Mulligan Concept: Difference between revisions
Venus Pagare (talk | contribs) No edit summary |
Venus Pagare (talk | contribs) No edit summary |
||
| Line 13: | Line 13: | ||
*Mulligan proposed that injuries or sprains might result in a minor "positional fault" to a joint causing restrictions in physiological movement. | *Mulligan proposed that injuries or sprains might result in a minor "positional fault" to a joint causing restrictions in physiological movement. | ||
*The techniques have been developed to overcome joint `tracking' problems or `positional faults', i.e. joints with subtle biomechanical changes. | *The techniques have been developed to overcome joint `tracking' problems or `positional faults', i.e. joints with subtle biomechanical changes. | ||
*Normal joints have been designed in such a way that the shape of the articular surfaces, the thickness of the cartilage, the orientation of the fibres of ligaments and capsule, the direction of pull of muscles and tendons, facilitate free but controlled movement while simultaneously minimizing the compressive forces generated by that movement <ref name="Ed">Wilson, Ed. "The Mulligan concept: NAGS, SNAGS and mobilizations with movement." Journal of bodywork and movement therapies 5.2 (2001): 81-89.</ref> | *Normal joints have been designed in such a way that the shape of the articular surfaces, the thickness of the cartilage, the orientation of the fibres of ligaments and capsule, the direction of pull of muscles and tendons, facilitate free but controlled movement while simultaneously minimizing the compressive forces generated by that movement <ref name="Ed">Wilson, Ed. "The Mulligan concept: NAGS, SNAGS and mobilizations with movement." Journal of bodywork and movement therapies 5.2 (2001): 81-89.</ref> | ||
*Normal proprioceptive feedback maintains this balance. Alteration in any or all of the above factors would alter the joint position or tracking during movement and would provoke symptoms of pain, stiffness or weakness in the patient. It is common sense then that a therapist would attempt to re-align the joint surfaces in the least provocative way <ref name="Ed" /> | *Normal proprioceptive feedback maintains this balance. Alteration in any or all of the above factors would alter the joint position or tracking during movement and would provoke symptoms of pain, stiffness or weakness in the patient. It is common sense then that a therapist would attempt to re-align the joint surfaces in the least provocative way <ref name="Ed" /> | ||
== Principles of Treatment | == Principles of Treatment == | ||
<div> | <div> | ||
#A passive accessory joint mobilization is applied following the principles of Kaltenborn. This accessory glide must itself be pain free. | |||
#During assessment the therapist will identify one or more comparable signs as described by Maitland. These signs may be; a loss of joint movement, pain associated with movement, or pain associated with specific functional activities | |||
#The therapist must continuously monitor the patients reaction to ensure no pain is recreated. The therapist investigates various combinations of parallel or perpendicular glides to find the correct treatment plane and grade of accessory movement. | |||
#While sustaining the accessory glide, the patient is requested to perform the comparable sign. The comparable sign should now be significantly improved | |||
#Failure to improve the comparable sign would indicate that the therapist has not found the correct treatment plane, grade of mobilization, spinal segment or that the technique is not indicated. | |||
#The previously restricted and/or painful motion or activity is repeated by the patient while the therapist continues to maintain the appropriate accessory glide.<br><br> | |||
<br></div> <div class="researchbox"></div> | |||
<br> < | |||
<div class="researchbox"> | |||
</div> | |||
== References == | == References == | ||
Revision as of 16:05, 12 April 2014
Original Editor - Your name will be added here if you created the original content for this page.
Top Contributors - Venus Pagare, Asma Alshehri, Sheik Abdul Khadir, Kim Jackson, Jason Cirolia, Garima Gedamkar, Evan Thomas, WikiSysop, Admin and Wendy Walker
Description
[edit | edit source]
- The concept of Mobilizations with movement (MWM) of the extrmities and SNAGS (sustained natural apophyseal glides) of the spine were first coined by Brian R. Mulligan [1]
- Mobilization with movement (MWM) is the concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end range applied by the patient. Passive end-of-range overpressure, or stretching, is then delivered without pain as a barrier.[2]
Concept of Positional Fault[edit | edit source]
- Mulligan proposed that injuries or sprains might result in a minor "positional fault" to a joint causing restrictions in physiological movement.
- The techniques have been developed to overcome joint `tracking' problems or `positional faults', i.e. joints with subtle biomechanical changes.
- Normal joints have been designed in such a way that the shape of the articular surfaces, the thickness of the cartilage, the orientation of the fibres of ligaments and capsule, the direction of pull of muscles and tendons, facilitate free but controlled movement while simultaneously minimizing the compressive forces generated by that movement [3]
- Normal proprioceptive feedback maintains this balance. Alteration in any or all of the above factors would alter the joint position or tracking during movement and would provoke symptoms of pain, stiffness or weakness in the patient. It is common sense then that a therapist would attempt to re-align the joint surfaces in the least provocative way [3]
Principles of Treatment[edit | edit source]
- A passive accessory joint mobilization is applied following the principles of Kaltenborn. This accessory glide must itself be pain free.
- During assessment the therapist will identify one or more comparable signs as described by Maitland. These signs may be; a loss of joint movement, pain associated with movement, or pain associated with specific functional activities
- The therapist must continuously monitor the patients reaction to ensure no pain is recreated. The therapist investigates various combinations of parallel or perpendicular glides to find the correct treatment plane and grade of accessory movement.
- While sustaining the accessory glide, the patient is requested to perform the comparable sign. The comparable sign should now be significantly improved
- Failure to improve the comparable sign would indicate that the therapist has not found the correct treatment plane, grade of mobilization, spinal segment or that the technique is not indicated.
- The previously restricted and/or painful motion or activity is repeated by the patient while the therapist continues to maintain the appropriate accessory glide.
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Mulligan, BR: Manual Therapy “NAGS,” “SNAGS,” “MWM’S: Etc., ed 4. Plane View Press, Wellington, 1999
- ↑ Kisner, Carolyn, and Lynn Allen Colby. Therapeutic exercise: foundations and techniques. FA Davis, 2012.
- ↑ 3.0 3.1 Wilson, Ed. "The Mulligan concept: NAGS, SNAGS and mobilizations with movement." Journal of bodywork and movement therapies 5.2 (2001): 81-89.
