About KKMT® Mobilization

Krishna's Kinetikinetic Manual Therapy® (KKMT®) is a school of thought in manual therapy founded by Dr. Krishna N. Sharma, a physiotherapist from India. KKMT® emphasizes on realigning the incongruity or recoiling the restrictions of joint by mobilization and manipulation to facilitate the homeostatic kinetic forces of joint.

History

  • The concept of KKMT® Mobilization (3D Glides) first sprouted in 2004 when he was still a student.
  • The first draft of basic concepts and techniques for Knee Joint KKMT® was completed on September 4th, 2015.
  • The first 2 students learned who learned KKMT® for knee joint were Mr. Donfack Philip (Lecturer- St. Louis University, Cameroon) and Mr. Chu Buh Franklin (Student- University of Rome Tor Vergata, Italy)
  • The first batch of KKMT® Mobilization (Knee Joint) was taught on the 19th of March, 2016 in St. Louis University Campus, Cameroon.
  • KKMT® is in the Cameroon's national physiotherapy curriculum by the Ministry of Higher Education. (2016).
  • KKMT® was launched in Sri Lanka in 2016 at the University of Peradeniya.
  • This first ever book on KKMT® was published in April, 2016.

Principles

The KKMT® joint mobilization techniques are based on the following principles:

  1. Proper arthrokinematic motion and homeostatic kinetic forces are essential for proper and smooth osteokinematic motion.
  2. Homeostatic kinetics of the joint is important to maintain static and dynamic alignment of a joint. The homeostatic kinetic forces help the joint come back in its proper alignment after a motion. The factors that produce and govern the homeostatic kinetics of joint are:
    1. Local/Intrinsic Factors: e.g. ligament, cartilage, meniscus etc.
    2. Global/Extrinsic Factors: e.g. muscles, fascia, gravity etc.
  3. Limitation or restrictions in the arthrokinematic motion can be restored by facilitating homeostatic kinetics of the intrinsic and extrinsic factors.
Indications
  • Joint Pain
  • Decreased range of motion
Contraindications
Though pain during application of the techniques itself is the best way to know if the technique is contraindicated, KKMT® joint mobilization should be applied with caution in the cases of acute injuries e.g. fracture, acute sprain etc. and joint instability.

Techniques

The KKMT® Joint Mobilization is applied after muscle and joint conditioning. There is a range to techniques that can be applied to restore the joint motion and facilitate the homeostatic kinetics. Few of them are below:
  1. Joint Gaping®
  2. 3D Gliding®
  3. Functional Articular Rolling®
Joint Gaping®:
It is a joint distraction technique performed with functional osteokinematic motion.
Functional 3D Gliding®:
There is never a unidirectional arthrokinematic motion in a functional joint, so I started exploring the possibilities of 3D gliding and coined the term- 3D Glide®. The restricted/ painful osteokinematic movement is performed passively with variations of 3D glide patterns to identify the preferred pattern.
Since physiologically, 3D glides occur obviously only during active motion and not when the joint is static, I prefer to perform the 3D glides only with active motion. The 3D Glide® patterns can be combined with other techniques e.g. post-isometric relaxation, reciprocal inhibition, oculocervical reflex, etc. too.
Functional Articular Rolling®:
Rolling is the most ignored component in manual therapy as most of the techniques focus on gliding only. My joint rolling techniques are mostly combined with joint gaping®.