CCEP Joint Mobilization 5 — Questions and Answers
Question 1: During mobilization of the radiocarpal joint for restricted wrist flexion, which direction should the proximal carpal row glide?
- Dorsally (posteriorly) (Correct answer)
- Volarly (anteriorly)
- Radially
- Ulnarly
Correct answer: Dorsally (posteriorly)
To restore wrist flexion, the proximal carpal row must glide dorsally (posteriorly) on the radius.
Question 2: What is the primary clinical purpose of assessing joint play (accessory motion) prior to performing joint mobilization?
- To determine the patient's pain threshold
- To identify the direction and degree of hypomobility (Correct answer)
- To warm up the surrounding musculature
- To assess neurovascular integrity
Correct answer: To identify the direction and degree of hypomobility
Assessing joint play identifies the specific direction and degree of hypomobility so that the mobilization can be precisely targeted.
Question 3: Which of the following is a relative contraindication (precaution) rather than an absolute contraindication to joint mobilization?
- Malignancy at the treatment site
- Unhealed fracture
- Osteoporosis with mild joint stiffness (Correct answer)
- Active joint infection
Correct answer: Osteoporosis with mild joint stiffness
Osteoporosis is a relative contraindication requiring modification of force, not an absolute contraindication that prohibits mobilization entirely.
Question 4: The Mulligan concept of Mobilization with Movement (MWM) for lateral epicondylalgia involves applying which accessory glide to the elbow while the patient actively grips?
- Valgus glide of the ulna
- Lateral glide of the ulna on the humerus (Correct answer)
- Posterior glide of the radial head
- Distraction of the radiohumeral joint
Correct answer: Lateral glide of the ulna on the humerus
The Mulligan MWM for lateral epicondylalgia applies a lateral (valgus) glide of the forearm on the humerus while the patient performs pain-free gripping.
Question 5: Which ankle joint mobilization technique is most appropriate for a patient with restricted plantarflexion following prolonged immobilization?
- Posterior talar glide
- Anterior talar glide (Correct answer)
- Medial talar glide
- Lateral talar glide
Correct answer: Anterior talar glide
An anterior glide of the talus on the tibia/fibula mortise is used to restore restricted plantarflexion at the talocrural joint.
Question 6: In the context of extremity joint mobilization, 'end-feel' assessment is used to:
- Grade the patient's level of pain during motion
- Characterize tissue behavior at the limit of passive range to guide treatment selection (Correct answer)
- Determine the grade of muscle weakness
- Measure intra-articular effusion
Correct answer: Characterize tissue behavior at the limit of passive range to guide treatment selection
End-feel assessment characterizes the tissue behavior (bony, capsular, soft tissue, etc.) at the limit of passive range, guiding selection of appropriate mobilization technique.
Question 7: A patient presents with restricted supination of the forearm. Which accessory motion at the proximal radioulnar joint should the CCEP apply?
- Anterior glide of the radial head (Correct answer)
- Posterior glide of the radial head
- Lateral distraction of the radial head
- Medial compression of the radial head
Correct answer: Anterior glide of the radial head
An anterior (ventral) glide of the radial head at the proximal radioulnar joint is used to restore restricted forearm supination.
CCEP Joint Mobilization 5
During mobilization of the radiocarpal joint for restricted wrist flexion, which direction should the proximal carpal row glide?