Range of motion

Question 1

What is joint ROM?

Answer 1

the amount of movement that is possible at a joint. The arc of motion on a specific plane.

Question 2

What is PROM?

Answer 2

Passive range of motion - movement applied to a joint from an outside force

Question 3

What is AROM?

Answer 3

Active range of motion - movement of a joint provided entirely by the muscles acting on a joint to perform an exercise.

Question 4

True or false: AROM is greater than PROM in a normal individual?

Answer 4

False, PROM is greater than AROM

Question 5

How is ROM tested?

Answer 5

1. Functional motion test
2. screening tests
3. measuring joint ROM with goniometer

Question 6

Name 3 ROM contraindications

Answer 6

1. Joint dislocations
2. Unhealed fracture
3. Immediately after surgery
4. Presence of myositis ossificans (bone tissue develops in muscle after injury
5. When ectopic ossification is a possibility (new bone forming in tissues that do not usually ossify).

Question 7

Name 3 ROM precautions

Answer 7

1. Joint inflammation or infection
2. Taking medication for pain or muscle relaxants
3. Osteoporosis, hypermobility or subluxation of a joint
4. Haemophilia
5. Haematoma
6. Just sustained an injury to soft tissue
7. Newly united fracture
8. Undergone prolonged immobilisation
9. Bony ankylosis suspected (stiffness of a joint due to abnormal adhesion and rigidity of bones of the joint due to injury or disease.
10. Carcinoma (cancer) of the bone or any fragile bone condition

Question 8

What is normal end feel?

Answer 8

Normal – full ROM achieved, motion limited by normal anatomical structures

Question 9

Why is ROM measurement useful?

Answer 9

1. identifies limitations that interfere with function or may produce deformity.
2. identifies additional motion needed to increase functional capacity or reduce deformity.
3. identifies the need for assistive devices or splints and progression of treatment.

Question 10

What is hard end-feel?

Answer 10

Bone hits bone

Question 11

What is firm end feel?

Answer 11

A stretching or spring feel

Question 12

What is soft end feel?

Answer 12

When soft tissue hits soft tissue

Question 13

Name 3 causes of limitation of ROM during occupations

Answer 13

1. Shortening if soft tissue (muscle, tendon, ligaments, skin)
2. Inflammation, oedema, haemotoma
3. Localised destruction of bone - arthritis
4. Amputation
5. Congenital abnormalities
6. Acute and chronic pain
7. Maladaptive environmental conditions

Question 14

What 5 features do you look for when assessing ROM?

Answer 14

1. Compensatory movement
2. Posture
3. Muscle contours
4. Skin – colour or condition
5. Compare with contralateral (non-injured side) parts

Question 15

What are the 4 uses of palpation?

Answer 15

1. Assess bony/soft tissue contours, skin temperature and texture
   2, Locate bony landmarks to align goniometer
2. Determine presence or absence of muscle contraction
3. Identify soft/bony tissue irregularities

Question 16

What are the 5 points of technique when palpating?

Answer 16

1. Client is comfortable
2. Observe area
3. Palpate with finger pads of index and middle finger
4. Fingers in direct contact of skin
5. Sensitive but firm touch.

Question 17

What is the normal ROM for flexion and extension at the shoulder?

Answer 17

Flexion: 0-170 degrees
Extension: 0-60 degrees

Question 18

What is the normal ROM for flexion at the elbow?

Answer 18

Flexion: 0-135/150 degrees

Question 19

What is the normal ROM for flexion and extension at the wrist?

Answer 19

Flexion: 0-80 degrees
Extension: 0-70 degrees

Question 20

What is the normal ROM for for ulnar deviation and radial deviation at the wrist?

Answer 20

Ulnar deviation: 0-30 degrees

Radial deviation: 0-20 degrees

Question 21

What is the normal ROM for MP flexion and IP flexion at the thumb?

Answer 21

MP flexion: 0-90 degrees

IP flexion: 0-80/90 degrees

Question 22

What is the normal ROM for MP flexion, PIP flexion and DIP flexion at the finger?

Answer 22

MP flexion: 0-90 degrees
PIP flexion: 0-110 degrees
DIP flexion: 0-80 degrees

Question 23

What is the normal ROM for Cervical flexion and extension?

Answer 23

Flexion: 0-45 degrees
Extension: 0-45 degrees

Question 24

What is the normal ROM for Thoracic/Lumbar flexion and extension?

Answer 24

Flexion: 0-80 degrees
Extension: 0-30 degrees

Question 25

What is the normal ROM for flexion and extension at the hip?

Answer 25

Flexion: 0-120 degrees Extension: 0-30 degrees

Question 26

What is the normal ROM for flexion at the knee

Answer 26

Flexion: 0-135 degrees

Question 27

What is the normal ROM for plantarflexion and dorsiflexion at the ankle/foot?

Answer 27

Plantarflexion: 0-50 degrees Dorsiflexion: 0-15 degrees

Question 28

How is ROM remediated?

Answer 28

1. Maintain and prevent limitations in ROM (compression, positioning, movement through full ROM) 2. Increase ROM (stretching, splinting/casting)

Question 29

What can be done if ROM limitations cannot be reduced?

Answer 29

Compensation - techniques and/or equipment to enable participation in patient's occupations.

Question 30

What are the 3 parts of a goniometer?

Answer 30

1. Stationary (proximal) arm 2. Moving (distal) arm 3. Fulcrum (or axis)

Question 31

Where should the stationary arm of a goniometer be positioned?

Answer 31

Aligned parallel to the longitudinal axis of the body segment proximal to the joint being measured

Question 32

What does the distal arm of a goniometer do?

Answer 32

1. Acts as a dial | 2. points to the number of degrees

Question 33

Where should the moving arm of a goniometer be placed?

Answer 33

Aligned parallel to the longitudinal axis of the body segment distal to the joint being measured.

Question 34

Where should the fulcrum of a goniometer be placed?

Answer 34

Placed over the approximate location of the axis of rotation of the joint