The Maitland-Australian Approach is considered a cornerstone of Orthopedic Manual Therapy for treatment of both spinal and peripheral conditions. The Maitland-Australian Approach uses primarily the assessment and treatment of the patient’s signs and symptoms to develop an effective treatment plan. The Maitland-Australian Approach intentionally gently provokes the patient’s symptoms using carefully-graded osteokinematic (physiological) and arthrokinematic (accessory) passive mobilization. This approach is recognized worldwide as an efficient, safe and gentle way to evaluate and treat the orthopedic patient to alleviate pain, reduce inflammation, restore movement, and maximize function.
The Maitland-Australian Approach was pioneered in the 1950s by the Australian physiotherapist Geoffrey Maitland and it has continued to evolve over the years with groundbreaking concepts such as irritability, neurodynamics, combined movements, stabilization training, and advanced clinical reasoning with supporting evidence-based medicine research.
The following joint mobilization grades are as per the Maitland-Australian approach:
- Grade 1: small amplitude, short of resistance
- Grade 2: large amplitude, short of resistance
- Grade 3: large amplitude, 50% of R1-R2
- Grade 4: small amplitude, 50% of R1-R2
- Grade 5: small amplitude, high velocity thrust at end of available range
Grades 3 and 4 can be refined as follows:
- Grades 3– or 4–: first onset of R1
- Grades 3- or 4-: 25% of R1-R2
- Grades 3+ or 4+: 75% of R1-R2
- Grades 3++ or 4++: max R or end of range