Lecture 3 (9-16) Flashcards
What are the 3 reasons AROM could be limited
- Active muscle dysfunction
- Passive motion restriction
- Joint stability
What is active muscle dysfunction
Problem with the muscle
Examples of active muscle dysfunction
Organic weakness, reflex, inhibition due to pain or effusion, or abnormal motor recruitment
What falls under abnormal motor recruitment (3)
- Antagonists: guarding or splinting
- Synergists: Substitutions
- Abnormal temporal characteristics
What is passive motion restriction
Something is blocking the joint
What is joint stability
The person doesn’t want to do the same action that caused the injury
What are the 3 reasons PROM can be limited
- Passive insufficiency
- Intraarticular obstruction
- Muscle guarding or splinting
What structures is passive insufficiency due to
Capsule, ligament, or muscle that crosses 2 joints
What is intraarticular obstruction due to
Loose body, cartilage, or tissue
Can the amount of motion change with intraarticular obstruction
Yes, because loose body moves around
What is muscle guarding or splinting due to
Apprehension or pain from tissue reactivity
Who designed the contractile inert test (screen exam)
James Cyriax
When did Cyriax develop the contractile inert test
1930s
What does the contractile inert test examine
AROM, PROM, and resisted isometric testing
What end feel is bone on bone
Hard end feel
What end feel is springy rebound
Firm end feel
What end feel is soft tissue approximation
Soft end feel
What end feel occurs anytime a patient has pain or excessive ROM
Empty end feel
What are the 4 scores of the resisted isometric test
- Strong painless
- Strong painful
- Weak painful
- Weak painless
What is abnormal end feel
Limited ROM
How do you find the percentage of loss for pattern limitations
Take measured value and divide by normal value and multiple times 100 (% formula)
If pain you should ask what
Is it compression load intolerance or tensile load intolerance
What tissues experience compression load intolerance (6)
- Articular cartilage
- Periosteum
- Bursa/fat pad
- Tendon and/or tendon sheath
- meniscus or articular disc
- Neural tissue
What tissues experience tensile load intolerance (4)
- Capsule
- Ligament
- Tendon or muscle
- Neural tissue
Tendons resist what 99.9% of the time
Tensile load
True or False:
If AROM is full and pain free you can choose not to perform PROM
True
What might cause AROM to be less than PROM
- Active muscle dysfunction
- Tensile load intolerance
- Patient reluctance