BARRIER CONCEPTS IN MANUAL THERAPY..pptx
- 2. BARRIER CONCEPTS •Barrier defines limit of motion •Concept of doing joint mobilization & manipulation •Describes motion in a joint or in tissue in one plane •Types of barriers : * Physiological barrier * Anatomical barrier * Restrictive barrier
- 3. 1. PHYSIOLOGICAL BARRIER • The point at which voluntary range of motion in an articulation is limited by soft tissue tendon. • A normal joint moves through a certain range of active motion and the limit of this motion is physiological barrier. • Thus active movement is also called physiological movement. Contractile tissues, nervous tissues and inert tissues are involved or moved during active movement. • The first barrier felt during active movement due to tension of soft tissues.
- 4. 2. ANATOMICAL BARRIER • The point at which passive ROM is limited by bone contour or soft tissues (especially ligaments) or both. • This serves as the final limit to motion in a articulation. • Movement beyond this cause disruption of tissue, subluxation / fracture. • The limit of PROM is anatomical barrier. No more further range is achieved. • An obstruction , a factor that tends to restrict from movement – Elastic barrier. It is the normal limit to joint motion that occurs when the joint and surrounding tissues are fully tensed.
- 6. Cont. • A neutral point exists along with barriers. • Midrange of the joint where there is least amount of support from non-muscular tissues and ligaments. •It minimizes stress on joint.
- 7. 3. RESTRICTIVE BARRIER • An impediment or obstacle to movement within physiologic limits of an articulation that reduces active range of motion. • They may occur secondary to changes in the following tissues : skin, fascia, muscles, ligaments, joint capsule and joint surfaces. • The presence of somatic dysfunction will alter normal barriers and produce a pathologic neutral point. It is the resting position that shifts away from midline due to restrictive barrier. It usually occurs at the midpoint of the available range of motion.
- 9. In our joint, the space has been provided for following events : 1. Joint play : (accessory movement) initial motion between joint surfaces. In addition to active ROM, there is a small ROM that can be obtained only passively by examiner. 2.AROM : exercises are done in joint play and AROM phase. 3. PROM : force is applied by therapist for movement which a patient cannot move actively. 4. Physiological barrier : first barrier felt during active movement due to tension of soft tissue.
- 10. Cont. 5. Anatomical barrier : barrier felt at the last range of passive movement as bony ends come in contact. 6. Paraphysiological space : space between physiological and anatomic barrier where passive ligamentous stretch occurs before tissue disruption. 7. Mobilization : done in PROM & paraphysiological space. 8. Manipulation : only done in paraphysiological space.
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