Mobility of joints might get restricted because of degenerative changes, trauma, chronic pain. The restricting factors may be pain, muscle spasm, oedema, fibrous contracture of fascia, ligament or capsule.
Restoration of normal function of joints is very important.
Pain itself may be relieved by restoring normal movements. The relief could be because of direct effect of passive joints movements by the stimulation of mechanoreceptors, which in turn inhibits the transmission of pain impulses from the periphery through the spinal cord to the brain.
Rhythmical passive movements of joints has effects on skin, fascia, muscles, tendons and ligaments. This probably moves fluid through the tissue planes and increase lymphatic and venous drainage. This results in removal of metabolites which act as irritant to the nonciceptive nerve endings in the tissues and pain is reduced.
Treatment of under limiting factors and regaining movement and maintaining it by exercise is often effective in pain relief or reduction.
Contraindications for passive mobilization
- Inflammatory arthritis with acute flare up
- Instability of joints
- Spinal cord compression
- Vertebrobasilar insufficiency
- Severe pain which is easily provoked
- Local malignancy
- Infection
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hey can any one tell me what can be done after bilateral excision hip arthoplasty done as far as rehabilitation is concerned. can we make him stand? after bilateral excision arhoplasty what is the weight transferring area if i make him stand??as patient is younger he is very enthusiastic about standing and mobility.please guide me.
Dr Arun Pal Singh Reply:
January 17th, 2011 at 8:04 am
@Dr.Amit Akhare(physio),
After bilateral hip arthroplasty or Girdlestone arthroplasty, we follow with heavy traction and in bed hip flexion exercises by making patient touch his nose to knee.
Following that patient is advised to stand and walk with support.
The upper end of resected femur abuts with the acetabulum for bearing weight. Initially, it is unstable but gets better as fibrosis gets strength.
I hope that helps.
Thanks Arun sir for your reply…patient is also had history of myositis ossificans…major joint involved were knee,hip,elbow…..so this history make some difference in protocol???
Dr Arun Pal Singh Reply:
February 4th, 2011 at 7:43 am
@Dr.Amit Akhare(physio),
It should not but you would need to evaluate.