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Joint ROM Flashcards

1
Q

Joint ROM

A

The motion available at any single joint

How much elbow flex and extension do you have

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2
Q

Muscle Length

A

flexibility

Ability of a muscle crossing the joint to lengthen, allowing one or more joints to move through the available ROM.

Looking at a specific muscle and how much excursion it has

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3
Q

what do we need for full ROM

A

Adequate joint ROM and muscle length

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4
Q

Active Range of Motion (AROM):

A

the range of motion in a joint reached by voluntary movement

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5
Q

Passive Range of Motion (PROM)

A

the range of motion that can be achieved by external means such as another person or a device

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6
Q

what does Active joint motion testing gives you info about

A

Willingness to move
Range of motion
Muscle strength
Motor control – for example, neurological issues can tell us about paralysis

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7
Q

Passive joint motion testing gives you info about

A

what is the barrier to motion

Capsule
Integrity of joint surface
Extensibility of musculotendinous unit
Pain to restriction of motion sequence – is there pain at end range or before

Does NOT provide info about strength

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8
Q

what is normal relationship between active and passive ROM

A

Normally, PROM > or = to AROM

if this is not the case you made a mistake

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9
Q

what causes pain in AROM

A

Contraction or stretching of contractile tissue
Quad strain, as we get to end range this quad will probably be uncomfortable

Stretching or pinching (compression) of non-contractile tissues
lateral hip issues, abd movement everything in the hip becomes compressed

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10
Q

what causes pain in Passive ROM

A

Stretching or pinching of non-contractile tissues

Pain at end of ROM due to stretching of muscle-tendon complex

NOT likely due to muscle contraction

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11
Q

Tissue Irritability

A

Term used by PTs to reflect tissue’s ability to handle physical stress

Important for guiding clinical decisions regarding treatment frequency, intensity, duration and type
Guides how aggressive we are when treating pts

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12
Q

what is the goal oriented with issue iratblity

A

Important for guiding clinical decisions regarding treatment frequency, intensity, duration and type
Guides how aggressive we are when treating pts

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13
Q

high irritability

A

7/10
high disability
pain occurs before end range movment
AROM is less the PROM

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14
Q

moderate irritability

A

4-6/10 pain
moderate disability
pain occurs at end range of active or passive
AROM similar as PROM

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15
Q

low irritability

A

<3/10
no night or resting pain
min disability
pain occurs with over pressure in end range motion
AROM same as PROM

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16
Q

symptom modulation of irritable tissue

A

Try to minimize symptoms so we can work on other impairments, high irritability

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17
Q

Movement control tissue irritability

A

Encourage normal movement, moderate irritability

The symptoms are calmed down

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18
Q

Functional optimization tissue irritability

A

Resolve impairments to complete high levels of activity
Doing ADL and sports things

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19
Q

end feel

A

Sensation imparted to examiner’s hand at end of motion when over-pressure is applied

At the end of PROM, push a little farther to see what is causing movement to stop

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20
Q

what does end feel provide information on

A

Provides information concerning irritability and structure that is limiting motion

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21
Q

in what can of movement can end feel be assessed

A

PROM

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22
Q

Hard (Bony) end feel

A

normal end feel

Hard, abrupt stop, and further motion is impossible. Due to approximation of two bones.

Elbow extension

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23
Q

Soft end feel

A

A gradual increase in resistance at the end of the range as when soft tissue in adjacent limb segments approximate

Elbow and knee flexion

normal end feel

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24
Q

Firm (Tissue Stretch) end feel

A

An abrupt increase in the resistance with some give at the end of the range – the stretch of soft tissues is the limiting factor

Tissue stretch, capsular stretch, ligamentous stretch
Ankle dorsiflexion
Faster then soft end feels

normal end feel

25
Muscle Spasm
pathological end feel Abrupt end feel with some “rebound” due to a reflexive muscle spasm and pain. May indicate acute joint inflammation or a fracture
26
Springy end feel
pathological end feel An abrupt end feel with “rebound” due to an internal joint derangement Like the firm end feel but occurs where you would not expect it limited knee extension – meniscus tear: push and it very firm and then there is a little rebound
27
Empty end feel
patho end feel No restriction is felt but the movement is stopped by the patient due to pain or apprehension May indicate a severe or non-musculoskeletal lesion May indicate abnormal illness behavior
28
Limited motion (ROM testing) means
Usually referring to a joint contracture Adaptive shortening of muscle or other soft tissues
29
Adaptive shortening
muscle tightness caused by a muscle being forced to remain in a shortened position for a prolonged period of time
30
Joint contracture
painful deformity that prevents the movement of a joint through its normal range
31
Stiffness (ROM of testing)
Stiffness (Young’s Modulus) = Stress/Strain The more stress it takes to strain a material, the stiffer the material (lead pipe) This is not telling us anything about ROM – instead, talks about how hard we must push on that joint
32
what is the point of ROM Assessment
Measurement of motion to determine presence or absence of impairment
33
Visual Estimation use most when
most use for joints that are hard to measure “Thoracic rotation is (25%, 50%, or 75%- based on normal) limited”- hard to measure this with instruments
34
Linear Measurement used when
TMJ bend forward and measure how far fingertips are from there feet
35
CROM and BROM
Cervical or Back Range of Motion instruments
36
Electrogoniometer
seen most in studies, an electrical device for measuring joint angles, electrical device used to assess the flexibility and mobility of a joint
37
Composite Methods
not measuring any one component of flexibility, does not tell us what structure is impaired
38
Goniometry Techniques stablization
Stabilize proximal segment to isolate joint motion Subject’s body weight Manual pressure provided by PT
39
do we use + or _ with goniometer measurements
Do not use (+) or (-)
40
Sagittal Frontal Transverse Rotational (SFTR) Method
Hyperextension / 0° / Flexion
41
Single Motion (A/PROM) Method
Each motion for each joint is documented separately. Active / Passive Flexion: 145°/150°; Extension: 0°/0°
42
Always inquire about response to motion
“Any pain with that motion?” “How did that feel?” “Did that recreate any of your symptoms?”
43
Adhesive capsulitis (frozen shoulder)
The capsule around the shoulder becomes inflamed and eventually reduces movement
44
Is my patient’s ROM/flexibility pathological or abnormal?
Best option: Compare to uninvolved side Reference norms are also available Compare to those with similar age and sex Okay as a starting point but need to consider individual factors Works well with limbs not great with thoracic types of regions
45
Hypermobility or Laxity
ROM greater than expected but individual can control movement in that range and no pathology is present
46
Instability
Inability to control joint motion within available range of motion
47
Anatomical Instability
Excessive or gross physiological movement in a joint where the patient becomes apprehensive at the end of the ROM because subluxation or dislocation is imminent - have popped my ​shoulder 5 times
48
Functional Instability
Inability to control movement in the available ROM during functional movement (e.g. giving way) ACL tear: go to run and jump and the knee starts to give out Not a specific ROM were this will occur the subjective feeling of ankle instability or recurrent, symptomatic ankle sprains
49
Voluntary Instability
Initiated by muscle contraction (party subluxer) Example: look I can pop my shoulder out
50
Beighton Hypermobility Index
Used to classify individual as having widespread joint hypermobility
51
Capsular Pattern of Limitation in Joint Motion
Limitation in multiple planes, usually in a predictable pattern Indicates pathology of the joint capsule Inflammation of entire joint (arthritis) – would expect ROM to be lost in a predictable manner Contracture or fibrosis of entire capsule e.g., shoulder capsular pattern: loss of ER > Flex/Abd > IR
52
Non-capsular Pattern of Limitation in Joint Motion
Limitation in one plane Internal derangement Adhesion or contracture of isolated portion of capsule or ligament Musculotendinous unit
53
Contracture
Adaptive shortening of muscle or other soft tissues resulting in limited ROM elbow flexion contracture results in limited elbow extension motion – stuck in flexion
54
Functional Excursion
Distance muscle is capable of shortening after it has been maximally lengthened
55
Functional Excursion 1 joint muscle
functional excursion determined by the joint it crosses Limited by the ankle range of motion
56
Functional Excursion 2 joint muscle
Two-joint muscle – functional excursion depends on configuration of all related joints
57
Active Insufficiency
When a multi-joint muscle is shortened across multiple joints to the point that it can no longer maintain/generate effective tension at all joints.
58
Passive Insufficienc
When a multi-joint muscle is maximally lengthened across multiple joints, preventing maximum range of motion at one or more joints. Lengthened the muscle so we cannot get full ROM straight leg raises vs. knee to chest

Kinesolgy (6 decks)

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