Passive movements used to increase mobility of joints and decrease pain performed at a speed in which it is possible for patient to prevent the movement may be gentle-smooth or stretching-staccato. It is either: Passive physiological intervertebral movements (PPIVM):
PPIVM is used as an assessment to identify the location, nature, severity and irritability of vertebral symptoms, joint hypermobility or hypomobility. It tests the movement available at a specific spinal level through the application of a passive physiological movement. As a treatment used to mobilize stiffness and decrease pain.
Passive accessory intervertebral movements (PAIVM):
The purpose of PAIVM is to assess the amount and quality of movement at various intervertebral levels, and to treat pain and stiffness. the aim is to assess the end feel of movement, quality of resistance, behaviour of pain throughout the range of movement, and observe any muscle spasm.
Types of Passive Accessory Movements:
CPA - Central Posterior Anterior Used for pain evenly distributed on both sides when pain/ protective spasm is present in same direction
UPA - Unilateral Posterior Anterior Used for unilateral pain when pain is reproduced in AP direction.
CAP - Central Anterior Posterior Used for spondylolisthesis or intradiscal disorder
UAP - Unilateral Anterior Posterior Used mostly in cervical region
Rotation (General or Localized) For unilateral pain whether referred or not Transverse Used for unilateral distribution. Push towards the painful side. Distraction gentle for acute localized pain. Grades For Pain Relief (Irritable):
Grade I: small amplitude at the beginning of the range
Grade II: large amplitude not reaching the end of range
For Stiffness (Non-irritable):
Grade III: large amplitude up to the limit
Grade IV: small amplitude into the limit
Grade V: (manipulation) low amplitude, high velocity, thrust.