Maitland Lumbar PAIVM (skeletal model)

Purpose
PAVIMs are used to assess the passive accessory intervertebral mobility of the lumbar spine. Can also be used as a treatment if hypomobility is found.

Technique
Central PA
Patient positioned prone.
Clinician stands on one side of the patient.
Clinician palpates L5 spinous process.
Clinician places both thumbs on L5 spinous process, gets his body over the patient, and then does a PA glide of L5 spinous process.
Clinician moves up to the L4 spinous process repeats the process as he continues in a cranial direction up the lumbar spine.
Unilateral PA
Patient is positioned in prone.
Clinician stands on one side of the patient.
Clinician palpates L5 spinous process.
Clinician moves a thumbs width lateral to the spinous process to L5 facet joint.
Clinician places both thumbs on L5 facet joint, gets his body over the patient, and then does a PA glide of the facet joint.
Clinician finds L4 spinous process and repeats the process as he continues in a cranial direction up the lumbar spine to L1.
Clinician then moves to test the patients other side.
Positive
Reproduction of symptoms or comparable signs.
Interpretation
Reproduction of symptoms indicates a hypomobility of the segment being tested.

References
Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York, NY: The McGraw-Hill Companies, Inc.

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