JOINT MOBILITY – Arthrokinematics Huei-Ming Chai, Ph.D., PT School of Physical Therapy National Taiwan University Classification of Joints - based on anatomic structure and movement potential • diarthrosis: an articulation that contains a articular cavity between two bones • synarthrosis: an articulation between bones that is held together by dense irregular connective tissues • amphiarthrosis: an articulation between bones that is formed primarily by fibrocartilage and/or hyaline cartilage intervertebral disc 1 Comparisons of Joint Types diarthrosis prefix syn = together amphi = both articular cavity, presence capsule, synovial membrane no no articular surfaces hyaline cartilage or fibrocartilage linked by fibrocartilage, fibrous tissues, or ligaments linked by fibrocartilage and/or hyaline cartilage to connect bones to transmit forces to allow motions + + maximum exapmples di = double synarthrosis amphiarthrosis extremity joints + + no or little cranial suture + + some IVD synovial joint Classification of Diarthrosis • Plane (Irregular or Arthrodial) • Hinge (Ginglymus) • Pivot (Trochoid or Screw) • Condyloid (Ovoid or Ellipsoidal) • Saddle (Sellar) • Ball-and-socket (Spheroidal) 2 Plane Joint • irregular or arthrodial • non-axial joint • only sliding movements • DOF=1 • e.g. facet joint of the spine Hinge Vs. Pivot Joint hinge (ginglymus) uniaxial joint DOF = 1 e.g. humeroulnar joint pivot (trochoid or screw) uniaxial joint DOF = 1 e.g. humeroradial joint 3 Ball-And-Socket Joint • spheroidal • triaxial joint • DOF = 3 • Ideal joint surface: ovoid • e.g. glenohumeral joint Ellipsoidal Joint • condyloid (ovoid or ellipsoidal) • biaxial joint • DOF = 2 • Ideal joint surface: ovoid • e.g. radiocarpal joint 4 Saddle Joint • sellar • biaxial joint • DOF = 2 • e.g. first carpometacarpal joint Horse and Saddle concave on sagittal plane convex on frontal plane 5 Factors affecting structure and function of synovial joint • aging • immobilization • trauma • disease • habit • psychological status Joint Mobility • Osteokinematic movements – physiological movements – movements between 2 bony segments • Arthrokinematic movements – accessory movements – movements between 2 articular surfaces 6 Osteokinematic Movements Swing: rotary movement around an axis Spin: rotation around longitudinal axis of distal segment Arthrokinematic Movements • rolling • sliding • gliding – incongruent joint surfaces – a combination of rolling and sliding • traction (distraction) • compression 7 Rolling Vs. Sliding Rolling: new points on one surface meet new points on the opposite surface Sliding: same point on one surface meet new points on the opposite surface In Neumann's book fundamental arthrokinematic movements • roll： not really found in human joints • slide： not really found in human joints • spin 8 Gliding glide： a combination of roll and slide between two incongruent joint surfaces Rolling vs. Sliding vs. Gliding 9 Concave-Convex Rule concave on convex: -- concave surface moving on convex surface -- The concave articular surface moves in the same direction as the moving bone glide occurs in the same direction as the physiological movement -- e.g. tibia on femur motion Concave-Convex Rule convex on concave: convex surface moving on concave surface movement -- The convex articular surface moves in the opposite direction of the moving bone glide occurs in the direction opposite to the physiological movement -- e.g. humerus on scapula motion 10 Traction Vs. Compression Traction (distraction): joint surfaces separation Compression: joint surfaces meet together Description of Osteokinematic Movements • plane of motion • axis of rotation • degree of freedom • range of motion • open vs. closed kinematic chain • concentric vs. eccentric contraction • factors checking motions 11 Description of Arthrokinematic Movements • joint morphology to establish concave-convex rule • plane of motion • direction of motion • amplitude of motion 12
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