Module 4: Joint Mobility Flashcards
What is a joint?
The location where two or more bones meet to allow movement.
What structures can compose a joint?
Bones, cartilage, joint capsules, synovial membranes & fluid, ligaments, menisci, bursa, labrum
What are the three types of joints found in human body? Give an example of each.
Synarthrosis – fibrous: immovable; sutures
Amphiarthrosis – cartilaginous: slight movement; intervertebral discs
Diarthrosis – synovial: freely movable; knee
Name 3 types of synovial joints and give one example of each.
Ball and socket - hip
Condyloid (ellipsoid) – radiocarpal
Hinge - elbow
Pivot – proximal radioulnar
Plane (gliding) – intertarsal
Saddle – CMC of thumb
Name and describe the 3 planes of movement in the human body.
Frontal (coronal) – divides the body into front and back
Sagittal – divides the body into right and left
Transverse – divides the body into top and bottom
Name the 3 axes of movement and place them according to the plane of movement. What joint motion occurs in each?
1) Frontal plane (coronal)| divides the body into front / back| with a Sagittal axis (anteroposterior)| for Abduction / Adduction| and movements like Jumping jacks
2) Sagittal plane| divides the body into Left / right| with a Frontal axis (transverse)| and Flexion / Extension| for movements like Squats
3) Transverse plane (horizontal)| divides the body into Top / Bottom| with a Vertical axis (longitudinal)| and movements like Rotation Russian twists
What is a uniaxial joint? Give an example.
A joint that allows movement in one plane. Example: Elbow (hinge joint).
What is biaxial joint? Give an example.
A joint that allows movement in two planes. Example: Wrist (condyloid joint).
What is a multiaxial joint? Give an example.
A joint that allows movement in multiple planes. Example: Shoulder (ball and socket joint).
What are accessory movements of a joint? Give 3 examples.
Movements that occur within a joint that allow the physiological movement of the joint.
Spin – radial head spins in the proximal radioulnar joint
Roll – femur condyles of the knee roll backwards on the tibia
Glide – femur condyles of the knee glide forward on the tibia
Define the movement of glide. Describe one joint in the body where this accessory movement occurs.
Translatory movement, where one fixed point glides over another at a joint surface.
Anteroposterior or mediolateral direction.
Femoral condyles gliding forward in the knee joint during flexion/extension.
Define the movement of spin. Describe one joint in the body where this accessory movement occurs.
Rotational movement, one surface rotates around another fixed surface.
Proximal radioulnar joint in supination/pronation
Define the movement of roll. Describe one joint in the body where this accessory movement occurs.
One joint surface roll over another.
Femoral condyles roll over the tibia in the knee joint in flexion/extension
Define closed packed position of a joint.
The joint surfaces are most congruent and stable; the joint surfaces fit together tightly; the ligaments and capsule are taut.
Define loose-packed position of a joint.
The position where the joint surfaces are less congruent, less stable, allowing for more movement, the joint surfaces are least aligned, the ligaments and capsule to be loose.
When measuring ROM, what is the difference between full ROM, inner ROM and outer ROM?
Full ROM: The complete range of motion from start to end.
Inner ROM: The range during muscle contraction, focusing on stability and strength.
Outer ROM: The range during muscle extension, focusing on flexibility and stretch.
Give 4 factors that contribute to normal ROM. Describe how they facilitate ROM.
Bony Shape and Integrity: structure and alignment in a joint.
Cartilage: hyaline cartilage cushions and smooths joint surfaces.
Joint Capsule: provides stability while allowing movement.
Ligamentous Tissue: connect bones and limit excessive movement.
How does muscles facilitate ROM?
Muscles support ROM by stretching across joints but have limits. For example, the hamstrings cross the hip and knee. When the hip is bent, knee extension is limited because the hamstrings are stretched. When the hip is straight, more knee extension is possible
Joints can be hypomobile and hypermobile. What is the difference?
Hypomobility: Restricted joint movement.
Hypermobility: Excessive joint movement.
What can be the problem if a joint has decreased ROM?
Disease, injury, pain, scarring, stiffening, contractures, spasticity, flaccidity
What can be the problem if a joint has increased physiological ROM (hypermobile)?
Greater risk of hyperextension: This can damage connective tissues, ligaments, and joints.
Increased joint instability: This can lead to pain and a higher likelihood of injury.
Name 4 factors that can decrease ROM. Describe how they can decrease ROM.
Immobilization: Leads to stiffness and loss of flexibility in joints and surrounding structures.
Injury: Causes physiological blocks that restrict movement.
Pain: Inhibits willingness to move during joint movement.
Muscle weakness: Reduces strength and limits effective movement.
Inflammation: Swelling restricts joint movement.
Name 2 factors that can lead to a hypermobile joint. Describe how they contribute to hypermobility.
Congenital conditions: Affect connective tissues and increase joint laxity (e.g., Ehlers-Danlos syndrome leads to hypermobility due to collagen production abnormalities).
Acquired conditions: Result from repetitive stress or injury, which can stretch or damage ligaments and connective tissues over time.
What is goniometry?
Measurement of joint angles to assess changes in ROM over time
What is the definition of passive ROM? How would you perform this?
PROM is movement performed by an external force. It is performed by moving the joint without the patient’s active involvement.
What is the definition of active ROM? How would you perform this?
AROM is movement actively performed by the patient without external assistance.
What is the definition of end-feel?
The sensation felt at the end of a joint’s ROM during passive movement.
Why is it important to feel for the end-feel?
To assess the condition of the joint and surrounding tissues.
What are the indications for performing passive ROM?
When full AROM is not possible due to muscle weakness, neurological problem, pain, stiffness, surgery, or injury
What are the indications for performing active ROM?
When full or near-full PROM is achieved but AROM is decreased, the focus should be on strengthening muscles, improving coordination and control, and promoting circulation. AROM is preferred whenever possible.
Give 3 examples of situations in which you would perform passive ROM and not active ROM.
After surgery when the patient cannot move independently.
When assessing joint stiffness.
To prevent joint contractures in immobile patients.
Provide 3 examples of when active ROM would be more indicated than passive ROM.
During rehabilitation for muscle strength.
To maintain joint flexibility after injury.
To assess muscle function.
Name 2 contraindications for passive ROM.
Acute injury to joint, ligament, muscles
Early fractures
What is the definition of stretch?
Taking a joint or muscle to the end of its available ROM and holding the position to lengthen the muscle or soft tissues.
What is the difference between stretches and passive ROM?
Stretching lengthens muscle and/or soft tissue, improving flexibility and increasing tissue elasticity over time.
PROM maintains or restores full joint ROM by moving the joint through its available ROM.
Name 3 physiological properties of the muscle tissue that need to be taken into consideration when performing a stretch.
Elasticity - Muscle’s ability to return to original length
Extensibility – Muscle’s ability to stretch
Contractility – Muscle’s ability to forcefully shorten
List 3 indications for stretching.
Maintain or increase ROM
Prevent muscle tightness, injury or contractures
Increase circulation
Decrease muscle spasm
Increase tissue compliance/flexibility
Decrease pain
List 3 contraindications for stretching.
Acute injury to joint, ligament, muscles
Early fractures
Joint hypermobility
What are accessory movements?
Small, involuntary movements that occur within a joint that are not under voluntary control and allow the physiological movement of the joint.
What is the difference between passive ROM and accessory movements?
PROM is the total movement available without muscle effort, while accessory movements are involuntary actions that support and enhance active movements within a joint.
List 3 contraindications for performing accessory movements.
Acute inflammation
Pain
Surgery or Injury
Joint instability
What is a manipulation?
High-velocity, low-amplitude movements applied to the joint past the available range to increase ROM
What is the difference between accessory movements and manipulations?
Accessory movements are gentle and involuntary, focusing on normal joint function. Manipulations are fast, forceful movements (think chiropractor) aimed at addressing joint dysfunction and pain relief.
