Since the early 1970s, there has been
a steady increase in the use of joint
mobilization techniques by physical
therapists.' The primary indication for
use has been mechanical joint dysfunction
in which there is restriction
of joint play (accessory motion) leading
to pain or limitation of active
physiological m~vement.~ Joint mobilization
has most often been used in
the evaluation and treatment of patients
who have musculoskeletal disabilities
of the spine and extremities.
More recently, Cochrane3 has suggested
mobilization as an appropriate
form of treatment for some of the
joint restrictions that occur in children
with cerebral palsy. The goals of
the introductory section of this article
are to define joint mobilization as
used traditionally for adults with musculoskeletal
disabilities, to discuss
various rationales for its effects, to
describe contraindications and precautions,
and to discuss the efficacy of
this treatment approach as reported
in the research literature. The latter
part of the article will deal with the
applicability of joint mobilization for
children with central nervous system
(CNS) disorders.