**6. Indication and contra-indication of chest mobilization techniques**

There has been no information on the indication for chest mobilization before, which gives a tendency for limitation of chest movement; either structurally or physiologically. However, this technique can be used for various conditions such as COPD, prolonged bed rest, abnormal spine, deconditioning and aging.

The contra-indications for using this method are listed (Viekk, 1991) below:


From the biomechanics of chest movement, vertebral joints connect to the ribs and sternum with a complex unit that promotes chest expansion. Although this movement is very hard to observe, it also is very effective for ventilation. Therefore, this joint movement is promoted

Fig. 13. Mobilization of the facet joint by flexion and extension (Vibekk, 1991), direct rib stretching at the supine lying (left above), facet joint (right above), and costovertebral joint

There has been no information on the indication for chest mobilization before, which gives a tendency for limitation of chest movement; either structurally or physiologically. However, this technique can be used for various conditions such as COPD, prolonged bed rest,

**6. Indication and contra-indication of chest mobilization techniques** 

The contra-indications for using this method are listed (Viekk, 1991) below:

**5.4 Thoracic joint mobilization (Figure 13)** 

for improving ventilation (Vibekk, 1991).

abnormal spine, deconditioning and aging.

Severe and unstable rib fracture

 Metastasis bone cancer Tuberculosis spondylitis Severe osteoporesis

Unstable vital signs

 Herination Severe pain

(below).
