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CHAPTER OBJECTIVES

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Chapter Objectives

At the conclusion of this chapter, the reader will be able to:

  • Identify the major influences leading to the development of the Functional Mobilization approach to orthopaedic manual physical therapy (OMPT).

  • Understand the examination and treatment philosophy of The Institute of Physical Art and Functional Mobilization.

  • Conduct a functional examination, including assessment of rolling and gait.

  • Understand the use of functional movement patterns and proprioceptive neuromuscular facilitation patterns to identify biomechanical dysfunctions.

  • Understand the importance of the impact test.

  • Use Functional Mobilization to identify, localize, mobilize or stabilize, and reeducate dysfunctional movement segments.

  • Appreciate how the Functional Mobilization approach to OMPT can combine treatment of structural dysfunctions, neuromuscular dysfunctions, and motor learning into one treatment.

  • Understand how to involve the patient in treatment through movement education, active release, and neuromuscular control and reeducation.

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INTRODUCTION

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Functional Mobilization (FM) is an inherent component of Functional Manual Therapy (FMT), a systematic approach to patient care designed to identify the mechanical, neuromuscular, and motor control factors inhibiting and preventing efficient function. Differing from traditional passive approaches, FM couples active and resisted movements with specific, directional pressures to restore functional mobility. FM offers a seamless progression from assessment of mobility to a three-dimensional approach to intervention.

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Notable Quotable

"The Functional Manual Therapy Approach offers concepts and tools for examination and intervention…. Examination is performed through the use of observation of form and motion, palpation to determine condition, and resistance to explore neuromuscular control. Through intervention, we improve the interplay of motor control, structure, and functional capacity…."

-G. Johnson

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Functional Mobilization, developed by Gregory S. Johnson in 1980, represents a synergy of eclectic study and clinical experience. Following graduation from the University of Southern California in 1971, Johnson attended a yearlong proprioceptive neuromuscular facilitation (PNF) residency under Margaret "Maggie" Knott at Kaiser Rehabilitation Hospital in Vallejo, California (Fig. 12–1). Continuing at Kaiser as senior faculty in the residency program until 1978, Johnson's experiences reinforced his understanding of the importance of evaluating function, applying manual resistance, and using developmental postures and motions for movement reeducation.

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FIGURE 12–1

Margaret "Maggie" Knott, developer of proprioceptive neuromuscular facilitation.

Graphic Jump Location
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From 1972 to 1978, Johnson augmented his training in PNF with extensive study in joint mobilization approaches and alternative therapies. In 1978, together with his wife and cofounder of the Institute of Physical Art, Vicky Saliba Johnson, Johnson began teaching continuing education directed at the enhancement of function. The principles of PNF, joint mobilization, and soft tissue mobilization laid the foundation for the development of FM as a dynamic three-dimensional approach.1-5

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The FM approach has been influenced by a variety of orthopaedic manual physical therapy (OMPT) approaches, including the Nordic (Chapter 6), Australian (Chapter 8), Paris ...

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