

Used to treat joint dysfunctions that limit ROM by specifically addressing altered joint mechanics

Factors that may alter joint mechanics:

Pain & Muscle guarding

Joint hypomobility

Joint effusion – Edem articlar

Contractures or adhesions in the joint capsules or supporting ligaments

Malalignment or subluxation of bony surfaces

Terminology

Mobilization – passive joint movement for increasing ROM or decreasing pain

Applied to joints & related soft tissues at varying speeds & amplitudes using physiologic or accessory motions

Force is light enough that patient’s can stop the movement

Manipulation – passive joint movement for increasing joint mobility

Mişcare bruscă, în forţă (controlată), fără ca pacientul sa aibă capacitatea de a controla oprirea mişcării.

Self-Mobilization (Automobilization) – self-stretching techniques that specifically use joint traction or glides that direct the stretch force to the joint capsule

Mobilization with Movement (MWM) – concurrent application of a sustained accessory mobilization applied by a clinician & an active physiologic movement to end range applied by the patient

Applied in a pain-free direction

Physiologic Movements – movements done voluntarily

Osteokinematics – motions of the bones

Accessory Movements – movements within the joint & surrounding tissues that are necessary for normal ROM, but can not be voluntarily performed

Component motions – motions that accompany active motion, but are not under voluntary control

Ex: Upward rotation of scapula & rotation of clavicle that occur with shoulder flexion

Joint play – motions that occur within the joint

Determined by joint capsule’s laxity

Can be demonstrated passively, but not performed actively

Arthrokinematics – motions of bone surfaces within the joint

5 motions - Roll, Slide, Spin, Compression, Distraction

Concave – hollowed or rounded inward

Convex – curved or rounded outward

Relationship Between Physiological & Accessory Motion

Biomechanics of joint motion

Physiological motion

Result of concentric or excentric active muscle contractions

Bones moving about an axis or through flexion, extension, abduction, adduction or rotation

Accessory Motion

Motion of articular surfaces relative to one another

Generally associated with physiological movement

Necessary for full range of physiological motion to occur

Ligament & joint capsule involvement in motion

Noţiuni de artrologie

Mişcarea angulară - indică o creştere sau o descreştere a unghiului format dintre două oase (exemplu: flexia - extensia);

Circumducţia

Rotaţia

Alunecarea

Mişcarea angulară

Circumducţia - mişcarea unui os ce descrie un con (exemplu: circumducţia şoldului, a umărului);

Rotaţia

Alunecarea

Mişcarea angulară

Circumducţia