Range of motion Flashcards
what is range of motion?
- the amount of motion available at a joint
what is the starting position for measurement of ROM ?
anatomical position
what is osteokinematics?
- the study of movement of bones around joints
what is arthrokinematics?
- study of movement of joint surfaces / accessory movements etc
-ie the roll, glide and spin of joints
what is the anatomical position?
- positioning of the body when standing upright
-each arm hanging by the side - palms facing forward
-legs parallel, with feet flat on the floor and facing forward
what is a plane of motion?
- planes of motion describe the axis along which an action is performed
what is an axis?
-a straight line around which an object rotates
-movement at a joint takes place in a plane around an axis
what movement takes place in the sagittal plane?
flexion and extension
what movement takes place in the frontal plane?
abduction and adduction
what is arthrokinematics necessary for ?
-necessary for pain free range of motion
what is a ‘roll’ movement, in terms of arthrokinematics?
- a rotary movement
-one bone rolling on another
what is congruency in terms of joints?
congruency = how well 2 surfaces fit together when they are superimposed on one another
what is a ‘spin’ movement, in terms of arthrokinematics?
- rotary movement
- all points on the moving joint surface rotate at a constant distance around a fixed axis of motion
what does congruent vs incongruent mean in terms of rolling and gliding etc ?
- congruent - more gliding
-incongruent - more rolling
what is a convex joint surface?
- rounded or arched
what is a concave surface?
- concave means hollowed
- think of a cave as hollow
what is a glide or slide movement?
-the slide of one joint surface oner another
-occurs when the 2 surfaces are congruent and either flat or curved
-eg tarsal bones in ankle and carpals in wrist
what is the concave motion rule?
REWATCH VIDEO ON ONE NOTE
- the convex surface is stationary and the concave surface moves
- when the concave surface moves, the concave joint surface and the bone itself move in the same direction
what is the convex motion rule?
- concave surface is stationary and convex surface moves
- when the convex surface moves up for eg, the convex joint surface is moving in a downward direction and vice versa
- opposite direction
what is physiological movement?
- joint movement that can occur voluntarily
what is accessory movement?
movement that accompanies physiological joint movement but cannot be performed voluntarily eg arthrokinematic motions
what does AROM stand for?
- active range of motion
what is active range of motion?
- unassisted (ie not assisted by physio) voluntary joint range of movement
-occurs due to muscles contracting and relaxing
-less than passive range
what dies PROM stand for?
-passive range of movement
what is passive range of movement?
- movement provided externally eg by a physio
-usually the maximum available range at a joint
what is a close-packed position of joints?
-the position in which the articulating bones have their maximum area of contact with each other
- ie joint stability is greatest
what is a loose packed position?
- the position in which the articulating bones are not maximally congruent and the surrounding bones and ligaments are not taut (ie not at max tension)
- ie less stability in the joint
what is an example of a joint in ‘closed packed’ position?
the knee joint in the extension position
are accessory movements maximal or minimal for a closed packed joint position?
minimal
are accessory motions maximal or minimal at a loose packed joint position?
maximal
what factors influence joint ROM?
-genetics
-age - ROM decreases as we age as joints become stiffer
-gender- women more mobile
-occupation
-temperature - high temp loosens and improves mobility of joints
-injury and diseases - eg osteoporosis
what is ‘end-feel’?
-the sensation transmitted to the therapist’s hand when taking a joint to the end of range
-can be normal or abnormal
what are the contra-indications of joint assessment (ie in what situations would you not test ROM)?
- joint dislocation
-unhealed/untreated fracture
-immediately post op - tendons, muscle, joint capsule etc
-acute joint flare up - eg rheumatoid arthritis - metabolic bone disease
what kind of end feel does a knee flexion have (ie contact between posterior soft tissue of the calf and thigh)?
a soft end feel
what are the precautions to keep in mind when undertaking a joint assessment?
- early stage of healing - less than 48 hours
- if muscle relaxants or analgesics have been taken
-bone fragility
-hypermobile or subluxed joints
-excessive pain or swelling
-pregnancy
-region of haematoma - bleeding within a muscle
what is an example of a firm end feel?
- hip flexion with the knee straight
what are examples of measurement tools to quantify ROM?
-inclinometer
-goniometer
-goniometer app on phone
what does a universal goniometer measure?
-measures the beginning and end of the movement, not what happens in between
-measures angles of the osteokinematic motion and not arthrokinematics
what are the principles of ACTIVE ROM assessment using a goniometer?
- ask the patient to move actively throughout the full ROM
-either move the movable arm of the goniometer through the entire range to the end of AROM or realign the goniometer at the end of AROM
-ask the patient is that as far as you can go?
what are the principles of passive ROM assessment using a goniometer?
- move the moveable arm of the goniometer, whilst passively moving the limb segment to be tested - eg arm or leg
-if it is hard to move the limb and the goniometer eg large joints, you can move the limb first without the goniometer
-ensure the joint is at the end of available range, by applying passive overpressure
what is the capsular pattern of ROM limitation?
- when there is proportional loss of rom in specific directions
-when a pathology involves the entire joint capsule eg joint effusion/synovial inflammation eg rheumatoid arthritis RA
what is a non capsular pattern of ROM limitation?
- usually results from a condition involving structures other than joint capsules eg muscles and ligaments
