ROM Flashcards
Where does ROM fit on ICF?
Body structure functions–> impairments
from: swelling, nerve impinge, pain, posture, muscle weakness, etc.
What is joint ROM?
motion available at any single joint
influenced by: bony structure surrounding ligs joint capsule muscle patient SINS
What is muscle length?
ability of muscles surrounding a joint to lengthen, allowing one joint/series of joints to move through available ROM
referes to end range measurement of muscle across joint
(some pass over 2 joints)
How muscle length affects ROM measurements?
ONE joint muscles: ROM=length
TWO joint muscles: total ROM> length
ex:
gastroc (2 joints)- range of length less than total joint ROM at ankle in dorsiflexion
soleus (1 joint)- length same as joint ROM in dorsiflextion
Muscle length vs. Joint ROM test example
to measure LENGTH w/ 2 joint:
muscle needs to be elongated across ALL joints!
to measure Joint ROM w/ 2 joint:
uninvolved joint in short position!
Kinematics definition
human movement w/out regard to cause of the motino
osteokinematics and arthrokinematics are subcats
Arthrokinematics
Actual movement of joint surfaces
roll- rotary motion between joint surfaces
slide- translation between joint surfaces
occur simultaneously to preserve joint integrity
Osteokinematics
quality and degree of motion observed of whole bone
the result of arthokinematic motions
occurs in planes of mvmnt (front, sag, trans) around axis of rotation
WHAT WE MEASURE- ROM OVER DIFF PLANES!
Procedures in obtaining a measurement
- explain to patient
- porperly position patient
- stabilize prox joint segment
- instruct patient on motion to be performed (document if outside standardized test position–have limitation)
- palpate bony landmarks
- move patient through available ROM
- re-palp landmarks and take measurement
- return to initial position
- record measurement– RANGE= neutral to end position
Types of ROM and advantages
ACTIVE: patient moves
measure first
shows if patient willing to move joint
functional task observation- PT can get info on multiple joints
PASSIVE: examiner moves patient
determines total ROM patient has
determine limitations of full ROM- end feel!!
Reasons for differences in ROM measurements P/AROM
AROM could be less if: weakness habit muscle memory fear of pain neuro deficit muscle tear
Normal end feels
BONY: approx of 2 bones- abrupt, hard stop- no more motion
FIRM:
- Capsular: limited by joint capsule/non-contractile tissues- slight amount of give
- Muscular: limited by muscle tension- not as firm as capsular
SOFT: approx of soft tissue that limits (ex: fat)
Pathological end feels
Empty: motion limited due to PAIN complaint
Muscular spasm
Springy (ex: meniscus catching)
When normal end feel found where not expected (ex: frozen shoulder has capsular end feel early)
Boggy end feel: swollen squishy end feel
Factors affecting ROM
changes in lifespan gender culture occupation/rec activities anatomy
Instruments of ROM
goni: central proctor, axis, moving/stationary arm
inclinometer: fluid filled disc w/ protractor, weighted-gravity pendulum
tape measure
