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  Joint Mobilization of the Upper Extremity

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CEUs: .4 CA approved 4.8 hours 40-H23
Contact Hours: 4 NBCOT® 5 PDUs

*University & multi-center Licensure available upon request; all courses single user only
*FL Live Interactive approved 20-171353 for 4 hours

*Watch on your idevices, smart phones, tablets and MORE
Domain of OT, Occupational Therapy Process

Instructors:

Marc Allan OTR/L CHT

Description:

This interactive course is in movie format. This course is excellent for occupational and physical therapists, COTA's, and PTA's that want to learn the art of joint mobilization. You will learn mobilizations techniques up close and learn how to make stiff joints move. Watch, rewind and re-watch. This feature allows you to "take the instructor home with you". This is a mixed learning level course. Note: This mixed learning level online movie course provides conceptual preparation to seek additional training, and does not provide you a mentored hands-on skills session. Please seek additional experience, with a mentor, to perform hands-on skills. Upon Successful completion of the examination (80%) your certificate will be sent via email.

Objectives:

  • Review precautions and contraindications for joint mobilization
  • Review joint mobilization techniques that promote good body mechanics and mechanical advantages
  • Intrroduce joint mobilization skills that will insure accuracy and consistency
  • Understand the type of joint you are mobilizing
  • Introduce joint mobilization skills that will insure effective and efficient treatment
  • Adjunctive DVDs available for some courses for an additional fee. Call 727-560-5552 for details
  • I.       Introduction

    A.      Definition-skilled passive movement of a joint

    B.      Overview

    1.       One "tool" in the therapists "tool box"

    2.       Used only after determined by a thorough evaluation that joint mobilization is needed

    3.       More effective if combined with an active rehabilitation program

    C.      Indications

    1.       Joint hypomobility

    D.      Contraindications

    1.       Unstable joint

    2.       Hemiarthrosis-bleeding in the joint

    3.       Healing fracture-involved or adjacent joint

    4.       Acute inflammation

    5.       Boney disease

    6.       Cancer

    7.       Infection

    E.      Precautions

    1.       Muscle guarding

    2.       Osteoporosis

    3.       OA

    4.       RA

    5.       Hypermobile joint

    6.       Swelling and inflammation

    7.       Fracture not fully healed or undiagnosed

    F.      Anatomy & physiology-know what you are mobilizing so you have an expectation (patient also) as to what is going to happen

    1.       Joints

    a.       Type

                                                                                                                                           i.      Saddle (i.e. carpometacarpal jt. of the thumb)

                                                                                                                                         ii.      Gliding (i.e. intercarpal jts.)

                                                                                                                                        iii.      Ball and socket (i.e. glenohumeral jt.)

                                                                                                                                        iv.      Pivotal (i.e. radiohumeral jt.)

                                                                                                                                          v.      Hinge (i.e. humeroulnar jt.)

                                                                                                                                        vi.      Ellipsoid (i.e. metacarpal phalangeal jts.)

                                                                                                                                       vii.      Bicondylar (i.e. interphalangeal jts.)

    b.       Cartilage

                                                                                                                                           i.      Concave surface cartilage is more dense around the periphery

                                                                                                                                         ii.      Convex surface cartilage is more dense in the center

                                                                                                                                        iii.      Cartilage is bloodless

    c.       Concave-Convex principle

                                                                                                                                           i.      Concave on Convex

                                                                                                                                         ii.      Convex on Concave

                                                                                                                                        iii.      Instances where concave-convex principle does not apply

    2.       Ligaments and Capsule

    a.       Ligaments contain kinesthetic receptors

                                                                                                                                           i.      Ruffini endings

                                                                                                                                         ii.      Golgi tendon receptors

                                                                                                                                        iii.      Pacinian corpuscles

    b.       Capsule tissue is fibrous and is interlaced with ligaments and tendons

    c.       Ligaments have great tensile strength

                      G. Osteokinematics

                                 1. Classical motions (i.e. flexion, extension, pronation, supination, etc.)

                      H. Athrokinematics

                                 1. Movement relationships within the joint (i.e. glide, spin, roll, etc.)

     

    II.                   Examination-General Principles

    A.      Avoid assumptions; start from scratch and do not assume anything

    1.       Avoid the "I give you a hammer you look for a nail-syndrome."

    B.      Thorough

    1.       Examination format should include

    a.       Subjective-interview and intake information (see syllabus)

    C.      Motion

    1.       Active/Passive

    2.       End feel

    3.       Quality

    D.      Absolutes

    1.       Evaluate involved and uninvolved sides

    2.       Evaluate before and after treatment

     

    III.                  Treatment General Principles

    A.      Prepare the patient

    1.       Relaxed

    2.       Supported

    3.       Clear instructions on what to do, what not to do, and what to expect (i.e. pressure, pulling)

    B.      Prepare yourself

    1.       Wide base of support

    2.       Set up in gravity assist position whenever possible

    3.       Firm relaxed hold, not tense

    C.      Accuracy

    1.       Forearm alignment to help guide therapistsí direction of force

    2.       Palpate during the mobilization with stabilizing hand

    3.       Observe proximal- when movement begins, you are moving something else and therefore becoming less accurate

    D.      Technique

    1.       Slack skin

    2.       Use pads of fingers, not tips

    3.       Energy conservation/joint protection methods

    4.       Distractions

    5.       Glides

    6.       Tilts

    7.       Rotations

    E.      Mobilization grades

    1.       Grade I

    2.       Grade II

    3.       Grade III

    4.       Grade IV

    5.       Tip on how to determine range and grade

    a.       Stabilization hand compared to mobilization hand

    IV.                Joint Mobilization

    A.      Shoulder Complex

    1.       Sternoclavicular joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Posterior glides

                                                                                                                                         ii.      Inferior glides

    2.       Acromioclavicular joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Anterior glides

                                                                                                                                         ii.      Posterior glides

    3.       Scapulothoracic joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Superior glides

                                                                                                                                         ii.      Inferior glides

                                                                                                                                        iii.      Medial glides

                                                                                                                                        iv.      Lateral glides

                                                                                                                                          v.      Distraction

    4.       Glenohumeral joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Lateral distraction

                                                                                                                                         ii.      Posterior glides

                                                                                                                                        iii.      Anterior glides

                                                                                                                                        iv.      Inferior glides

    B.      Elbow

    1.       Radiohumeral joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Distraction

                                                                                                                                         ii.      Approximation

    2.       Humeroulnar joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Distraction

                                                                                                                                         ii.      Valgus tilt

                                                                                                                                        iii.      Varus tilt

    C.      Forearm

    1.       Proximal radioulnar joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Anterior glides (radius on ulna)

                                                                                                                                         ii.      Posterior glides (radius on ulna)

    2.       Distal radioulnar joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Distractions

                                                                                                                                         ii.      Approximations

                                                                                                                                        iii.      Anterior glides

                                                                                                                                        iv.      Posterior glides

                                                                                                                                          v.      Outward roll

     

    D.      Wrist

    1.       Intercarpal joints

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Anterior glides

                                                                                                                                         ii.      Posterior glides

    2.       Radiocarpal joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Medial glides

                                                                                                                                         ii.      Lateral glides

                                                                                                                                        iii.      Anterior glides

                                                                                                                                        iv.      Posterior glides

    3.       Ulnocarpal

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Ulnomeniscotriquetrial glide

    4.       Midcarpal joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Medial glides

                                                                                                                                         ii.      Lateral glides

                                                                                                                                        iii.      Anterior glides

                                                                                                                                        iv.      Posterior glides

    5.       Carpal metacarpal joints (2-5)

    a.       Evaluation

     

    E.      Thumb

    1.       CMC

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Medial glides

                                                                                                                                         ii.      Lateral glides

                                                                                                                                        iii.      Anterior glides

                                                                                                                                        iv.      Posterior glides

                                                                                                                                          v.      Distraction

                                                                                                                                        vi.      Rotations (supination/pronation)

    2.       Metacarpal phalangeal joint

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Medial glides

                                                                                                                                         ii.      Lateral glides

                                                                                                                                        iii.      Anterior glides

                                                                                                                                        iv.      Posterior glides

                                                                                                                                          v.      Medial tilts

                                                                                                                                        vi.      Lateral tilts

                                                                                                                                       vii.      Rotations (supination/pronation)

    F.      Fingers

    1.       Metacarpal phalangeal joints

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Medial glides

                                                                                                                                         ii.      Lateral glides

                                                                                                                                        iii.      Anterior glides

                                                                                                                                        iv.      Posterior glides

                                                                                                                                          v.      Medial tilts

                                                                                                                                        vi.      Lateral tilts

                                                                                                                                       vii.      Rotations (supination/pronation)

    G.     Fingers and thumb

    1.       Interphalangeal joints

    a.       Evaluation

    b.       Treatment

                                                                                                                                           i.      Anterior glides

                                                                                                                                         ii.      Posterior glides

                                                                                                                                        iii.      Medial tilts

                                                                                                                                        iv.      Lateral tilts

                                                                                                                                          v.      Anterior-posterior unicondilar glides

     

     

     
    Qty Discount Available with this item. Click Here for details.

    Format Movie Presentation
    Price $155.99

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    Reviews

    Maybe more advanced then I expected. Work outpt and SNF. Looking for course's for contracture management/ROM etc dealing with, elbows, hands(in general,not going through ever single finger), wrist, shoulder.
    Kenny D. Maynes, OTR/L  
       
    This is a great course. One of the better courses I've bought online. Mr. Allen demonstrates all UE mobilizations with commentary on body/hand positions that flows nicely. The question session at the end offers additional information regarding convex/concave rule, precautions and a couple of case studies.
    Shannon OTR/L,CHT  
       
    Great information. Very well presented. I think that with a Joint Mob course, I need to have more hands on experience and hands on feedback. The information is great to have though, and I feel I got a lot from the course.
    Gretchen Proctor OTR/L CHT  
       
    • After purchase is complete please register the course to the participants name and email address where the certificates will be received.
    • Participants have one year to access the CEU course and exam to obtain CEUs.
    • All CEU activities are associated with an online exam to ensure understanding of learner objectives. Once an 80% is achieved a CEU certificate is sent to the email that was used for registering the participant for the CEU course.
    • Course cancellations or refunds are not available once the material or the exam have been accessed.
    • Treatment2go is an AOTA approved provider ID #3397. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.
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