passive RoM

Question 1

why used as an assessment tool

Answer 1

presence of symptoms (differentiate contractile v non contractile dysfunction)
info re: end feel (hard, soft, firm)
feel resistance to movement (spasticity, rigidity, apprehension)

Question 2

why important to have consistent positioning

Answer 2

active and passive insufficiency

Question 3

why used as a treatment tool

Answer 3

maintain RoM when patient unable to
reduce spasticity with neurological dysfunction
re-educate movement pattern

Question 4

general how to do it

Answer 4

patient and physio comfortable
ask about pain at rest
inner to outer RoM
isolate movement if possible
slowly
look for signs of pain/discomfort (facial)
patient feedback
compensatory movements
note RoM and end feel
return limb to start

Question 5

contra-indications

Answer 5

where it could possibly disrupt healing
interrupt healing process after injury or surgery
suspected fracture/dislocation/subluxation
suspected myositis ossifications or ectopic ossification

Question 6

cautions

Answer 6

pain
inflammation
pain medication/muscle relaxants
osteoporosis
hypermobility
haemophilia
in region of a haematoma
suspect bony ankylosis
soft tissue disruption eg sprain
recently healed fracture
after prolonged immobilisation

Question 6

end feel and how you would perform for hip flexion

Answer 6

EF: soft or firm
SP: supine, hip + knee neutral
S: Ipsilateral pelvis at ASIS and iliac crest to maintain neutral pelvis
Distal hand under posterior femur
Or: proximal hand under distal femur, distal hand under heel of foot, once past 90, proximal hand move to proximal tibia to increase flex

Question 7

end feel and how you would perform for hip ab/adduction

Answer 7

EF: firm
SP: supine, pelvis level
S: ipsilateral pelvis or opposite leg on stool
Distal hand on medial aspect of distal femur
Or: proximal hand under distal femur, distal hand patients heel

Question 8

end feel and how you would perform for hip rotation

Answer 8

EF: firm
SP: supine, hip +knee 90
S: maintain femur position with proximal hand
Distal hand on distal tibia/fibula
Or: proximal hand stabilise femur, distal hand support foot (move to create rotation)

Question 9

end feel and how you would perform for knee flexion/extension

Answer 9

EF: (f) = firm/soft, (e) = firm
SP: supine, towel under distal femur
S: (e) femur
Distal hand on distal tibia/fibula

Question 10

end feel and how you would perform for ankle dorsiflexion

Answer 10

EF: firm/hard
SP: supine, towel under knee (20-30 flex)
S: tibia/fibula
Distal hand posterior calcaneus, forearm plantar aspect of forefoot

Question 11

end feel and how you would perform for ankle plantar flexion

Answer 11

EF: firm/hard
SP: supine, towel under knee (20-30 flex)
S: tibia/fibula
Distal hand dorsum of foot with radial border of index finger over anterior talus + calcaneus

Question 12

end feel and how you would perform for wrist flexion/extension

Answer 12

EF: (f) = firm, (e) = firm/hard
SP: sit, elbow flex, forearm resting pronate, wrist neutral over table edge
S: forearm
Distal hand hold metacarpals

Question 13

end feel and how you would perform for elbow flexion/extension

Answer 13

EF: (f) = soft/hard/firm, (e) = firm/hard
SP: supine/sit, anatomical, towel under distal humerus
S: humerus
Distal hand on distal radius/ulna

Question 14

end feel and how you would perform for shoulder flexion

Answer 14

EF: firm
SP: crook, palm face trunk
S: weight, thorax
Distal hand on distal humerus
Maintain elbow extend, prevent triceps restriction

Question 15

end feel and how you would perform for shoulder abduction

Answer 15

EF: firm
SP: humerus head needs to be laterally rotate, sit/supine, trunk extension
S: trunk
Distal hand on distal humerus

Question 16

end feel and how you would perform for shoulder lateral rotation

Answer 16

EF: firm
SP: supine, 90 ab, elbow 90, forearm mid, towel under humerus
: if 90 ab not available, do sitting
: if Hx anterior GHJ dislocation
S: weight, scapula
EP: dorsum of hand move towards floor
Distal hand on distal radius + ulna