Joint assessment

Question 1

AROM

Answer 1

Mvmt of a jt provided entirely by the individual performing the exercise. In this case, other than gravity, there is no outside force aiding the mvmt
ex. bicep curl

Question 2

PROM

Answer 2

movement applied to a jt. solely by an external force (something other than the muscles around the jt.
-gravity assisted
-self ROM utilizing other parts of the pt’s body to generate force
-another person
-an outside assistive device: Dynamic splint or passive motion machine

Question 3

AAROM

Answer 3

The handler directs and guides the motion, asking the patient to assist. The safest place to begin in learning to handle joints and assess physiologic motion

Question 4

Quality of Motion

Answer 4

-Terms indicating a healthy finding
ex. smooth, with ease, without substitution
-Terms indicating presence of dysfunction
ex. guarded, slow, with effort, wincing, substitution
-Quality may be totally different at mid range
-End ranges into overpressures-know as assessing the end feel

Question 5

Subjective Response

Answer 5

A continuous dialogue with your patient. May be different at mid range and end range

Question 6

Normal ROM

Answer 6

Requires tissue excursion of: Jt, surrounding muscles, surrounding soft tissues AND No adverse: pain or guarding, abnormally increased tone

Question 6

Quantity of Motion

Answer 6

-Not enough: stiff, limited
-Just right: within normal limits, within functional limits, clears, unrestricted, unimpaired
-Too much: Hypermobile, unstable
-Estimate a percentage of normal
-Measure Linear displacement between 2 points with ruler or tape measure
-Measure angular displacement (in degrees) using principles of goniometry

Question 6

PROM stresses the

Answer 6

-Non-contractile tissues: jt capsule, ligaments, bursas, fascia, internal derangements, dura mater, nerve roots
-Contractile tissue of antagonists at end range
-limitations: capsular pattern: multidirectional mvmt restrictions with or w/o pain

Question 6

Normal end feels

Answer 6

Sensing and describing the feel of mvmt at the end of a joints physiological range
-soft tissue approximation: soft and spongy
-muscular: elastic like
-Ligamentous: firm arrest of mvmt, slight give
-cartilaginous: sudden stop but not hard
-capsular: firm arrest of mvmt with slight creep

Question 7

Abnormal end fields

Answer 7

painful/guarded/spasm
-edematous: a watery give
-bony block: a sudden stop
-empty: no resistance
-spastic/clonus
-Bony grate: a grating, rough sensation