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Maitland Approach Post Mind Map - Coggle Diagram
Maitland Approach Post Mind Map
Core Principles
Four Components
• Examination
• Planning and clinical reasoning
• Treatment
• Continuous assessment
Clinical Reasoning
• Clinical presentation guides treatment
• Theory informs but does not direct treatment
• Signs and symptoms are prioritised
• Continuous hypothesis testing
• Ongoing reassessment using asterisk signs
Assessment (S.I.N. Framework)
Severity
• Intensity of symptoms
• Patient reported pain levels
Irritability
• Aggravating factors
• Severity of symptoms
• Time required to settle
• Easing factors
Nature
• Stage of healing
• Stability of condition
• Inflammatory status
• Individual patient characteristics
Types of Movement
Physiological Movements
• Flexion
• Extension
• Rotation
• Lateral flexion
Accessory Movements
• Glide
• Spin
• Traction
Mobilisation Grades
Grade I (Pain Relief)
• Small amplitude
• Beginning of range
Grade II (Pain Relief)
• Large amplitude
• Within range
• Prior to resistance
Grade III (Mobility Improvement)
• Large amplitude into resistance
Grade IV (Mobility Improvement)
• Small amplitude into resistance
Grade V (Manipulation)
• High velocity thrust at end range
Treatment Categories
Group 1 – Pain
• Small amplitude mobilisation
• Early range treatment
• Slow smooth oscillations
• Guided by irritability
Group 2 – Stiffness
• End-range mobilisation
• Focus on restricted movement
• Repeated reassessment
Group 3 – Pain and Stiffness
• Combination of pain reduction and mobility restoration
• Physiological and accessory movements combined
Group 4 – Momentary Pain
• Functional movement focus
• Grade III-IV mobilisation
• Longer treatment duration
Precautions and Contraindications
• Osteoporosis
• Inflammatory arthritis
• Malignancy
• Anticoagulant use
• Hypermobility disorders
• Vertebrobasilar insufficiency
• Structural instability
• Spondylolisthesis (avoid strong end-range techniques in the direction of instability)
Evidence Base
Adhesive Capsulitis
Ulla et al. – Evaluating the Effectiveness of Grade I and II Maitland Mobilizations for Pain Relief in Adhesive Capsulitis: A Systematic Review
• Improved shoulder function
• Most effective when combined with exercise therapy
• Supports the use of lower-grade mobilisations for highly irritable conditions
• Grade I and II Maitland mobilisations reduced pain
Mechanical Low Back Pain
Effectiveness of Maitland Mobilisation on Pain and Function in Individuals with Mechanical Low Back Pain: A Systematic Review
• Improved functional outcomes
• Supports Maitland mobilisation as an effective treatment option for low back pain
• Relevant to rural physiotherapy populations with high rates of spinal pain
• Demonstrated reductions in pain
Patellofemoral Pain Syndrome
Shabiethaa – Study to Compare the Effectiveness of Tibiofemoral Joint Mobilization versus Maitland Mobilization in Patellofemoral Pain Syndrome
• Maitland mobilisation improved pain and function
• Supports use of Maitland techniques beyond spinal conditions
• Demonstrates versatility across musculoskeletal presentations
Key Strengths
• Patient-centred
• Individualised treatment
• Continuous reassessment
• Strong clinical reasoning framework
• Adaptable to multiple musculoskeletal conditions
• Supported by evidence across spinal and peripheral joint conditions