Objective - RoM

Question 1

AROM

Answer 1

> Testing inert (ligaments, joints, bones, capsule) and Contractile tissue (muscles + tendons)
Looking at
- Load acceptance
- Quality of movement (smoothness/effort)
- Range (compare sides + normative values)
- Pain behaviour (throughout movement, painful arc, constant, increasing/decreasing)
- Muscle spasm
- Resistance to movement
* Measured with goniometer (think about axis + plane of movement)
Also look at psychological factors
- Willingness to move
- Pain behaviours
- Fear/Reluctance/avoidance

Question 2

PROM

Answer 2

> Testing inert tissues
*Patient = comfortable + bed height is correct
Guided by AROM - recorded as full range (tick) + pain free full range (double tick)
*If pain free can apply overpressure to get end range feel
Looking at: for affected joint + those around it
- Quality
- Further range
- Resistance (limit + end feel)
- Muscle spasm
- Pain (start = P1, end = P2)
+ other symptoms

Question 3

PROM - end feel

Answer 3

• soft - soft tissue approximation
• hard - bony approximation
• spongy - inflamed/effused joint
• spongy with hard end feel - lig/soft tissue damage (less resistance until bony approximation)

> Abnormal end feels

• muscle spasm
• bone on bone (hard) - should only be at elbow ext.
• Capsular/elastic - too early in range
• Empty - no end feel (not appropriate to take to end range)
• Springy/block - meniscal tears (door jam)

Question 4

PROM - Capsular pattern

Answer 4

ARTHRITIS
> restrictions in particular directions (problem is likely with joint or capsule)
- only in joints directly controlled by muscles
> test in all ranges to gauge patterns of restriction

> Causes

• Capsular contraction
• Muscles spasm
• Osteophyte formation

Question 5

PROM - Non-capsular patterns

Answer 5

> Internal derangement (fragment of soft tissue or bone interfering with normal joint motion)
Extra-articular lesions
Single muscle involvement

Question 6

Recording RoM

Answer 6

> Goniometry = usually for passive (have to note if it is active movement measured)

• 1 direction at a time ie start at 0 degrees
• Intra-tester reliability <5 degrees

> Record
- Joint
- Movement
- Active/Passive 
- Position (supine/standing etc.)
- Start and end position 
- Range 
- Limiting factor 
\+ If passive (quality and end feel)