Week 2

Question 1

• *Range of Motion**
• *(ROM)**

Answer 1

The amount of movement that occurs at a joint and can be defined as the measurements of motion available

Question 2

What is observed in a range of motion assessment?

Answer 2

How the patient is moving the joint/joints
Protective positioning
Is there edema, pain or spasticity

Question 3

When would you use the range of motion assessment?

Answer 3

Need to assess joint range to identify strengths and limitations that will impact occupation

Question 4

What are some causes of limitation when measuring joints?

Answer 4

Tight joint structure (PROM vs AROM)
Weakness (PROM vs AROM)
Edema
Soft tissue adhesions

Question 5

• *Passive Range of Motion**
• *(PROM)**

Answer 5

Arc of motion through which a joint passes when moved by an outside force

External force is moving joint

Question 6

• *Active Assistive Range of Motion**
• *(AAROM)**

Answer 6

Arc of motion through which a joint passes when moved initially by muscles then completed by an outside force

Internal force moves joint and that motion is finished by an external force

Question 7

True/False

Activities can impact the mobility of joints

Answer 7

True

Question 8

True/False

Health status does not impact joint mobility

Answer 8

False

Health status can impact joint mobility

Ex.) inactivity of the muscles result in contractures due to muscle imbalance and the inability to perform normal activities. Limited external rotation over time results in tightening of the internal rotators.

Question 9

Edema

Answer 9

a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body

Question 10

Structural changes in , , , and affect ROM or wear and tear from a profession or repetitive occupation.

Answer 10

Structural changes in bone*, *cartilage*, *tendons*, and *joints affect ROM or wear and tear from a profession or repetitive occupation

Question 11

Client Factors of Pain

Answer 11

Pain is a major area of assessment for all clinicians.

Pain limits participation in function as well as limiting range of motion.

Important to assess intensity, duration and intensity of pain.

Question 12

Active Range of Motion (AROM)

Answer 12

Arc of motion through which a joint passes when moved by muscles acting on a joint.

Question 13

Functional ROM

Answer 13

Amount of motion necessary to complete essential ADL tasks

Question 14

Total Active Range of Motion (Total AROM)

Answer 14

Combination of MCP, PIP and DIP measurements.

Question 15

What do you use to measure ROM in joints?

Answer 15

Universal Goniometer

Question 16

What is end feel in ROM?

Answer 16

End feel is resistance to further motion

This can be normal or abnormal depending on the circumstances

Question 17

What are the types of end feel?

Answer 17

• Soft end feel: due to soft tissue
• Firm end feel: firmer but can feel a stretch- muscular, capsular or ligamentous stretch.
• Hard: bone against bone
• Empty: no “feel”

Question 18

How are ROM results usually recorded?

Answer 18

Most record results in 0-180 degree
Ex.) 90 degrees of shoulder flexion OR client exhibits 0-90 degrees of shoulder flexion

Sometimes results are recorded in a range from starting position to ending position
Ex.) Elbow flexion 20 degrees to 150 degrees (this would indicate a limitation in full elbow extension)

Sometimes results are recorded to indicate the limitation specifically
Ex.) -20 degrees of elbow extension

Depends on where you are practicing

Question 19

In a ROM assessment one needs to observe quality of motion AND….

Answer 19

• Speed
• Stiffness
• Joint swelling
• Coordination
• Alignment
• Assess joint motion proximally to distally

Question 20

Passive Insufficiency

Answer 20

occurs when a multi-joint muscle is lengthened to its fullest extent at both joints, but also preventing the full range of motion of each joint it crosses.

Question 21

Active Insufficiency

Answer 21

multi-joint muscle shortens over BOTH joints simultaneously, and hence, creates so much slack, that muscle tension is almost completely lost.

Question 22

Metacarpophalangeal (MCP) Joints

Answer 22

located where the hand’s fingers and thumb meet the palm

Question 23

Proximal Interphalangeal (PIP) Joints

Answer 23

commonly known as the middle knuckles of the fingers

Question 24

Distal Interphalangeal (DIP) Joints

Answer 24

Synovial joints located where middle and distal phalanges meet

the joints closest to the tips of the toes, fingers, and thumbs