PHYSIOTHERAPY INSTRUMENT MOBILISATION (PIM)

6th November 2011, a public holiday which the Muslim in Malaysia were celebrating Hari Raya Qurban, but me and some of my colleugues will have to control our lazy mood, to attend a workshop on  Physiotherapy Instrument Mobilisation (PIM).
A drizzling rain in the morning, and I was 10 minutes late to the venue, and the class were already started with some theory about the tecnique, which I manage to catch up later.

                                                       

PIM, a mechanical assisted joint mobilisation utilise a technological instrument and the treatment principal are according to physiotherapy principles, including the concept of physiotherapy model of joint mobilisation and manipulation, Mulligan's concepts of mobilisation with movement and positional faults. According to the speaker, these technique has being accredited by the Australian Physiotherapy Association as complying with their high standards of continuing professional(physiotherapist) development.

Manual therapy is a hard work - PIM technique using the mobilising device substitutes  high velocity and lower forces generated tools, ensuring effective joint mobilisation. One question raised, what would you prefer, an effective dose controlled repeatable reliable 2 second instrument application or 4 sets of  grade IV Passive Accessory mobilisations with clinician's thumbs? 

These is very true, because I started practicing since 1996, and in some busy days, my thumb already given me some sign of retirement ( oh no, I am too young to talk about retirement ...), this tools, seems to be a good option for me to rest my thumb's MCP( metacarpal phalangial joint), especially for small joint such as TMJ, cervical, acromio-clavicular, carpal and tarsal joint, very excellent result.

Furthermore, this instrument mobilisation enable the clinician to give fast and effective manual therapy, saving not only the clinician's thumb, but the energy and time for treating more patients in a day with less fatigue. 

From patient's feedback, PIM is less painful, compared to my fingers (are you sure?), and most of the time, patient no need to expose, with light clothing is desirable, and it showed quite an exciting clinical outcomes, which is what the clinician want.

Well, overall the workshop was so enjoyable, all the participants kept 'gun' here, 'gun' there, and I gun on my Right wrist's carpal joint, which already given me some problem due to joint mobilisation, and the result was satisfactory, my wrist extension improved after my self treatment.

Look at our lovely, sweet face and the powerful firing 'gun'....

squatting, 2nd from left - me....

A number of studies have investigated instrument mobilisation for its effectiveness and found it to be equivalent to manual mobilising techniques in reducing pain and improving function in patients. Ongoing research in to the basic science of instrument mobilisation and clinical trials have quantified intervertebral motions, electromyographic and neurophysiological responses to instrument mobilisation. 

Last and not least, allow me to express my appreciation to Mr Tim Mann and his lovely wife, Pam, who came all the way from Australia to conduct the workshop. Hope to see them soon for --- PIM 2nd part.