Joint Motion- Examination

Question 1

What is Active ROM (Physiologic) motion testing?

Answer 1

Osteokinematic motion or physiologic motion testing

Question 2

What is Pasive ROM (physiologic) motion testing?

Answer 2

Osteokinematic motion or physiologic motion testing

Question 3

What is Joint play (Accessory) Motion testing

Answer 3

Arthrokinematic motion

Question 4

What is Osteokinematics?

Answer 4

Gross movements of bones at joints

• Flexion/ Extension
• ABD/ADD
• IR/ER

Question 5

What is Arthrokinematics?

Answer 5

Small amplitude motions of bones at joint surface

• roll
• glide (or slide)
• Spin

Question 6

What are we assessing during motion testing?

Answer 6

• Quality of the movement
• Movement pattern, asymmetry, end- feel
• Quantity of movement
• Symptom response

Question 7

What does AROM look at ?

Answer 7

@ joint range of motion

• Motor control
• Muscle function
• Strength
• Power
• patients willingness to move

Question 8

What are progressions?

Answer 8

Applied to normal ROM to reproduce symptoms when necessary

Question 9

What is PROM?

Answer 9

• Examiner takes joint through ROM with patient relaxed
• Each movement compared with opposite side (preferred) or accepted norms
• Used when AROM is altered or painful

Question 10

What does PROM also determine?

Answer 10

• Helps us understand if there are any limitations in mobility (hypo-mobility or hyper-mobility)
• Helps us get a sense for the symptom response
• Get an idea of end- feel or capsular vs non- capsular patterns

Question 11

Motion testing- how far do I go? -Move to pain?

Answer 11

• Pain is the dominant factor in patients disorder

- Range to first onset of pain (and just beyond)

Question 12

Motion testing- how far do I go?- Move to resistance?

Answer 12

• Assess for stiffness/ hypo-mobility

- apply overpressure to assess end-feel and symptom response

Question 13

What is a Goniometer?

Answer 13

• Protractor with moveable arms

- Various sizes

Question 14

What is a Bubble inclinometer?

Answer 14

36- degree rotating dial with fluid indicator (mainly used to measure spinal motion)

Question 15

What are some of the ROM general procedures?

Answer 15

• Assess range of motion bilaterally (unaffected side first)
• Recommend two repetitions for each movement

Question 16

During ROM what is the first repetition?

Answer 16

Visually assess movement quality, quantity, and symptom response

Question 17

During ROM what is the second repetition?

Answer 17

Joint measurement as needed

Question 18

What are the ROM specific procedures?

Answer 18

• Patient in base position
• Locate pertinent bony landmarks
• Place goniometer axis of motion at the approximate axis of joint motion
• Align stationary and moving arms along the appropriate body parts and in line with identified bony landmarks
• Move the joint through its active or passive ROM
• Read the goniometer at appropriate ranges of motion

Question 19

How you should document ROM values?

Answer 19

Example: AROM, L shoulder abd, 150 degrees with pain at end range

Question 20

What is the Goniometer measurement error?

Answer 20

+/- 5 Degrees

Question 21

Intra- rater generally _____ than inter- rater reliability?

Answer 21

Better

Question 22

What is Accessory Joint motion?

Answer 22

• Arthrokinematic components of movement that make up a gross osteokinematice motion
• Can be assessed passively by examiner but cannot be performed actively by patient