Joint Mobilisation
Joint mobilisation refers to a therapeutic passive motion of a painful or dysfunctional peripheral or axial joint. Mobilisation under the Maitland system is classified into four grades of passive therapeutic motion based on the state of tension. Grade V is the same as manipulation.
Grade I – small amplitude movement at the beginning of the available range of movement
Grade II – large amplitude movement within the available range of movement. The maximal end range is not achieved.
Grade III – large amplitude movement that moves into the maximal end range.
Grade IV – small amplitude movement close to end range
Grade V – This is the same as high velocity low amplitude manipulation at the end range.
Lower grades (I + II) are used to reduce pain and irritability (use VAS + SIN scores).
Higher grades (III + IV) are used to stretch the joint capsule and passive tissues which support and stabilise the joint so increase range of movement.
The rate of mobilisation should be thought of as an oscillation in a rhythmical fashion at 2Hz (120 movements per minute) for 30 seconds to 1 minute.
