Central glides assist primarily with sagittal plane motion of forward and backward bending while unilateral glides enhance rotation and side bending.
Accessory Motion Technique
Patient Position:
Prone with a pillow supporting the lumbar spine.
Clinician Position & Hand Placement:
Stand to the side of the patient.
As a general technique, stabilization is not required.
The region of the hand just distal to the pisiform contacts the spinous process for central glides and the transverse process for unilateral glides while the mobilizing hand lies over the contact hand. The elbows are extended, and the forearms are in the direction in which force is applied.
Alternate hand placement includes thumb-over-thumb pressure, or split finger contacts over the transverse processes of the same segment or the transverse processes of adjacent segments.
Force Application:
Anteriorly directed pressure is applied through hand contacts at either the spinous or transverse processes.
Slight changes in force direction can be provided to improve specificity.