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Grade I

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small amplitude rhythmic oscillations are performed at the beginning of the range

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Grade II

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large amplitude rhythmic oscillations are performed within the rage, not reaching the limit

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Grade III

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large amplitude rhythmic oscillations are performed up to the limit of the available motion and are stressed into the tissue resistance

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Grade IV

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small amplitude rhythmic oscillations are performed at the limit of the available motion and stressed into the tissue resistance

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Grade V

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small amplitude, high velocity thrust techniques is performed to snap adhesions at the limit of the available motion. thrust techniques used for this purpose require advance training.

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Grade I & II

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primarily used for treating joints limited by pain.

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Grade III & IV

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primarily used for stretching maneuvers

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Grade I (loosen)

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small amplitude distraction is applied where no stress is placed on the capsule. it equalizes cohesive forces, muscle tension, and atmospheric pressure acting on the joint

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Grade II (tighten)

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enough distraction or glide is applied to tighten this tissues around the joint (kaltenborn called it "taking up the slack"

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Grade III (stretch)

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a distraction or glide is applied with an amplitude large enough to place stretch on the joint capsule and surrounding periarticular structures

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Grade I (loosen)

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used with all gliding motions and may be used for pain relief

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Grade II (tighten)

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used for the initial treatment to determine how sensitive the joint is. Once the joint reaction is known, treatment dosage is increased or decreased accordingly

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Grade II (tighten)

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applied intermittently may be used to inhibit pain, may be also used to maintain joint play when ROM is not allowed

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Grade III (stretch)

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distractions or glides are used to stretch the joint structures and thus increase joint play

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glenohumeral caudal glide

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to increase abduction

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increase shoulder abduction > 90°

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glide the humerus in a progressively anterior direction against the inferior folds of the capsule in the axilla

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glenohumeral posterior glide

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to increase shoulder flexion and internal rotation

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glenohumeral posterior glide with shoulder flex = 90°

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in supine position, increases horizontal adduction, glide the humerus posteriorly by pushing down the elbow

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glenohumeral anterior glide

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to increase extension and to increase external rotation patient is in prone position for this glide the mobilizing force is glide head of humerus anterior and slightly medial

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glenohumeral external rotation progression

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to increase external rotation patient in supine, shoulder at ≈ 80° of abduction and max external rotation, then distract

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glenohumeral external rotation progression

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careful not to bring shoulder abduction ≥ 90° because of the risk of subluxation

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acromioclavicular anterior glide

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to increase mobility of the joint

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sternoclavicular posterior glide

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to increase retraction

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sternoclavicular superior glide

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to depression of the clavicle

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sternoclavicular anterior glide

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to increase protraction

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sternoclavicular caudal glide

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to increase elevation of the clavicle

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volar glide

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from anatomical position = anterior

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dorsal glide

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from anatomical position = posterior

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humeroulnar distal glide

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to increase elbow flexion

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humeroradial glide

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to increase varus

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humeroulnar ulnar glide

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to increase valgus

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humeroradial dorsal glide

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to increase elbow extension

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humeroradial volar glide

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to increase elbow flexion

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humeroradial compression

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to reduce elbow subluxation

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proximal radioulnar joint dorsal glide

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to increase pronation (proximal)

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proximal radioulnar joint volar glide

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to increase supination (proximal)

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distal radioulnar joint dorsal glide

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to increase supination (distal)

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distal radioulnar joint volar glide

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to increase pronation (distal)

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radiocarpal joint volar glide

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to increase wrist extension

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radiocarpal joint dorsal glide

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to increase wrist flexion

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radiocarpal joint radial glide

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to increase ulnar deviation

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radiocarpal joint ulnar glide

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to increase radial deviation

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patellofemoral joint distal glide

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to increase knee flexion

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distal tibiofibular anterior glide

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to increase dorsiflexion

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distal tibiofibular posterior glide

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to increase plantarflexion

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talocrural dorsal (posterior) glide

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to icnrease dorsiflxion: position: long leg sitting toes point up

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talocrural anterior (volar) glide

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to increase plantarflexion

joint mobilization grades & Technique – Flashcards

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