Dear all,
on a recent visit to australia i was at a teaching centre for
Maitland type Manipulation (mobilisation) where they teach that
a grading system is only for an individual physiotherapist in an
arbitary way to evaluate the range of movement. They were a bit
surprised that grades were still used in the definitive way here in
the UK.
I hope i have represented them accurately!!!!!
my own research has showed that using a spinal simulator MMACP
physiotherapists varied in the forces they applied for a Grade III++
mobilisation by over 400%.
Makes you wonder?
What is the point of a Grade III (someone else's Grade XXIII maybe)
What then can a '++' "actually" mean?
Another question:
What is resistance?
What does it mean and does it exist?
Is it muscle spasm, is it rapidly increasing stiffness, is it merely
a change in the tactile stimulation of the therapists hand (or
thumbs), or is it resistance??
yours
jonnie
> > This caused some confusion for me too but I have discussed this
> > with Maitland trained MMACP physios and understand that: * Grade 1
> > is small amplitude out of resistance * grade 2 large amplitude out
> > of resistance ( both usually used to treat pain but not
> > necessarily) , * gd 3 large amplitude within resistance, * Gd 4
> > small amplitude within resistance.
> > The range is immaterial as you are guided by resistance and this
> > can be anywhere in range.
>
> Interestingly enough it would seem that under this system you can
> have a grade one mob that is farther into range than a grade two
> mob. Also you could have a grade four mob that was earlier in range
> than a grade three mob. Did anyone offer a reasonable justification
> for this potential paradox?
Jonathan T McCrea BSc (Hons) MCSP
Research Student
Department of Physiotherapy
Queen Margaret College
Edinburgh
Scotland
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