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Operational Definitions

  • Mobilization/Manipulation: A manual therapy procedure that comprises a continuum of skilled passive movements to joints &/or related soft tissues applied at varying speeds & amplitudes. The terms mobilization and manipulation are considered to be synonymous & include the entire continuum of techniques ranging from non-thrust to thrust procedures.

  • Note: The terms mobilization & manipulation are often used interchangeably within the field of Physical Therapy. In order to provide clarity, throughout this text the term mobilization will be used to define techniques that are performed at Grades I–IV. Grade V techniques will be described through the use of the term high-velocity thrust.

  • Osteokinematics/Physiologic Motion: Gross movements of limbs or other body parts relative to the body or environmental references & typically measured in degrees by a goniometer.

  • Arthrokinematics/Accessory Motion: Relative motions that occur between articular surfaces & related structures within a joint. These motions include:

    • Component Motions: Motions taking place in a joint or related joints to facilitate a particular active or passive motion (i.e., roll, spin, glide, roll-glide).

    • Joint Play Motions: Motions not under voluntary control that occur only in response to outside forces (i.e., ligament stress testing).

  • Accessory Roll: One type of accessory motion that occurs between 2 articular surfaces where new points on 1 surface contact new points on the opposing surface. This motion is always in the same direction as the physiologic motion primarily when friction is high & the joint surfaces are incongruent. In order for rolling to occur, the concave aspect of the joint must be at least as large as the convex surface.

  • Accessory Glide: One type of accessory motion that occurs between 2 articular surfaces where the same point on 1 surface contacts new points on the opposing surface. The direction of glide is dependent upon whether the convex surface or the concave surface is moving & primarily occurs when the joint surfaces are congruent.

  • Accessory Roll-Glide: The term used to define the combination of rolling & gliding, as previously defined, that occurs between 2 opposing joint surfaces during movement.

  • Accessory Spin: One type of accessory motion described as rotatory motion in the transverse plane of 1 joint surface relative to the other. This type of accessory motion often occurs when the concave aspect of the joint is significantly larger than the convex (i.e., the hip joint).

  • End Feel: The quality of the resistance at the end range of joint motion that is perceived when overpressure is applied to either physiologic or accessory joint motion.

  • Open-Packed Position (OPP): A position of 2 articular surfaces relative to one another in which there is less than maximal joint congruency; any position other than the closed-packed position in which a joint is less stable & better able to be moved.

  • Close-Packed Position (CPP): A unique position of a joint in which 2 articular surfaces are maximally congruent relative to one another; the specific position in which a joint is most stable & least able to be moved.

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