Phys Med #1 Flashcards
what’s the correct order for range of motion testing?
- active ROM
- passive ROM
- resisted ROM
when testing ROM always start with…
the unaffected/non-painful side of patient
describe AROM
active ROM
- performed by the patient
- will test: contractile, nervous and inert tissues that are moved
describe PROM
passive ROM
- performed by the examiner while the patient is relaxed
- usually normal, full range, and pain free, with possibly some pain at the end of ROM when contractile or nervous tissue is stretched
what is end feel
the sensation that the examiner feels in the joint as it reaches the end of ROM
- overpressure is applied at the end of ROM to determine end feel
describe RROM
resisted ROM
- finds problem in contractile tissues
- always done with patient in neutral position so that minimal tension is placed on the inert tissue
- the patient is asked to contract the muscle as strongly as possible while the examiner resists for a few seconds to prevent any movement from occurring
what are the grades of the ROM
0-zero - no evidence of muscle contraction
1-trace - evidence of slight muscular contraction; no joint motion evident
2-poor - complete ROM with some assistance and gravity eliminated
3-fair - complete ROM against gravity with no resistance
4-good - complete ROM against gravity with some resistance
5-normal - complete ROM against gravity with full resistance
what are the 3 views to assess posture?
anterior, lateral, and posterior
definition of gait analysis
manner or style of walking
when does examination of gait begin?
as soon as the patient enter the room
what are the 2 phases to the normal walking cycle
stance phase and swing phase
what is the stance phase
when the foot is on the ground (60% of gait cycle)
what is the swing phase
when the foot is moving forward (40% of gait cycle)
what is arthogenic gait
- stiff hip or knee
- results from stiffness, laxity, or deformity, and it may be painful or painless
what is ataxic gait
- stagger gait with exaggerated movements
- patient presents with poor sensation or lacks muscle coordination, poor balance, and a wide broad bas stance
- results usually from damage to the cerebellum
what is gluteus maximus gait
- backward lurch of the trunk
- results from a weak gluteus maximus
- patient thrusts the thorax posteriorly at heel strike to maintain hip extension of the stance leg
what is Trendelenburg’s gait (gluteus Medius gait)
- results from weak glutes med/minimus
- during the stance phase, patient exhibits an excessive lateral liftwhere the thorax moves to keep centre of gravity over the stance leg
what is hemiplegic gait?
- presents as a swinging of the paraplegic leg outward and ahead in a circle or pushes it ahead. also, the affected upper limb is carried across the trunk for balance
what is parkinsonian gait (festinated gait)
- neck, trunk, and knees are flexed
- there is a SHUFFLING or rapid short steps
- arms are held stiffly and patient may lean forward and walk progressively faster as though unable to stop
what is scissors gait?
- result of spastic paralysis of the hip adductor muscles
- causes the knees to be drawn together so that the legs can be swung forward only with great effort
what is steppage or drop foot gait
- result from weak or paralyzed dorsiflexor muscles
- to avoid dragging the toes against the ground, the patient lifts the knee higher than normal
- for initial contact, the foot SLAPS on the ground
