Joint Motion- Examination Flashcards
What is Active ROM (Physiologic) motion testing?
Osteokinematic motion or physiologic motion testing
What is Pasive ROM (physiologic) motion testing?
Osteokinematic motion or physiologic motion testing
What is Joint play (Accessory) Motion testing
Arthrokinematic motion
What is Osteokinematics?
Gross movements of bones at joints
- Flexion/ Extension
- ABD/ADD
- IR/ER
What is Arthrokinematics?
Small amplitude motions of bones at joint surface
- roll
- glide (or slide)
- Spin
What are we assessing during motion testing?
- Quality of the movement
- Movement pattern, asymmetry, end- feel
- Quantity of movement
- Symptom response
What does AROM look at ?
@ joint range of motion
- Motor control
- Muscle function
- Strength
- Power
- patients willingness to move
What are progressions?
Applied to normal ROM to reproduce symptoms when necessary
What is PROM?
- 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
What does PROM also determine?
- 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
Motion testing- how far do I go? -Move to pain?
- Pain is the dominant factor in patients disorder
- Range to first onset of pain (and just beyond)
Motion testing- how far do I go?- Move to resistance?
- Assess for stiffness/ hypo-mobility
- apply overpressure to assess end-feel and symptom response
What is a Goniometer?
- Protractor with moveable arms
- Various sizes
What is a Bubble inclinometer?
36- degree rotating dial with fluid indicator (mainly used to measure spinal motion)
What are some of the ROM general procedures?
- Assess range of motion bilaterally (unaffected side first)
- Recommend two repetitions for each movement
During ROM what is the first repetition?
Visually assess movement quality, quantity, and symptom response
During ROM what is the second repetition?
Joint measurement as needed
What are the ROM specific procedures?
- 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
How you should document ROM values?
Example: AROM, L shoulder abd, 150 degrees with pain at end range
What is the Goniometer measurement error?
+/- 5 Degrees
Intra- rater generally _____ than inter- rater reliability?
Better
What is Accessory Joint motion?
- Arthrokinematic components of movement that make up a gross osteokinematice motion
- Can be assessed passively by examiner but cannot be performed actively by patient
