Range of Motion Testing Flashcards
What is the correct order of ROM testing?
Active: 100% by patient
Passive: 100% by examiner
Resisted: isometric movement, tested from neutral position
What side should you started ROM testing?
The unaffected/non painful side, gives us a true sense of the ROM that should be achieved on affected side
What movements are done last?
Painful ones as it prevents “overflow” of painful symptoms
What is tested in active ROM? What should examiner note?
Will test: Contractile, nervous, and inert tissues that are moved
Contractile tissues have tension placed on them by stretching or contraction
Nervous tissue and their sheaths have tension put on them by stretching
Inert tissue includes all tissues that are not contractile or neurological (ligaments, bursae, bone, cartilage, and the capsule)
Examiner should note:
When and where during each movement the onset of pain occurs
Whether the intensity and quality of pain increases with the movement
The reaction of the patient to the pain
The degree of restriction
The rhythm and quality of movement
The movement of associated joints
The willingness of the patient to move the part
Any limitation and its nature (ask why?)
What are common causes of abnormal active movement?
Pain is a common cause for abnormal movement
Muscle weakness
Paralysis
Spasm
Other causes include tight or shortened tissues, altered length-tension relationships, modified neuromuscular factors, and joint-muscle interaction
Which type of ROM is usually normal, full range, and pain free, with possibly some pain at the end of ROM when contractile or nervous tissue is stretched?
Passive ROM
Other than degree of movement, what else is important in PROM?
quality of movement
Describe the appropriate stress that is applied during PROM?
When the examiner is doing passive range of motion testing, the appropriate stress is applied gently and repeated several times. The stress is increased up to but not beyond the point of pain and is done in all ranges.
What should the examiner note during PROM?
Examiner should note:
Any Differences in ROM between active and passive movements may be caused by:
Spasm
Muscle Deficiency
Neurological deficit,
Contractures
Pain
What is the sensation that the examiner feels in the joint as it reaches the end of ROM?
end feel
Evaluation of end feel can help you do what 3 things?
Assess the type of pathology present
Determine a prognosis for the condition
Learn the severity or stage of the problem
End feels (Normal vs abnormal) chart
Muscle strength grading
Pain sensation and associated structure
Resisted ROM: what problems are found? How is testing conducted?
Finds problems in contractile tissues
Testing is always done with the 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
To keep movement to a minimum, it is best for the examiner to position the joint properly in the resting position and then to say to the patient, “Don’t Iet me move you, “
In this way, the examiner can ensure that the contraction is isometric and can control the amount of force exerted.
Both AROM and RROM demonstrate symptoms if contractile tissue is affected
Muscle Strength Grading must be used to determine if there is weakness or not
