~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. The
techniques are always applied in a pain-free direction and
are described as correcting joint tracking from a positional
fault.
- Principles of Application
- MWM is the concurrent application of pain-free accessory mobilization with active and/or passive physiological movement
■ No contraindication for manual therapy exists (described
earlier in the chapter).
■ A full orthopedic examination has been completed, and
evaluation of the results indicate local musculoskeletal pathology.
■ A specific biomechanical analysis reveals localized loss of movement and/or pain associated with function.
■ No pain is produced during or immediately after application
of the technique
- Principles of Application
- A comparable sign is a positive test sign that can be repeated after a therapeutic maneuver to determine the effectiveness of the maneuver
- A comparable sign may include loss of joint play movement, loss of ROM, or pain associated with movement during specific functional activities, such as lateral elbow pain.
- Principles of ApplicationUtilizing knowledge of joint anatomy and mechanics, a sense of tissue tension, and sound clinical reasoning, the therapist investigates various combinations of parallel or perpendicular accessory glides to find the pain-free direction and grade of accessory movement. This may be a glide, spin, distraction, or combination of movements. This accessory motion must be pain-free.
Principles of Application
- Repetitions. The previously restricted and/or painful motion or activity is repeated 6 to 10 times by the patient while the therapist continues to maintain the appropriate accessory mobilization.
