Rehab - Quiz #2
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Questions and Answers

What is generally reduced in swayback postural assessment related to lumbar spine?

Lumbar lordosis is reduced.

Which muscles are considered elongated and weak in swayback posture?

One-joint hip flexors, upper T-S erector spinae, external obliques, and neck flexors.

In flat back posture, what is the position of the lumbar spine?

The lumbar spine is flattened or flexed.

Which hip and knee positions are characteristic of flat back posture?

<p>The hip is extended, and the knee is extended.</p> Signup and view all the answers

What is a notable feature of the pelvis in lateral imbalance posture?

<p>The pelvis is higher on the left side.</p> Signup and view all the answers

Identify the short and strong muscles associated with lateral imbalance.

<p>One-joint hip flexors.</p> Signup and view all the answers

What type of head and shoulder position is associated with upper crossed syndrome?

<p>Forward head posture and rounded shoulders.</p> Signup and view all the answers

Which muscles are considered weak in upper crossed syndrome?

<p>Rhomboids, serratus anterior, lower trapezius, and deep neck flexors.</p> Signup and view all the answers

What structures are primarily responsible for preventing a person from regaining range of motion (ROM)?

<p>Shortened muscles and joint adhesions.</p> Signup and view all the answers

What are the two types of normal movement described in the context of joint motion?

<p>Physiological (osteokinematic) and accessory (arthrokinematic) movements.</p> Signup and view all the answers

Explain the term 'mobilization' as used in joint therapy.

<p>Mobilization refers to passive movement done at a slow speed that a patient can stop.</p> Signup and view all the answers

How does pure rolling affect a joint?

<p>It can dislocate the joint.</p> Signup and view all the answers

According to the convex-concave rule, what direction does gliding occur when the moving surface is convex?

<p>Glide occurs in the opposite direction of bone movement.</p> Signup and view all the answers

What is the treatment plane in joint mobilizations?

<p>A plane that is perpendicular to the axis of rotation in the convex surface.</p> Signup and view all the answers

Identify the two positions of joints and their characteristics during physiological motion.

<p>Closed-pack (maximum joint surface contact) and open-pack (least contact).</p> Signup and view all the answers

When is it necessary to mobilize or stretch a joint?

<p>When active or passive range of motion shows restriction compared to the opposite side.</p> Signup and view all the answers

What is the recommended number of treatments to potentially see an effect from joint mobilization?

<p>Typically 4-5 treatments.</p> Signup and view all the answers

What warning should be given to clients undergoing joint mobilization therapy?

<p>Soreness may occur after the first treatment.</p> Signup and view all the answers

What are the contraindications for joint mobilization therapy?

<p>Hypermobility, joint effusion, and inflammation.</p> Signup and view all the answers

List two effects of joint mobilization on articular tissues.

<p>Moves synovial fluid and maintains extensibility of tissues.</p> Signup and view all the answers

What are the effects of joint mobilization on pain perception?

<p>It mediates pain through stimulation of joint receptors.</p> Signup and view all the answers

What should you do if a patient experiences pain during compression of a joint?

<p>Identify it as a possible articular lesion requiring specific treatment.</p> Signup and view all the answers

What postural characteristic suggests excessive stretching of posterior ligaments in swayback posture?

<p>A posteriorly tilted pelvis suggests excessive stretching of the posterior ligaments.</p> Signup and view all the answers

In flat back posture, how is the thoracic spine characterized?

<p>The thoracic spine exhibits upper increased flexion and a flattened or straight lower segment.</p> Signup and view all the answers

What is a key feature of the cervical spine in lateral imbalance posture?

<p>The cervical spine is slightly extended in lateral imbalance posture.</p> Signup and view all the answers

Identify the weak muscles typically found in upper crossed syndrome.

<p>The weak muscles include rhomboids, serratus anterior, lower trapezius, and deep neck flexors.</p> Signup and view all the answers

In the context of swayback posture, which are the short and strong muscles?

<p>The hamstrings, upper fibers of internal oblique, and lumbar erector spinae are short and strong.</p> Signup and view all the answers

What postural alignment is observed in the lumbar spine during flat back posture?

<p>The lumbar spine is typically flattened or flexed in flat back posture.</p> Signup and view all the answers

Which hip position characterizes the swayback posture?

<p>The hip is held in extension in swayback posture.</p> Signup and view all the answers

What is a distinguishing feature of the pelvis in lateral imbalance?

<p>The pelvis is higher on the left side in lateral imbalance posture.</p> Signup and view all the answers

What is the relationship between joint congruency and gliding movement?

<p>Increased congruency allows more gliding, while decreased congruency favors rolling movements.</p> Signup and view all the answers

Under what circumstances would a patient likely experience pain during traction of the joint?

<p>Pain during traction usually indicates a soft-tissue or extra-articular lesion.</p> Signup and view all the answers

What is the primary effect of joint mobilization on synovial fluid?

<p>Joint mobilization facilitates the movement of synovial fluid, enhancing nutrient delivery to articular cartilage.</p> Signup and view all the answers

How does mobilization differ from manipulation in joint therapy?

<p>Mobilization involves passive movement at a slow speed, while manipulation applies a thrust to achieve movement.</p> Signup and view all the answers

In which position should a joint be mobilized to optimize the technique?

<p>A joint should be mobilized in the open-pack position for maximum effectiveness.</p> Signup and view all the answers

What treatment grade involves movements of 2-3 per second for 10 seconds?

<p>This corresponds to Grade 1 joint mobilization.</p> Signup and view all the answers

What is a key characteristic of the closed-pack position in joint therapy?

<p>In closed-pack position, joint surfaces are maximally in contact, and the supporting capsule is taut.</p> Signup and view all the answers

What does the convex-concave rule state regarding gliding movement based on surface shapes?

<p>If the moving surface is convex, the glide occurs in the opposite direction of the bone movement, and vice versa for concave surfaces.</p> Signup and view all the answers

What determines the grade of mobilization required when pain occurs during accessory motion testing?

<p>If pain occurs before resistance, Grade 1 or 2 mobilizations are indicated; if at resistance, Grade 3 or 4 should be applied.</p> Signup and view all the answers

In what conditions should joint mobilization be approached with caution due to potential complications?

<p>Caution is advised in cases involving malignancy, bone disease, or excessive pain.</p> Signup and view all the answers

When should a therapist consider mobilizing instead of stretching a joint?

<p>Mobilization is preferred if accessory motion is different or painful compared to the opposite side.</p> Signup and view all the answers

What are the four effects of joint mobilization?

<p>The effects are movement of synovial fluid, maintenance of tissue extensibility, integrity of neuroreceptors, and pain mediation.</p> Signup and view all the answers

What position characterizes an open-pack joint and its significance?

<p>In open-pack position, joint surfaces are least in contact and supporting structures are more lax, allowing for optimal joint play.</p> Signup and view all the answers

How does the number of mobilizations depend on previous session reactions?

<p>The reaction to previous sessions dictates how many mobilizations are performed in subsequent treatments.</p> Signup and view all the answers

When is it justified to treat a patient with low-grade joint mobilizations?

<p>Low-grade mobilizations are indicated if pain occurs before the end range of accessory motion.</p> Signup and view all the answers

What is a distinctive postural feature observed in the thoracic spine of individuals with swayback posture?

<p>The thoracic spine exhibits increased kyphosis.</p> Signup and view all the answers

Which muscles are primarily weak and elongated in flat back posture?

<p>The one-joint hip flexors are primarily weak and elongated.</p> Signup and view all the answers

Describe the hip joint position in lateral imbalance posture.

<p>The left hip is adducted with slight medial rotation, while the right hip is abducted.</p> Signup and view all the answers

Identify one strong and short muscle commonly found in individuals exhibiting upper crossed syndrome.

<p>The upper trapezius (UFT) is a strong and short muscle in upper crossed syndrome.</p> Signup and view all the answers

In the context of swayback posture, what is the position of the pelvis?

<p>The pelvis is held in a posterior tilt.</p> Signup and view all the answers

How is lumbar lordosis characterized in individuals with swayback posture?

<p>Lumbar lordosis is typically increased in swayback posture.</p> Signup and view all the answers

What feature of the cervical spine is associated with individuals suffering from upper crossed syndrome?

<p>The cervical spine is slightly extended.</p> Signup and view all the answers

What is the typical ankle position seen in both flat back and swayback postures?

<p>The ankle is in slight plantarflexion.</p> Signup and view all the answers

What should be monitored if there is pain during traction of the joint?

<p>This may indicate a soft-tissue or extra-articular lesion.</p> Signup and view all the answers

How does the degree of joint congruency affect movement patterns during joint mobilization?

<p>Higher congruency allows more gliding, while lower congruency results in increased rolling.</p> Signup and view all the answers

In which scenarios would it be appropriate to employ grade 1 and 2 joint mobilizations?

<p>They are used when pain occurs before the end range of accessory motion or when there's active inflammation.</p> Signup and view all the answers

When should joint mobilization techniques be avoided due to potential contraindications?

<p>Mobilization should not occur with hypermobility, joint effusion, or inflammation.</p> Signup and view all the answers

What outcomes may occur from ineffective joint mobilization treatment after several sessions?

<p>If no effect is observed after 4-5 treatments, reassessment is needed for alternative therapy.</p> Signup and view all the answers

How does the treatment plane relate to the application of joint mobilizations?

<p>Joint mobilizations are applied parallel to the treatment plane.</p> Signup and view all the answers

When addressing chronic injuries, what is the primary focus of joint mobilization?

<p>The focus is on restoring normal accessory motion through mobilization techniques.</p> Signup and view all the answers

What should be done if accessory motion testing reveals a difference or pain compared to the opposite side?

<p>Mobilization should be employed when accessory motion differs or is painful.</p> Signup and view all the answers

In terms of treatment parameters, what defines a grade 3 joint mobilization?

<p>Grade 3 involves movements of 2-3 per second for 30-60 seconds, with a rest duration of 30-60 seconds.</p> Signup and view all the answers

What is the significance of 'joint play' during the open-pack position?

<p>Joint play allows for increased movement and flexibility in the joint during this position.</p> Signup and view all the answers

What neurological involvement may warrant caution when considering joint mobilization?

<p>Precautions are necessary in cases of neurological involvement to prevent exacerbating conditions.</p> Signup and view all the answers

How many joints should be mobilized simultaneously during treatment?

<p>Only one joint should be mobilized at a time.</p> Signup and view all the answers

Identify a major functional effect of joint mobilization on synovial fluid.

<p>It helps move synovial fluid, which nourishes avascular articular cartilage.</p> Signup and view all the answers

What is the main purpose of mobilization in cases where patients have functional immobility?

<p>The purpose is to restore motion and alleviate the causes of immobility.</p> Signup and view all the answers

Which posture is characterized by tight hamstrings and a posterior tilt of the pelvis?

<p>Flat back (C)</p> Signup and view all the answers

In upper crossed syndrome, the weak muscles include the rhomboids and deep neck flexors.

<p>True (A)</p> Signup and view all the answers

What is the position of the hip joint in swayback posture?

<p>Extension</p> Signup and view all the answers

The thoracic spine in flat back posture is characterized by increased ______ in the upper region and being straight in the lower region.

<p>flexion</p> Signup and view all the answers

Match the following postures with their descriptions:

<p>Swayback = Weak anterior muscles and tight posterior muscles Flat back = Tight posterior lower spine with straightened lumbar spine Lateral imbalance = Asymmetrical pelvis with adducted and abducted hips Upper crossed syndrome = Tight upper back muscles and weak neck flexors</p> Signup and view all the answers

Which of the following muscles are categorized as short and strong in flat back posture?

<p>Hamstrings (B)</p> Signup and view all the answers

In lateral imbalance posture, the left leg appears longer due to adduction of the left leg.

<p>True (A)</p> Signup and view all the answers

Name a muscle that is elongated and weak in swayback posture.

<p>External obliques</p> Signup and view all the answers

What type of joint movement is manipulation characterized by?

<p>Passive movement using physiologic or accessory motions with a thrust (A)</p> Signup and view all the answers

Traction refers to the compression of joint surfaces.

<p>False (B)</p> Signup and view all the answers

What is the first indication for joint mobilization?

<p>Pain, reflex muscle guarding, muscle spasm</p> Signup and view all the answers

Most articular surfaces are not purely __________; therefore, individual accessory motion rarely happens.

<p>congruent</p> Signup and view all the answers

Match the movement type with its description:

<p>Rolling = Can dislocate the joint Gliding = Must occur with congruent articular surfaces Traction = Separation of joint surfaces Compression = Decrease in joint space</p> Signup and view all the answers

Which statement is true regarding the direction of gliding?

<p>Occurs in the opposite direction of bone movement when the moving surface is convex (D)</p> Signup and view all the answers

An open-pack position has the most joint surface contact.

<p>False (B)</p> Signup and view all the answers

How many joints should be mobilized at a time?

<p>Just one</p> Signup and view all the answers

The treatment plane is defined as a plane at right angle from the axis of rotation in the convex surface to the __________ of the concave surface.

<p>middle</p> Signup and view all the answers

Hypomobility is an indication for joint mobilization.

<p>True (A)</p> Signup and view all the answers

What is the most likely reason for patient soreness after treatment?

<p>Increased sensitivity from mobilization</p> Signup and view all the answers

Compression during weight bearing typically results in a __________ in the joint space.

<p>decrease</p> Signup and view all the answers

What grade of joint mobilization involves a movement of 2-3 per second for 30-60 seconds?

<p>Grade 3 (C)</p> Signup and view all the answers

Match the contraindications of joint mobilization with their descriptions:

<p>Hypermobility = Excessive movement of joints Joint effusion = Fluid accumulation in joints Inflammation = Swelling due to injury or irritation</p> Signup and view all the answers

What are the primary causes of hyperextension at the knees in swayback posture?

<p>Weak one-joint hip flexors and tight hamstrings contribute to hyperextension at the knees in swayback posture.</p> Signup and view all the answers

How does the cervical spine position in lateral imbalance differ from that in upper crossed syndrome?

<p>In lateral imbalance, the cervical spine is slightly extended, while in upper crossed syndrome, it is also slightly extended but is associated with rounded shoulders.</p> Signup and view all the answers

What is the role of the upper fibers of the internal oblique in relation to swayback posture?

<p>The upper fibers of the internal oblique are short and strong, helping to stabilize the pelvis and lumbar spine.</p> Signup and view all the answers

Describe the impact of a posteriorly tilted pelvis in flat back posture.

<p>A posteriorly tilted pelvis in flat back posture leads to flattening of the lumbar spine and tightness in the posterior lower back and hamstrings.</p> Signup and view all the answers

Which muscles are notably weak and elongated in individuals displaying a flat back posture?

<p>One-joint hip flexors are notably weak and elongated in individuals displaying flat back posture.</p> Signup and view all the answers

In lateral imbalance, how is the position of the pelvis characterized?

<p>In lateral imbalance, the pelvis is higher on the left side, leading to postural adduction of the left leg.</p> Signup and view all the answers

How do the effects of joint mobilization differ when a joint is in an open-pack versus a closed-pack position?

<p>In closed-pack position, joints are maximally congruent, limiting mobilization effectiveness, whereas in open-pack position, there is more available motion for effective mobilization.</p> Signup and view all the answers

What distinguishes the posture of the thoracic spine in an individual with upper crossed syndrome?

<p>The thoracic spine in upper crossed syndrome is characterized by increased flexion in the upper region and a rounded shoulder position.</p> Signup and view all the answers

What type of movement is joint mobilization classified as?

<p>Accessory movement.</p> Signup and view all the answers

Describe the effect of pure rolling on a joint.

<p>Pure rolling can dislocate the joint.</p> Signup and view all the answers

What should gliding motion occur with to ensure safety for a joint?

<p>Congruent articular surfaces.</p> Signup and view all the answers

In what joint position should mobilizations ideally be conducted?

<p>In the open-pack position.</p> Signup and view all the answers

What is the primary purpose of joint traction during therapy?

<p>Separation of joint surfaces.</p> Signup and view all the answers

What is indicated if a patient shows pain during compression of a joint?

<p>An articular lesion is likely present.</p> Signup and view all the answers

How many joints should be treated at one time during mobilization?

<p>Just one joint.</p> Signup and view all the answers

According to the convex-concave rule, in which direction does gliding occur when the moving surface is concave?

<p>In the same direction as bone movement.</p> Signup and view all the answers

What is the established range for movements per second during Grade 3 joint mobilization?

<p>2-3 movements per second.</p> Signup and view all the answers

What signifies a closed-pack position in joint therapy?

<p>Joint surfaces have maximum contact and tight ligaments.</p> Signup and view all the answers

List the consequences of joint mobilization on synovial fluid.

<p>It moves synovial fluid, bringing nutrients to articular cartilage.</p> Signup and view all the answers

What type of joint mobilization grades should be applied if pain occurs before reaching the end range of motion?

<p>Grade 1 and 2 mobilizations.</p> Signup and view all the answers

What are the two types of normal movement essential for joint function?

<p>Physiological (osteokinematic) and accessory (arthrokinematic) movements.</p> Signup and view all the answers

What actions characterize the treatment plane in joint mobilization?

<p>Mobilizations occur parallel to the treatment plane.</p> Signup and view all the answers

What is the significance of assessing neural tension tests in nerve mobilization?

<p>Assessing neural tension tests helps to identify the specific problem related to nerve pathology.</p> Signup and view all the answers

How do sensitizing tests aid in diagnosing nerve-related issues?

<p>Sensitizing tests use structural differentiation to isolate and identify the source of symptoms.</p> Signup and view all the answers

Describe the role of the upper limb tension tests in course of nerve mobilization.

<p>Upper limb tension tests evaluate the flexibility and response of the nerves in the arm to determine neural tension.</p> Signup and view all the answers

What approach should be taken while treating irritable conditions during nerve mobilization?

<p>Treatment should begin with gentle techniques to minimize irritation before progressing to more active strategies.</p> Signup and view all the answers

What are the implications of continuing load on neural structures in relation to nerve mobilization?

<p>Prolonged loading increases the susceptibility of neurons to compression, potentially worsening nerve pathology.</p> Signup and view all the answers

How does the reaction to treatment influence the approach to nerve mobilization techniques?

<p>The intensity and amount of mobilization should be adjusted according to the patient's response to treatment.</p> Signup and view all the answers

What is the recommended duration for oscillation techniques during the treatment of non-irritable disorders?

<p>20-30 seconds of oscillations is recommended.</p> Signup and view all the answers

Describe how the behavior of symptoms is assessed during tension testing.

<p>Assessing the behavior of symptoms involves observing changes in pain and mobility during the range of tension tests.</p> Signup and view all the answers

Why is establishing all possible sources of signs and symptoms crucial in tension testing?

<p>Identifying all potential sources allows for a comprehensive assessment and targeted treatment of nerve pathology.</p> Signup and view all the answers

What is the primary purpose of the SLR sensitizing tests in assessing lower limb disorders?

<p>To assess lower limb overuse syndromes and identify specific nerve tension.</p> Signup and view all the answers

How should treatment progression be approached for irritable disorders according to Butler, Shacklock & Slater?

<p>One should change only one variable at a time during reassessment of symptoms.</p> Signup and view all the answers

What does 'non-provocative range' refer to in the context of treatment amplitude?

<p>It refers to the range in which treatment can be applied without provoking symptoms.</p> Signup and view all the answers

How do hip medial rotation and adduction affect sciatic nerve tension during testing?

<p>They increase tension in the sciatic nerve and can help assess nerve sensitivity.</p> Signup and view all the answers

What differentiates the Slump Test from the SLR in neural testing?

<p>The Slump Test includes a meninges/dural component that is not considered in the SLR.</p> Signup and view all the answers

What is a critical precaution to take during nerve mobilization treatment?

<p>Discontinue treatment if symptoms worsen.</p> Signup and view all the answers

Describe the main difference in treatment strategy between irritable and non-irritable disorders.

<p>Irritable disorders require stopping techniques prior to symptom provocation, whereas non-irritable disorders can tolerate some discomfort.</p> Signup and view all the answers

What is the initial approach to treating irritable disorders of the nervous system?

<p>Treat distal interfacing structures non-provocatively and avoid exacerbating symptoms.</p> Signup and view all the answers

What are some methods to increase tension in treatment for non-irritable disorders?

<p>Methods include increasing time of technique, going further into resistance, and using treatment closer to the source of symptoms.</p> Signup and view all the answers

In managing non-irritable disorders, which type of mobilization technique is preferred?

<p>Tensioners are preferred for non-irritable conditions to normalize nerve sensitivity.</p> Signup and view all the answers

Which two test components are suggested to be taken up first in Upper Limb Tension Tests when symptoms are distal?

<p>Taking up the distal components first is recommended for sensitivity.</p> Signup and view all the answers

What type of oscillations are used in treatments for irritable conditions, and what is their frequency?

<p>3-5 second oscillations are used, with a frequency that is slower than joint mobilization.</p> Signup and view all the answers

What is the overarching goal of treatment for conditions affecting the nervous system?

<p>To restore the range of movement and normalize sensitivity within the nervous system.</p> Signup and view all the answers

What is the primary goal of treatment for non-irritable disorders when using Grade III or Grade IV techniques?

<p>The goal is to increase the amplitude through the range without exacerbating symptoms.</p> Signup and view all the answers

Why are sliders more likely to be used in treating irritable conditions?

<p>Sliders facilitate movement while minimizing provocation of symptoms in sensitive areas.</p> Signup and view all the answers

What is the primary objective when treating irritable disorders according to Butler, Shacklock & Slater?

<p>To progress treatment based on symptom reassessment and change one variable at a time.</p> Signup and view all the answers

How long should oscillatory techniques be applied during the treatment of non-irritable disorders?

<p>20-30 seconds with 3-5 second oscillations.</p> Signup and view all the answers

In nerve mobilization, what should be the immediate action if a patient experiences worsening symptoms?

<p>The technique should be discontinued.</p> Signup and view all the answers

What is the main goal of treatment for the nervous system according to Butler, Shacklock & Slater?

<p>To restore range of movement of the nervous system and normalize its sensitivity.</p> Signup and view all the answers

What technique is recommended to treat irritable disorders in relation to the nervous system?

<p>Mobilization distant to the symptom area is recommended initially.</p> Signup and view all the answers

What treatment grade involves using Gr.III or Gr.IV techniques on relevant interfacing structures?

<p>Grade III or IV treatment techniques apply larger amplitude movements through the range.</p> Signup and view all the answers

What is indicated when moving from passive treatment to active self-treatment in the progression of irritable disorders?

<p>This indicates a shift towards greater patient involvement in their recovery process.</p> Signup and view all the answers

Which specific tests are utilized to determine the involvement of the nervous system?

<p>SLR, PKB, Slump, and ULTTs.</p> Signup and view all the answers

What is the key difference between the Slump Test and SLR?

<p>The Slump Test includes a meninges/dural component, while SLR does not.</p> Signup and view all the answers

What factor must be considered when assessing treatment techniques for non-irritable disorders?

<p>The treatment should stop just prior to provoking symptoms.</p> Signup and view all the answers

What is suggested to be used more in irritable conditions, sliders or tensioners?

<p>Sliders are more likely to be used in irritable conditions.</p> Signup and view all the answers

During the treatment progression for non-irritable disorders, what is one method to increase treatment challenge?

<p>Moving closer to the source of symptoms.</p> Signup and view all the answers

When treating non-irritable conditions, what type of techniques are advised?

<p>Tensioners are preferred in non-irritable conditions.</p> Signup and view all the answers

How should the amplitude of techniques be altered in the treatment of irritable disorders?

<p>The amplitude should be gradually increased during treatment sessions.</p> Signup and view all the answers

What is the impact of ankle dorsiflexion during SLR testing?

<p>It increases tension in the tibial branch of the sciatic nerve.</p> Signup and view all the answers

What should be the initial approach when treating an irritable nervous system condition?

<p>Start with non-provoking techniques and under-treat initially.</p> Signup and view all the answers

What is the principle of assessing interfaces in nerve mobilization?

<p>Treat interfaces first if they show the most restriction before addressing the nervous system.</p> Signup and view all the answers

What are sensitizing tests used for in tension testing?

<p>Sensitizing tests alter component movements remote from the site of symptoms to assist in identifying nerve involvement.</p> Signup and view all the answers

How does continued load affect neural and supporting structures?

<p>Continued load makes the neuron and supporting structures more susceptible to compression.</p> Signup and view all the answers

What should be done if progress in nerve mobilization plateaus?

<p>Reassess whether all contributing components have been adequately addressed.</p> Signup and view all the answers

What factors determine the intensity of nerve mobilization treatment?

<p>The amount and intensity of treatment are based on the patient's reaction to previous sessions.</p> Signup and view all the answers

In tension testing, what does the sequence of area response indicate?

<p>It indicates the order in which symptoms manifest during testing, helping to identify specific nerve involvement.</p> Signup and view all the answers

What role do upper limb tension tests play in assessing nerve pathways?

<p>Upper limb tension tests help determine the state of neural pathways and their response to stretching.</p> Signup and view all the answers

Why is structural differentiation important in conducting tension tests?

<p>Structural differentiation helps isolate movements and assess the role of non-neural tissue in symptom presentation.</p> Signup and view all the answers

Which of the following conditions is considered an injury with a neural component?

<p>Brachial plexus (A)</p> Signup and view all the answers

Nerve pathology does not affect innervated structures.

<p>False (B)</p> Signup and view all the answers

What is the primary focus when addressing nerve mobilization treatment?

<p>Assess interfaces and treat the most restricted structures first.</p> Signup and view all the answers

Sensitizing tests use structural differentiation to alter movements __________ from the site of symptoms.

<p>remote</p> Signup and view all the answers

Match the following nerve conditions with their definitions:

<p>Disc = Nerve compression due to disc herniation Sciatica = Pain radiating along the sciatic nerve Carpal Tunnel = Compression of the median nerve at the wrist Brachial plexus = Network of nerves supplying the arm</p> Signup and view all the answers

Which testing method includes the response of the contralateral limb?

<p>Tension tests (D)</p> Signup and view all the answers

Continued load on nerve structures can lead to increased resistance to compression.

<p>False (B)</p> Signup and view all the answers

What factors determine the amount and intensity of nerve mobilization treatment?

<p>Reaction to treatment and progress in the condition.</p> Signup and view all the answers

Which test includes a dural component and differs from the SLR test?

<p>Slump Test (C)</p> Signup and view all the answers

Dorsiflexion of the ankle decreases tension in the tibial branch of the sciatic nerve.

<p>False (B)</p> Signup and view all the answers

What is the primary goal of mobilizing the nervous system during treatment?

<p>To restore range of movement and normalize sensitivity of the system.</p> Signup and view all the answers

In treating irritable disorders, therapists should initially treat relevant interfacing structures ______ to the injury site.

<p>distal</p> Signup and view all the answers

Match the following terms with their corresponding actions:

<p>Sliders = Used for irritable conditions Tensioners = Used for non-irritable conditions SLR = Assess L/S and LE disorders Slump Test = Includes dural component</p> Signup and view all the answers

Which of the following conditions is more likely to use sliders in treatment?

<p>Irritable conditions (B)</p> Signup and view all the answers

Upper limb tension tests are more sensitive when taking up the proximal components first.

<p>False (B)</p> Signup and view all the answers

What is meant by 'mobilize, not stretch' in the context of treating the nervous system?

<p>It refers to using gentle and strong techniques to improve range of motion without overstretching.</p> Signup and view all the answers

What is the recommended duration for oscillation techniques in treating non-irritable disorders?

<p>20-30 seconds (A)</p> Signup and view all the answers

In treating irritable disorders, symptoms should be provoked to gauge treatment effectiveness.

<p>False (B)</p> Signup and view all the answers

List two modifications that can be made during the treatment progression of non-irritable disorders.

<p>Increase time of technique, Go further into resistance.</p> Signup and view all the answers

Maitland recommends discontinuing treatment if __________ worsens.

<p>symptoms</p> Signup and view all the answers

Which of the following techniques involves movements of 2-3 oscillations per second?

<p>Joint mobilization (B)</p> Signup and view all the answers

Match the treatment techniques with their description:

<p>Gr.III = Amplitudes through range Gr.IV = Higher amplitude techniques Passive treatment = Client is not actively involved Active self-treatment = Client performs the technique themselves</p> Signup and view all the answers

Nerve mobilization techniques should be applied to inflamed or infectious nervous system disorders.

<p>False (B)</p> Signup and view all the answers

What should a therapist do if cord signs are observed during nerve mobilization?

<p>Discontinue the treatment.</p> Signup and view all the answers

What should be the primary focus when treating non-irritable symptoms at a specific site?

<p>Treat relevant interfacing structures at the area of the symptoms.</p> Signup and view all the answers

How long should oscillatory techniques ideally be applied during treatment?

<p>20-30 seconds of oscillations are recommended.</p> Signup and view all the answers

What is a recommended strategy when increasing treatment intensity for non-irritable conditions?

<p>Increase time of technique or go further into resistance.</p> Signup and view all the answers

What could indicate that a treatment technique should stop if there are concerns about irritability?

<p>The technique should stop just prior to provoking symptoms.</p> Signup and view all the answers

In the context of treatment progression, what is crucial for evaluating the effectiveness of techniques?

<p>Treatment progression should be based on reassessment of symptoms.</p> Signup and view all the answers

What is the recommended number of oscillations per second with joint mobilization to achieve effective treatment?

<p>2-3 oscillations per second should be used.</p> Signup and view all the answers

What are the key factors to assess when determining the effectiveness of neural tension tests?

<p>The response of the contralateral limb and the behaviour of symptoms throughout the range of motion are key factors to assess.</p> Signup and view all the answers

In what scenario should treatment be focused on interfacing structures distal to the injury site?

<p>Treatment should be focused on interfacing structures distal to the injury site when addressing an irritable condition of the nervous system.</p> Signup and view all the answers

Which structures may be involved in treatment when addressing upper body complaints?

<p>Dural ligaments, costoclavicular interval, and cervicothoracic junction are key structures.</p> Signup and view all the answers

What is the significance of treating involved non-neural structures in a tension position?

<p>It allows for deeper muscle engagement and can lead to improved treatment outcomes.</p> Signup and view all the answers

What initial approach should be taken when mobilizing the nervous system in an irritable condition?

<p>An initial non-provoking approach should be taken, allowing for gradual increases in treatment based on symptoms.</p> Signup and view all the answers

What should be considered if patient progress plateaus during treatment?

<p>Reassess whether all components involved in the patient's condition have been adequately addressed.</p> Signup and view all the answers

What is the significance of sensitizing tests in the context of tension testing?

<p>Sensitizing tests use structural differentiation to alter movements that are remote from the site of symptoms.</p> Signup and view all the answers

What should a therapist do if symptoms worsen during treatment?

<p>The therapist should discontinue treatment immediately if symptoms worsen.</p> Signup and view all the answers

How should treatment intensity be determined in nervous system mobilization?

<p>Treatment intensity should be based on the patient's reaction to the treatment.</p> Signup and view all the answers

In tension testing principles, what is meant by the 'components concept'?

<p>The components concept considers all potential sources of signs and symptoms to establish their relationship to the disorder.</p> Signup and view all the answers

What are the primary contraindications for treatment related to the nervous system?

<p>Inflammatory, systemic, and infectious disorders such as AIDS, diabetes, and multiple sclerosis.</p> Signup and view all the answers

What should be done if a patient experiences worsening symptoms during treatment?

<p>Discontinue treatment immediately.</p> Signup and view all the answers

In tension testing, what is the importance of observing the contralateral limb's response?

<p>It helps to assess the presence of signs and symptoms related to the disorder.</p> Signup and view all the answers

When should treatment of neural structures be prioritized?

<p>When the nerve is the most comparable structure indicated in the assessment.</p> Signup and view all the answers

What is the initial approach in irritable treatment for the nervous system?

<p>Focus on treating relevant interfacing structures distal to the injury site.</p> Signup and view all the answers

How should treatment intensity and amount be adjusted during therapy?

<p>Based on the patient's reaction to the treatment.</p> Signup and view all the answers

What defines sensitizing tests in tension testing?

<p>They use structural differentiation to alter component movements remote from the site of symptoms.</p> Signup and view all the answers

What is the significance of treating relevant interfacing structures in non-irritable treatment?

<p>It helps to restore normal function and alleviate symptoms by addressing restrictions and mobility issues.</p> Signup and view all the answers

Why should treatment techniques stop just before provoking symptoms during non-irritable treatment?

<p>Stopping before symptoms arise prevents exacerbation of discomfort and maintains patient tolerance.</p> Signup and view all the answers

What is the rationale for under-treatment at the start of therapy for irritable conditions?

<p>To clarify the sensitivity of the system before progressing with treatment.</p> Signup and view all the answers

How does increasing the amplitude of techniques contribute to treatment progression?

<p>It allows for greater joint mobility and facilitates more effective engagement of affected structures.</p> Signup and view all the answers

What is the recommended duration for oscillation techniques during non-irritable treatment?

<p>Treatment should involve 20-30 seconds of oscillations.</p> Signup and view all the answers

Why is it important to reassess symptoms during treatment progression?

<p>Reassessment allows practitioners to gauge treatment effectiveness and adjust techniques accordingly.</p> Signup and view all the answers

What role does position play when treating involved non-neural structures?

<p>Positioning in tension helps optimize the technique's efficacy and reduce discomfort during treatment.</p> Signup and view all the answers

What are 3-5 second oscillations preferred over traditional joint mobilization methods?

<p>They provide more consistent engagement with the tissue and promote quicker adjustments in response to treatment.</p> Signup and view all the answers

How should one modify treatment when moving from oscillatory techniques to sustained techniques?

<p>Gradually increase the duration and intensity of resistance to ensure patient comfort and effectiveness.</p> Signup and view all the answers

What are two major contraindications for neural mobilization treatment?

<p>Inflammatory, systemic, infectious disorders of the nervous system such as AIDS and diabetes.</p> Signup and view all the answers

List two precautionary measures to take during neural mobilization.

<p>Discontinue treatment if symptoms worsen and monitor for cord signs.</p> Signup and view all the answers

In treatment protocols, when should neural structures be prioritized over interfaces?

<p>When nerve is the most comparable structure indicated in assessment.</p> Signup and view all the answers

What are sensitizing tests used for in the context of tension testing?

<p>They are used to alter component movements remote from the site of symptoms.</p> Signup and view all the answers

How should the intensity of treatment be adjusted during neural mobilization?

<p>It should be based on the patient's reaction to treatment.</p> Signup and view all the answers

Describe one characteristic of the oscillations used in Grade II mobilization.

<p>They involve 3-5 second oscillations that are slow and rhythmic through a non-provoking range.</p> Signup and view all the answers

What should be assessed if a patient's progress plateaus during treatment?

<p>Assess whether all components related to the symptoms have been addressed.</p> Signup and view all the answers

Why is it important to treat interfacing structures distal to the injury site?

<p>Because it can help relieve tension and symptoms without provoking the injury area.</p> Signup and view all the answers

How does changing one variable at a time impact treatment progression?

<p>It allows for clearer assessment of which changes positively or negatively affect the patient's symptoms.</p> Signup and view all the answers

What is the recommended duration for oscillations when treating symptoms?

<p>20-30 seconds of oscillations is recommended for optimal results.</p> Signup and view all the answers

Explain why techniques should stop just prior to provoking symptoms if irritability is a concern.

<p>Stopping before symptoms are provoked prevents exacerbation of pain and promotes patient comfort.</p> Signup and view all the answers

What treatment method involves transitioning from oscillatory techniques to sustained techniques?

<p>This method is used to increase the effectiveness of treatment by applying constant force for deeper tissue engagement.</p> Signup and view all the answers

What structures should be targeted when treating lower body interfaces?

<p>Structures like the lumbosacral junction, hip joint, and knee joint should be specifically targeted.</p> Signup and view all the answers

Describe the role of amplitude choice (Gr.III or Gr.IV) in non-irritable treatment techniques.

<p>Selecting an appropriate amplitude (Gr.III or Gr.IV) affects the extent of tissue mobilization and patient comfort during treatment.</p> Signup and view all the answers

Which of the following is a contraindication for treatment?

<p>Diabetes (C)</p> Signup and view all the answers

Treatment should always continue if symptoms are worsening.

<p>False (B)</p> Signup and view all the answers

What is the focus when treating interfaces in patients with nerve issues?

<p>Treat interfaces that have the most restriction first.</p> Signup and view all the answers

Tension tests affect both _____ and non-neural tissue.

<p>neural</p> Signup and view all the answers

Match the following principles with their descriptions:

<p>Assess neural tension tests = Determine problem areas Sensitizing Tests = Alter component movements remote from the site of symptoms Treatment progression = Based on reassessment of symptoms Active techniques = Needed for home programs</p> Signup and view all the answers

What treatment technique should be used if the sensitivity of the system is unclear?

<p>Non-provoking treatment (C)</p> Signup and view all the answers

It is always preferable to treat the nervous system first without assessing the interfaces.

<p>False (B)</p> Signup and view all the answers

What does the components concept emphasize in tension testing?

<p>Consider all possible sources of signs and symptoms.</p> Signup and view all the answers

What is the recommended duration of oscillations during treatment?

<p>20-30 seconds (A)</p> Signup and view all the answers

Moving from passive treatment to active self-treatment should be done gradually.

<p>True (A)</p> Signup and view all the answers

What should be monitored to determine if the technique should stop during treatment?

<p>symptom irritability</p> Signup and view all the answers

To treat relevant interfacing structures, practitioners should focus on structures such as the _ and the _ junction.

<p>dural ligaments, cervicothoracic</p> Signup and view all the answers

Match the following joints to their corresponding specific areas:

<p>Lumbosacral junction = L5-S1 Hip joint = Acetabulum and femur Knee joint = Femur, tibia, and patella Ankle joint = Tibia, fibula, and talus</p> Signup and view all the answers

Which of the following is a component to increase tension in treatment?

<p>Adding components that increase tension (A)</p> Signup and view all the answers

Treatment should involve no discomfort for the patient.

<p>False (B)</p> Signup and view all the answers

What is the primary focus when treating the upper body in therapy?

<p>Dural ligaments</p> Signup and view all the answers

Flashcards

Swayback posture

A postural distortion characterized by increased thoracic kyphosis, lumbar lordosis, and a posterior pelvic tilt.

Swayback - weak muscles

In swayback posture, the muscles at the front of the body are weak, while the muscles in the back are strong.

Flat back posture

Posture with a flattened lumbar spine, often with a posterior pelvic tilt, tighter posterior lower spine and hamstrings.

Flat back- tight muscles

In flat back posture, posterior lower spinal muscles, and hamstrings are tight.

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Lateral imbalance posture

Posture with a slight thoracolumbar curve convex to one side, often associated with tight leg muscles on one side and weak muscles on the opposite side.

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Lateral imbalance- weak muscles

In lateral imbalance, muscles on one side of the body (legs) are tight, while the opposite side muscles are weak.

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Upper crossed syndrome

Characterized by forward head posture, rounded shoulders, and tightness in specific upper back and neck muscles, coupled with weakness in opposing muscles.

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Upper cross syndrome- tight muscles

In upper crossed syndrome, upper back, and neck muscles along the front and top of the body are tight.

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Shortened muscles

Muscles that are contracted and unable to stretch fully, limiting range of motion (ROM).

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Joint adhesions

Sticky bands of scar tissue that form in the joint, restricting movement.

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Physiological/osteokinematic motion

The type of motion that a person can consciously or voluntarily control in a joint.

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Accessory/arthrokinematic motion

The involuntary joint motions necessary for normal physiological motion (e.g., gliding, rolling).

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Mobilization

Passive movement done at a slow pace, allowing the patient to stop movement if needed.

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Manipulation

Passive movement that uses a thrust and can include physiological or accessory motion.

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Joint congruency

How well the joint surfaces fit together.

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Convex-concave rule

A rule for determining the direction of gliding motion in a joint based on whether the moving joint surface is convex or concave.

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Compression

Decreased joint space, often occurring during weight bearing.

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Traction

Separation of joint surfaces.

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Treatment plane

The plane perpendicular to the axis of rotation through the middle of the concave joint surface.

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Closed-pack position

A position in a joint where articulating surfaces have maximum contact and supporting ligaments/capsule are taut.

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Open-pack position

A joint position where joint surfaces have minimal contact and supporting structures are loose.

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Joint Mobilization

A passive movement done at a slow pace, allowing the patient to stop movement if needed.

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Joint Manipulation

A passive movement that uses a thrust to restore joint motion, potentially including physiological or accessory motions.

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Accessory motion

Involuntary movements within a joint that are necessary for normal, conscious movement. They include gliding, rolling, and spinning.

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Physiological motion

Movement that a person can consciously control, such as bending your arm or extending your leg. It can be done eccentrically or concentrically.

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Joint mobilization grade 1

A small amplitude movement performed at the beginning of range of motion, used to assess and increase joint play.

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Joint mobilization grade 2

A larger amplitude movement performed within the mid-range of motion, used to increase joint play and reduce stiffness.

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Joint mobilization grade 3

A larger amplitude movement performed at the end range of motion, used to stretch the joint capsule and ligaments.

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Joint mobilization grade 4

A high amplitude movement performed at the end range of motion, used to stretch the joint capsule and ligaments with a strong force.

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Lateral Imbalance: Tight Leg Muscles

In lateral imbalance, leg muscles on one side (e.g., hip adductors and tibialis posterior) are tight, while opposing muscles on the other side are weak.

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What are the benefits of joint mobilization?

Joint mobilization can improve synovial fluid flow, maintain joint tissue extensibility, enhance neuroreceptor function, and mediate pain.

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When would you use joint mobilization?

Joint mobilization is indicated for pain, hypomobility, progressive limitations, and functional immobility. It's a good option for chronic injuries, recurrent acute injuries, post-immobilization, post-surgery, and spine/pelvis injuries.

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When should you avoid joint mobilization?

Joint mobilization is contraindicated in hypermobility, joint effusion, inflammation, malignancy, bone disease, congenital or neurological involvement, unhealed fracture, excessive pain, vertebral artery issues, total joint replacements, immediately post-surgery/injury, inflammatory arthritis, elderly patients, and coagulation problems.

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Physiologic Movement

Movement that occurs voluntarily and can be controlled consciously.

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Accessory Movement

Involuntary movement within a joint that is necessary for normal physiologic motion.

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What is the treatment plane?

The plane perpendicular to the axis of rotation of a joint, used as a reference for joint mobilization techniques.

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What is the difference between mobilization and manipulation?

Mobilization is a slow, controlled passive movement, while manipulation is a faster, more forceful passive movement that uses a thrust.

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What is a joint adhesion?

Scar tissue that forms within a joint, restricting its range of motion.

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What is meant by congruency in joint surfaces?

How well the articulating surfaces of a joint fit together.

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How many joint mobilizations are usually needed to see an effect?

Typically, 4-5 treatments are needed to see noticeable improvement.

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Indications for Joint Mobilization

Reasons why joint mobilization is appropriate, including pain, hypomobility, progressive limitation, and functional immobility.

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Contraindications for Joint Mobilization

Conditions where joint mobilization is not appropriate, including hypermobility, joint effusion, inflammation, malignancy, bone disease, and other specific issues.

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Effects of Joint Mobilization

Benefits of joint mobilization, including improving synovial fluid flow, maintaining tissue extensibility, enhancing neuroreceptor function, and mediating pain.

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What are the weak muscles in Swayback?

Swayback has weak one-joint hip flexors, upper T-S erector spinae, external obliques and neck flexors.

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What are the strong muscles in Swayback?

Swayback has strong hamstrings, the upper fibers of the internal oblique and lumbar erector spinae.

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What are the weak muscles in Flat Back?

Flat back posture has weak one-joint hip flexors.

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What are the strong muscles in Flat Back?

Flat back posture has strong hamstrings, upper fibers of the internal oblique and lumbar erector spinae.

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Joint Play

The movement that occurs in a joint when it's not actively being moved, allowing for gliding, rolling, and spinning of joint surfaces. It's an involuntary movement.

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Concave-Convex Rule

This rule helps determine the direction of gliding in a joint based on the shape of the moving surface. If the moving surface is convex, gliding happens opposite to the bone movement. If the moving surface is concave, gliding moves in the same direction as the bone.

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Irritable Joint

A joint that becomes painful when moved into specific positions or loaded beyond its limits.

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Treatment Progression for Irritable Joints

Start with gentle movements and slowly increase the intensity, duration, and range of motion as tolerated.

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Non-irritable Joint

A joint that doesn't experience significant pain or discomfort with movement.

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Treatment Progression For Non-Irritable Joints

Begin with larger movements and gradually increase the intensity, duration, and resistance over time.

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Oscillatory Technique

A technique involving rhythmic back-and-forth movements applied to a joint.

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Sustained Technique

A technique involving holding a joint in a specific position for a period of time.

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Nerve Mobilization Precautions

Be cautious when performing nerve mobilization techniques, especially if symptoms worsen or cord signs appear.

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Nerve Mobilization Contraindications

Don't use nerve mobilization in cases of inflammation, systemic disorders, or infections affecting the nervous system.

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SLR Test

A test used to assess lower limb nerve tension by extending the leg while keeping the knee straight. It can help diagnose nerve compression, sciatica, and other lower limb conditions.

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Slump Test

A test that assesses dural tension by flexing the neck, extending the spine, and flexing the knee. Useful for evaluating pain that originates in the meninges or dural structures.

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Upper Limb Tension Test (ULTT)

A series of tests that assess nerve tension in the upper limb by moving the arm through specific ranges of motion. Helps identify nerve compression in the neck, shoulder, or hand.

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Nerve Mobilization

A manual therapy technique that involves gently moving the nerve tissue through a range of motion to improve its mobility, reduce tension, and alleviate compression.

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Irritable vs. Non-Irritable Disorder

Irritable disorders are sensitive to movement and pain, while non-irritable disorders have limited pain despite movement. This influences the type of nerve mobilization technique used.

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Treatment Progression

Nerve mobilization starts with gentle movements and gradually increases intensity, duration, and range of motion as tolerated. This depends on whether a condition is irritable or non-irritable.

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What are the main principles of Nerve Mobilization?

The principles include assessing neural tension, identifying restricted interfaces (muscles, joints, fascia), treating the most restricted structure first, and progressing treatment based on patient response. Active techniques are often used for home programs to maintain mobility.

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What are the key aspects of neural tension tests?

They assess the response of the contralateral (opposite) limb, the range of movement, symptom behavior throughout the test, specific areas of response, the sequence of those responses, the effect of sensitizing maneuvers, and any abnormal responses.

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Sensitizing Tests

These tests help isolate specific components of the nervous system by influencing movement away from the site of symptoms. Examples include Upper Limb Tension Tests (Neurodynamic Tests), SLR (Straight Leg Raise), and Slump Test.

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What are the goals of nerve mobilization treatment?

The goals are to reduce pain, improve nerve function, restore normal range of motion, and improve overall quality of life by addressing nerve-related symptoms and movement limitations.

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Factors influencing nerve mobilization techniques

The amount and intensity of treatment are determined by the patient's reaction to treatment. Passive techniques are used to relax muscle interfaces, while active techniques are useful for longer-term maintenance.

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What is the significance of the interface in nerve mobilization?

Interfaces are the areas where the nerve interacts with other structures like muscles, joints, and fascia. These restrictions at the interface can influence the nerve's function and increase tension.

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When should you reconsider nerve mobilization?

If progress plateaus, it's crucial to reassess whether all components of the problem have been addressed. This might involve re-evaluating the tension tests and identifying any remaining restrictions.

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SLR Sensitizing Tests

These tests help identify nerve tension by increasing tension in specific nerve branches. Examples include ankle dorsiflexion, ankle inversion, hip adduction, and hip medial rotation.

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Nerve Mobilization Goal

To improve nerve function by restoring normal range of motion and reducing pain. It aims to address nerve-related symptoms and movement limitations.

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Irritable vs. Non-Irritable

Irritable conditions are sensitive to movement and worsen with activity. Non-irritable conditions are not as sensitive and respond less strongly to movement.

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Nerve Interfaces

These are points where the nerve interacts with other structures like muscles, joints, and fascia. Restrictions here can increase nerve tension.

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When to Reconsider

If progress plateaus, reassess the nerve tension tests and identify any remaining restrictions. It's crucial to address all contributing factors.

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Irritable Disorders

Conditions that are very sensitive to movement and cause pain when moved into specific positions or loaded beyond their limits.

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Non-Irritable Disorders

Conditions where there is limited pain and discomfort with movement, even when the joint is stressed.

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Interface

The area where a nerve interacts with other structures like muscles, joints, and fascia. Restrictions at these interfaces can affect the nerve's function and increase tension.

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Neural Tension Tests

A series of tests that evaluate the mobility and tension of a nerve by systematically moving the body through specific ranges of motion related to the nerve path.

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Interfaces in Nerve Mobilization

The points where a nerve interacts with surrounding structures such as muscles, joints, and fascia. Restrictions at these interfaces can contribute to nerve tension.

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Passive vs. Active Techniques

Passive nerve mobilization techniques involve a therapist manually moving the nerve, while active techniques involve the patient actively moving their body to improve nerve mobility.

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Treatment Progression in Nerve Mobilization

Nerve mobilization starts with gentle maneuvers, gradually increasing intensity and range of motion as the patient tolerates it, based on their response to treatment.

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Nerve Mobilization for Irritable vs. Non-irritable Disorders

Nerve mobilization techniques vary based on whether a condition is irritable (sensitive to movement) or non-irritable (minimal pain with movement). Irritable disorders require more gentle approaches.

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What is the goal of nerve mobilization treatment?

To restore normal range of motion, reduce pain, improve nerve function, and improve overall quality of life. This aims to address nerve-related symptoms and movement limitations.

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What are 'sensitizing tests' in nerve mobilization?

These tests help isolate specific nerve branches and components by increasing tension in those areas. Examples include ankle dorsiflexion, ankle inversion, hip adduction, and hip medial rotation.

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What's the difference between irritable and non-irritable disorders?

Irritable conditions cause pain with movement and are sensitive to activity. Non-irritable conditions have limited pain despite movement. This influences the type of nerve mobilization used.

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What are 'interfaces' in nerve mobilization?

These are points where the nerve interacts with surrounding structures like muscles, joints, and fascia. Restrictions here can increase nerve tension.

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Why is understanding interfaces crucial in nerve mobilization?

Restrictions at the interface, where the nerve interacts with other structures, can significantly influence nerve function and tension.

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What to do if nerve mobilization progress plateaus?

Reassess the nerve tension tests and identify any remaining restrictions. It's important to address all contributing factors to the problem.

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What are the general principles of nerve mobilization?

The principles include assessing neural tension, identifying restricted interfaces, treating the most restricted structure first, and progressing treatment based on the patient's response.

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What are the two main types of nerve mobilization techniques?

Passive techniques involve a therapist manually moving the nerve, while active techniques involve the patient actively moving their body to improve nerve mobility.

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Treatment Progression for Irritable Disorders

Starting with gentle movements and slowly increasing the intensity, duration, and range of motion as tolerated.

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Treatment Progression for Non-Irritable Disorders

Starting with larger movements and gradually increasing the intensity, duration, and resistance over time.

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Nerve Mobilization: Irritable vs. Non-Irritable

For irritable disorders (sensitive to movement), gentle, slow, and controlled mobilization is used. Non-irritable conditions allow for more forceful and faster techniques.

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When to Reconsider Nerve Mobilization

If improvement plateaus, re-assess the nerve tension tests and identify any unresolved restrictions. Addressing all factors is crucial.

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Sensitizing Tests in Nerve Mobilization

These tests isolate specific nerve branches by increasing tension in those areas (e.g., ankle dorsiflexion, hip adduction).

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Non-irritable Treatment

A treatment approach for joints that are not sensitive to movement and don't experience significant pain with mobilization.

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Treatment Progression (Non-Irritable)

Gradually increase the intensity, duration, and resistance of treatment over time, starting with larger movements.

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Treatment Progression (Irritable)

Start with gentle movements and slowly increase the intensity, duration, and range of motion as tolerated, gradually easing the joint into movement.

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Common Interfaces

Areas where nerves, muscles, joints, and fascia interact with each other. Restrictions at these interfaces can cause nerve tension.

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Interfaces Affecting Nerve Tension

Restrictions at the interface between nerves and other structures (muscles, joints, fascia) can affect nerve function and lead to increased tension.

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Treatment Progression (Nerve Mobilization)

Start with gentle movements and gradually increase the intensity, duration, and range of motion as tolerated, based on the patient's response to treatment.

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Interface Restrictions

Restrictions at the interface between nerves, muscles, joints, and fascia can cause nerve tension. These restrictions can limit nerve mobility and function.

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What is the purpose of Non-Irritable Treatment?

To improve joint mobility and reduce restrictions in joints that are not easily aggravated by movement, allowing for a more aggressive approach.

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How are Non-Irritable and Irritable Treatments Different?

Non-irritable treatment starts with larger movements and gradually increases intensity, while irritable treatment begins with gentle movements and progresses slowly.

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What is an Interface in the Body?

An interface is where different tissues connect, like nerves, muscles, joints, and fascia. Restrictions at these points can cause tension.

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Why are Common Interfaces Important in Treatment?

Understanding common interfaces helps identify where restrictions might be causing nerve tension and informs treatment strategies.

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Passive vs. Active

Passive techniques involve a therapist manually moving the nerve, while active techniques involve the patient actively moving their body to improve nerve mobility.

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Treatment Progression (Irritable vs. Non-Irritable)

For irritable conditions (sensitive to movement), gentle, slow, and controlled mobilization is used. Non-irritable conditions allow for more forceful and faster techniques.

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Study Notes

Swayback Posture

  • Characteristics: Weak anterior muscles (e.g., hip flexors, external obliques, neck flexors), strong posterior muscles (e.g., hamstrings, lumbar erector spinae, upper to middle lower spine erector spinae).
  • Lumbar Spine: Reduced lordosis, potentially leading to lumbar flexion.
  • Thoracic Spine: Increased kyphosis (swayed backward),
  • Pelvis: Posterior tilt, causing excessive posterior ligament stretch.
  • Hip Joint: Extended position.
  • Head: Forward posture.
  • Cervical Spine: Slightly extended.
  • Scapulae: Abducted (away from the spine).

Flat Back Posture

  • Characteristics: Tight posterior muscles (particularly hamstrings), strong posterior lower back muscles.
  • Lumbar Spine: Flattened, or flexed.
  • Head: Forward posture
  • Thoracic Spine: Upper portion has increased flexion, lower portion is straight.
  • Pelvis: Posterior tilt.
  • Hip Joint: Extended.

Lateral Imbalance Posture

  • Characteristics: Tight leg muscles on one side, weakness of leg muscles on the opposite side.
  • Pelvis: Higher on the side with less hip abduction.
  • Hip Joint (Affected Side): Adducted (pulled inward), slight medial rotation.
  • Hip Joint (Unaffected Side): Abducted.
  • Side with Tight Muscles: Weakness in lateral trunk muscles (e.g., QL, IO, EO), hip adductors, tibialis posterior, flexor hallucis longus, flexor digitorum longus muscles.
  • Side with Weak Muscles: Weakness in hip abductors, fibularis longus and brevis, TFL muscles.

Upper Crossed Syndrome

  • Characteristics: Tightness in upper trapezius, levator scapulae, pectoralis major, and pectoralis minor, weakness of rhomboids, serratus anterior, lower trapezius, deep neck flexors.
  • Specific Symptoms: Forward head posture, rounded shoulders.

Joint Mobilization

  • Purpose: Restore or improve range of motion.

  • Types of Movement:

    • Physiological/Osteokinematic: Gross movements—can be voluntary, occur concentrically or eccentrically.
    • Accessory/Arthrokinematic: Involuntary movements necessary for physiological motion, include joint play (roll, glide, spin).
  • Methods:

    • Mobilization: Passive movement at a slow enough speed to give the patient control.
    • Manipulation: Passive movement using physiologic or accessory motion with a thrust.
  • Important Concepts:

    • Roll and Glide: Pure rolling would dislocate a joint, gliding requires congruent articular surfaces. Combined motion is more common.
    • Direction of Gliding: Determined by the convex-concave rule (convex moves opposite, concave moves with).
    • Compression: Decrease in joint space, typically occurs during weight bearing.
    • Traction: Separation of joint surfaces.
    • Treatment Plane: Plane perpendicular to axis of rotation. Mobilization is parallel, traction is perpendicular.
  • Closed-Pack vs. Open-Pack:

    • Closed-Pack: Joint surfaces have maximum contact, ligaments/capsule tight.
    • Open-Pack: Joint surfaces have minimal contact, ligaments/capsule lax. Open pack position is ideal for mobilizations and traction.
  • Assessment Protocol:

    • Assess active and passive range of motion.
    • Assess accessory motion (compare to other side).
  • Intervention Protocol (Mobilization):

    • Grade 1, 2, 3, 4 mobilization parameters (speed, sets/set duration, rest).
    • Target one joint at a time in an open-packed position.
    • Small amount of traction.
  • Clinical Signs/Indications/Precautions:

    • Indications: Pain, muscle guarding, hypomobility, progressive limitation, functional impairment.
    • Contraindications: Hypermobility, joint effusion, inflammation, malignancy, osteoporosis, congenital abnormalities, etc.
  • Effects of Joint Mobilization: Positive effects on synovial fluid, articular and peri-articular tissues, neuroreceptors, and pain regulation.

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Test your knowledge on various postures, including Swayback, Flat Back, and Lateral Imbalance. This quiz will help you understand the characteristics of each posture and their effects on the spine and overall body alignment.

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