Joint Mobilization (Articulation, Nonthrust Technique; Nonimpulse Technique)

Chapter 25 Joint Mobilization (Articulation, Nonthrust Technique; Nonimpulse Technique)

OVERVIEW.

Joint mobilization (also called articulation, non-thrust) is a manual technique directed to the patient’s joint whereby the clinician imparts passive movements such as glides and distractions. The technique is characterized by low-velocity movements (i.e., rather than high-velocity thrusts) and is generally slow enough for the patient to stop. The goal is to relieve pain or improve range of motion by improving joint play and restoring the roll and glide arthrokinematics of the joint.¹

SUMMARY: CONTRAINDICATIONS AND PRECAUTIONS.

Seven sources cited a total of 51 concerns for joint mobilization. Concerns ranged from four to 18 per source. All seven sources were physical therapists. The largest proportion of concerns were musculoskeletal (>40%). The most frequently cited concern was neoplasm followed by recent fracture and hypermobility. Several absolute CIs were also listed. Notes: Grieve,² Kisner and Colby,¹ and Sprague³ address spinal mobilization, peripheral joint mobilization, and the cervical spine concerns, respectively. Harris and Lundgren⁴ address pediatric concerns with nervous system disorders.

Michaeli,⁵ in a 1993 descriptive study, reported on a 75-year-old man who suffered a minor CVA with aphasia a day or two following an occipito-atlantal and atlantoaxial joint mobilization with a forceful rotatory component. No premanipulative screening was conducted.