Grade IV joint mobilization is used for which combination?

• A. Small, pain
• B. Large, pain
• C. Large, increase tissue mobility
• D. Small, increase tissue mobility

Answer: (D)

Grade IV joint mobilization is the end-range, small-amplitude technique. The goal is to stretch and improve the mobility of the joint capsule and surrounding tissues (increase tissue mobility) without provoking pain, by applying a gentle, precise movement at the end of the available joint range. That makes the combination of small amplitude and increasing tissue mobility the best fit. The other options describe aims more aligned with different mobilization ideas—either focusing on pain relief with small amplitudes at the start of motion, or using larger amplitudes within the range to boost overall ROM—without targeting the end-range tissue mobility this technique specifically seeks.