Manipulation of joint release

The lever-like movement of the bone is called ~, i.e., physiologic movement, and the oscillation involves immobilization of the proximal end of the joint and back-and-forth movement of the distal end of the joint. The swing must be applied only when the ROM is >60% (normal). For example, the swing maneuver for shoulder anteflexion should be applied only when shoulder anteflexion reaches at least 100° (180°, 60%?100°), and if it does not reach this range it should be improved with accessory motion maneuvers first.

2. Rolling

When a bone rolls on the surface of another bone, the surface shapes of the two bones are necessarily inconsistent, and the points of contact change at the same time, and the motion that occurs? Angular motion, the direction of rolling is always in the direction of angular bone movement, often accompanied by joint sliding and rotation.

3. Sliding

When one bone slides on another, as in ? simple sliding, the surfaces of the two bones must be of the same shape, either flat or curved (the concavity and convexity of the two bone surfaces must be equal). When sliding, the same point on one bone surface contacts a different point on the opposite bone surface. The direction of sliding depends on the concave and convex shape of the articulating surfaces of the moving bone (convex - sliding in the direction opposite to the direction of osteogenic angular motion; concave - bone movement in the same direction as the direction of osteogenic angular motion)

The closer the shapes of the articulating surfaces are - the more sliding there is, and the more the shapes of the surfaces do not match - the more rolling there is. -the more rolling there is. When applied clinically, sliding is more often used because it relieves pain and combined with pulling it loosens the joint capsule, relaxes the joint and improves the range of motion of the joint.

4. Rotation

Rotation refers to the movement of the surface of a stationary bone around the axis of rotation, and when rotating, the same point of the moving surface makes a circumferential movement.

Rotation often occurs simultaneously with sliding and rolling, and rarely acts alone.

5. Separation and traction

Separation and traction are called ? traction.

Detachment: when an external force separates the surfaces of the two bones that make up the joint from each other at right angles, it is called detachment or intra-articular traction.

Distraction: when an external force acts on the long axis of the bone to displace the distal end of the joint, it is called ~ or long-axis traction.

Difference Separation- External force is perpendicular to the articular surfaces and the two joints must be separated.

Distraction-The external force is parallel to the long axis of the bone and the articular directions may not be separated.

Three, manipulation grading:

1. Matland grading criteria

Grade I-The therapist is at the beginning of the patient's joint movement, a small, rhythmic back and forth loosening of the joint.

Grade II-The therapist loosens the joint rhythmically back and forth over a wide range of motion within the patient's allowable range of motion, but does not touch the beginning or end of joint motion.

Grade III-The therapist loosens the joint rhythmically back and forth over a wide range of motion within the patient's allowable range of motion, each time contacting the endpoints of the joint, and sensing tension in the periarticular soft tissues.

IV-The therapist loosens the joint in a small, rhythmic back-and-forth motion over the terminal end of the patient's joint, each time contacting the terminal end of the joint movement and feeling the tension in the periarticular soft tissues.

2. Selection of manipulative application

Grade ⅠⅡ-pain Ⅲ-pain + joint stiffness Ⅳ-adhesion, contracture, manipulative grading can be used for accessory and physiological movements of the joint. Accessory movements - I-IV can be used. Physiologic motion - ROM > 60% of normal should be used, mostly grade III-IV, rarely grade I. The size of the graded range of joint motion varies.