Kaltenborn of Hand: Difference between revisions
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{{#ev:youtube|pkXIADrBuVc}} <ref>Alexandra Kopelovich. CONVEX-CONCAVE RULE: Easy animation and explanation. Available from: https://www.youtube.com/watch?v=pkXIADrBuVc [Last accessed 13/10/2020)</ref> | {{#ev:youtube|pkXIADrBuVc}} <ref>Alexandra Kopelovich. CONVEX-CONCAVE RULE: Easy animation and explanation. Available from: https://www.youtube.com/watch?v=pkXIADrBuVc [Last accessed 13/10/2020)</ref> | ||
Traction and Compression tests cam be utilised as part of the assessment; | |||
{| class="wikitable" | |||
!Traction | |||
!Compression | |||
|- | |||
!Relieves Joint pain | |||
!Aggravates joint pain | |||
|- | |||
|If positive in normal resting position, then locate a position | |||
of greater discomfort and reassess the patient's response to traction. | |||
|If negative this test should be conducted in several | |||
three-dimensional positions. | |||
Joint compression should be assessed separately and prior resisted tests, | |||
as resisted tests also provoke pain. | |||
|} | |||
==== Grades of translatoric movement<ref name=":0" /><ref name=":1" /> ==== | ==== Grades of translatoric movement<ref name=":0" /><ref name=":1" /> ==== | ||
Revision as of 13:09, 13 October 2020
Purpose[edit | edit source]
The Kaltenborn method, also referred to as Orthopedic Manual Physical Therapy (OMT), is a Nordic System of Manual Therapy derived by Freddy Kaltenborn and Olaf Evjenth over several years. This Nordic system seeks to repair usual joint mechanics[1].
All joints have positions that provide a degree of freedom or create a low level of laxity of the capsule and ligaments that allows little, accurate movements of joint play. This is the result of internal and external movement forces on the body. These joint play movements are referred to as accessory movements and are not under conscious control, but they are essential to permissive, painless functioning of active movement[2]. These joint play movements can be highlighted during passive movements and include;
- Distraction
- Sliding
- Compression
- Rolling
- Spinning of joint surfaces.
The term arthrokinematics describes these motions of the bone surfaces inside the joint. OMT Kaltenborn-Evjenth Concept use translatoric (linear) joint play movements in association to the treatment plane in both assessment and treatment. Translatoric traction, compression and gliding joint play movements are applied to assess joint function and translatoric gliding and traction mobilisations are used to restore joint play[2].
The Kaltenborn Treatment Plane passes through the joint and exists at a right angle to a line positioned from the axis of rotation in the convex bony partner, to the deepest position of the articulating concave surface. Therefore, the treatment plane remains with the concave joint surface despite the moving joint partner being concave or convex[2].
Technique[edit | edit source]
Assessment[2][3][edit | edit source]
There are two procedures that can determine the direction of restricted glides;
- Glide test; involves the application of passive translatoric gliding movements in all achievable directions and ascertain in which directions joint gliding is reduced. The glide test is the preferred procedure, as it gives the most accurate information about the degree and nature of a gliding restriction, including its end-feel.
- Kaltenborn Convex-Concave Rule: First decide which bone rotations are reduced and if the moving joint partner is convex or concave. Then gather the direction of reduced joint gliding by applying the Convex Concave Rule.
Kaltenborn established the Concave-Convex Rule to allow ease in identifying the direction of limitation and subsequently the direction that treatment is to be applied.
- When a convex joint surface is moving, the roll and glide transpire in the opposite direction. The therapist moves a convex joint surface opposite to the direction of reduced movement to instigate the capsule in the same direction as the glide.
- When a concave joint surface is moving the roll and the glide takes place in the same direction. The therapist moves a concave joint surface in the same direction of the reduced movement. The reverse capsule is provoked[4].
Traction and Compression tests cam be utilised as part of the assessment;
| Traction | Compression |
|---|---|
| Relieves Joint pain | Aggravates joint pain |
| If positive in normal resting position, then locate a position
of greater discomfort and reassess the patient's response to traction. |
If negative this test should be conducted in several
three-dimensional positions. Joint compression should be assessed separately and prior resisted tests, as resisted tests also provoke pain. |
Grades of translatoric movement[2][3][edit | edit source]
Three grades of translatoric movement specific for traction and gliding are described by OMT. The grades are deduced by the extent of joint slack (looseness and resistance) in the joint. This slack is taken up when assessing and treating joints with a glide or traction.
- Grade I (loosen); Equalises joint pressure without actual surface separation, provides pain relief by reducing compressive forces.
- Grade II (slack zone & transitional zone i.e. tightens); Separates articulating surfaces by taking up slack or removes play within joint capsule. Is used initially to identify joint sensitivity
- Grade III (stretch); Involves stretching of soft tissue surrounding joint and to increase joint play in hypomobile joint.
Joint pathology will affect the quality of end-feel and grades of movement. For instance, the presence of a marked hypomobility the slack is taken up sooner than normal and greater force may be necessary to overcome intra-articular compression forces. In comparison to hypermobility the slack is taken up later than normal and less force may be necessary to achieve Grade I traction.
Evidence[edit | edit source]
Provide the evidence for this technique here
Resources[edit | edit source]
References[edit | edit source]
- ↑ Kaltenborn FM. Orthopedic manual therapy for physical therapists Nordic system: OMT Kaltenborn-Evjenth concept. Journal of Manual & Manipulative Therapy. 1993 Jan 1;1(2):47-51.
- ↑ 2.0 2.1 2.2 2.3 2.4 University of Sargodha. Translatoric joint play, Grades of Kaltenborn and Cocave-convex rule. Available from: https://lms.su.edu.pk/lesson/156/translatoric-joint-play-grades-of-kaltenborn-and-cocave-convex-rule (accessed 12 October 2020)
- ↑ 3.0 3.1 Sreeraj S R. Kaltenborn Manual Mobilisation. Available from: https://www.slideshare.net/sreerajsr/kaltenborn-manual-mobilizations-srs [last accessed 13 October 2020]
- ↑ Manual Mobilisations. Kaltenborn Concept. Available from:https://manualmobilization.wordpress.com/kaltenbornconcept/ (accessed 13 October 2020)
- ↑ Alexandra Kopelovich. CONVEX-CONCAVE RULE: Easy animation and explanation. Available from: https://www.youtube.com/watch?v=pkXIADrBuVc [Last accessed 13/10/2020)
