Passive Physiological Movement Flashcards
what is the point of passive range of motion tests?
- looks at movement when the active contractile element is not involved
what does PPM assess?
- natural ROM without actively engaging muscles
- assesses mobility, flexibility & pain
what are the two movements that can be tested at the talocrural joint?
- plantarflexion
- dorsiflexion
what are the two movements that can be tested at the subtalar joint?
- inversion
- eversion
what is the patient position in all passive physiological movements of the ankle?
- pt in supine
- ankle hanging off the bed
where do the hands go in plantarflexion PPM? what is stabilised?
- stabilise above the malleolus
- grab the foot at the front below toes
what movement occurs in PF passive movement?
- moves toes towards the ground
where do the hands go in dorsiflexion PPM? what is stabilised?
- fixate above the malleolus
- grab onto the foot behind calcaneus with the foot resting on your forearm
what movement occurs in dorsiflexion PPM?
- bring toes up towards them/ ceiling
what are the hands doing in eversion PPM? what is fixated?
- fixate the tibia
- grab the foot from the outside
what movement occurs in inversion PPM?
- move the foot inwards to the other foot
where are the hands in eversion PPM? what is fixated?
- tibia fixated
- grab the foot in the inside
what movement occurs in eversion PPM?
- move the foot outwards
what are the four movements that occur at the tibiofemoral joint?
- flexion
- extension
- internal rotation
- external rotation
what is the pt position for knee flexion and extension PPM?
- Pt in supine with both legs extended
where are the hands in knee flexion PPM? what is fixated?
- fixate the femur above the patella with one hand
- grab onto the leg above the ankle and palpate the joint line with the other hand
what movement occurs in knee flexion PPM?
- bring the foot as close to the buttocks as possible
what is the normal end feel of knee flexion?
- tissue approximation
where are the hands in knee extension PPM? what is fixated?
- fixate the femur above the patella with one hand
- other hand should grab onto the leg above the ankle with fingers underneath leg
what movement occurs in knee extension PPM?
- instructed to push down into the plinth
what is the normal end feel of knee extension PPM?
- tissue stretch
what is the normal pt position for knee internal and external rotation?
- pt in supine
- knee in maximally loosed packed position
what is MLPP of the knee? how is this achieved in IR/ER PPM?
- maximally loosed packed position is 25 degrees of flexion
- cushion placed under the knee joint
where are the hands in internal and external rotation of the knee? what is stabilised?
- stabilise the underneath of the femur above the knee with one hand (lift it into flexion)
- other hand wraps around the ankle joint
what movement occurs for IR vs ER PPM?
IR= move leg out
- move foot in
ER= move leg in
- move foot out
what is the normal end feel for IR and ER of the knee?
- tissue stretch
what are the 6 movements of the hip?
- flexion
- extension
- abduction
- adduction
- ER
- IR
what position is the pt in for flexion PPM? what is instructed before?
- pt starts in supine
- pt instructed to relax
what do the arms do in hip flexion PPM?
- grab the leg with one arm below the knee and the other wrapped around the ankle
what movement occurs in hip flexion PPM?
- bring the leg as close to the chest as possible
what position is the pt in for hip extension PPM?
- prone position
where are the hands in hip extension PPM? what is fixated?
- ischial tuberosity fixated
- grab the leg by coming over the body and wrap the hand underneath above the knee joint
what movement occurs in hip extension?
- instructed to lift the leg up
what position is the pt in for hip adduction?
- supine condition
- cross one leg over the other
- one underneath is the one being tested
where are the hands during hip adduction PPM? what is fixated?
- fixate opposite iliac crest
- other hand grabs the ankle on the underneath side
what movement occurs in hip adduction PPM?
- leg is moved into midline as far as possible
what position is the pt in for hip abduction PPM?
- pt in a supine position
- legs extended
- prevents rotation
where are the hands in hip abduction PPM?
- one hand fixates the opposite iliac crest
- other hand supports the leg below the knee/ above ankle joint
what movement occurs in abduction PPM?
- move the leg out
what position does the pt start in for both lateral and medial rotation?
- pt in supine
- hip flexed to 90 degrees and knee flexed to 90
where are the hands in hip lateral rotation?
- one hand on medial thigh above the knee
- other wrapped around the underneath of the ankle
what movement occurs in hip lateral rotation PPM?
- bring the heel inwards
where are the hands in hip medial rotation PPM?
- leg grabbed using one hand on lateral thigh above knee
- other wrapped around the underneath of the ankle
what movement occurs in medial rotation PPM?
- bring the heel outwards
what are the 8 shoulder PPM movements?
- flexion
- extension
- abduction
- adduction
- horizontal adduction
- horizontal abduction
- external rotation
- internal rotation
what is the starting position of GHJ flexion PPM? what is the normal angle reached?
- start in supine
- 90 degrees
where are the hands in shoulder flexion PPM?
- one hand around the wrist
- other hand goes underneath the ankle
what stance do you use in shoulder flexion PPM and why?
- lunge stance
- push the arm into flexion
- rest pt arm on body
what movement occurs during flexion PPM? what happens if you let go of the fixation point?
- move the arm into forward flexion (limited to 90 degrees before clavicle moves)
- if you let go of the clavicle it can go up to 180 degrees of flexion
what is the starting position of shoulder extension? what is the normal angle?
- in supine
- 60 degrees
where are the hands in shoulder extension PPM?
- one hand stabilises the scapula and clavicle
- other hand grasps the arm just above the elbow from the outside
what movement occurs in shoulder extension?
- arm pulled back into extension
what is the starting position of shoulder abduction? what is the normal angle?
- pt starts in siting
- 90 degrees
where are the hands in shoulder abduction PPM?
- one hand fixates the scapula and clavicle
- other hand just above the elbow wrapped underneath
what movement occurs during shoulder abduction? what happens if you go further than 90 degrees?
- bring the arm up
- elbow flexed
- need to externally rotate to reach the end range
what is the starting position for abduction?
- supine and towards the side of the plinth where the therapist is
- pt must be relaxed
- slight abduction with 90 degree elbow flexion
where are the hands for shoulder abduction?
- one hand on the anterior aspect of the shoulder joint
- other hand cradling the elbow
- pt can rest their arm on the therapist’s body
what is the movement in shoulder abduction?
- therapist walks with feet and brings the arm with them
what is the normal shoulder abduction end feel?
- firm end feel
how do you do horizontal shoulder abduction?
- in supine
- abduct the patients arm to 90 degrees and bring it into horizontal abduction
what is the normal angle for shoulder horizontal abduction?
- 15 degrees
how do you do horizontal shoulder adduction?
- pt in supine with arm in 90 degrees of flexion
- support the arm with your hand above the elbow and bring the arm towards midline of body
what is the normal angle for horizontal adduction?
- 20 degrees GHJ
- 40 degrees combined
what is the pt starting position for shoulder internal and external rotation?
- in supine
- start in 90 degrees abduction (one hand on elbow and one hand on wrist)
where are the hands in shoulder external rotation?
- one hand cupped under the elbow on medial side
- other hand wraps around the wrist
what movement do you do in shoulder external rotation? what is the normal angle?
- slowly glide arm down
- 100 degrees
where are the hands placed in shoulder internal rotation?
- one hand cups the elbow more laterally
- other hand wraps around the wrist laterally to be able to push arm down towards the body
what is the normal range for shoulder internal rotation ?
- 70 degrees
what is the normal end feel of shoulder rotation?
- elastic end feel
what are the four movements that occur at the elbow?
- flexion
- extension
- supination
- pronation
how is the pt positioned in elbow flexion and extension?
- in sitting
where are the hands in elbow flexion? what is fixated?
- one hand stabilises the underneath above the elbow
- other pushes radius (below wrist)
what is the normal end feel for elbow flexion?
- tissue approximation
where are the hands in elbow extension? what is fixated?
- one hand stabilises underneath above the elbow
- other is above the ankle joint
what is the normal elbow extension end feel?
- bone to bone
what is the starting position of supination and pronation PPM?
- pt in sitting with elbow flexed to 90 degrees
where are the hands in supination PPM? what is stabilised?
- one hand stabilises the elbow
- the other is just below the wrist causing movement
what is the normal supination end feel?
- tissue stretch
where are the hands placed in pronation PPM?
- one hand on underneath of elbow
- other hand wrapped around wrist
what is the normal pronation end feel?
- tissue stretch
what is the difference between supination and pronation?
- in supination the wrist is rotated laterally
- in pronation the wrist is rotated medially
what are the four movements at the wrist?
- flexion
- extension
- radial deviation
- ulnar deviation
what is the starting position of wrist flexion and extension PPM?
- pt in sitting with forearm resting on the plinth
- elbow slightly flexed and propped up with the forearm in supination
where are the hands in wrist flexion PPM? what is fixated?
- forearm fixated with one hand on anterior aspect below wrist
- other hand on the carpals
what movement occurs in wrist flexion PPM? what is the normal angle?
- wrist comes forward towards pt
- 74 to 77 degrees
where are the hands in wrist extension? what is fixated?
- forearm fixated
- other hand pushes down on palmar aspect of the hand
what movement occurs in wrist extension? what is the normal angle?
- wrist comes forwards away from the body
- 64 to 68 degrees
what is the starting position of the pt for radial and ulnar deviation?
- pt in sitting
-pronated forearm flat on the bench
where are the hands in radial deviation? what is fixated?
- distal forearm on anterior aspect is fixated (hand wraps around wrist)
- metacarpals grabbed from ulnar side
what movement occurs during radial deviation? what is the normal angle?
- towards the thumb
- 17 to 19 degrees
where are the hands in ulnar deviation PPM? what is fixated?
- fixate the distal forearm on the anterior aspect (wrap around below wrist)
- grab the metacarpals from radial side
what movement occurs during ulnar deviation? what is the normal angle?
- move hand towards pinkie
- 30 to 32 degrees
