Week 2 Flashcards
Range of Motion
- *Range of Motion**
- *(ROM)**
The amount of movement that occurs at a joint and can be defined as the measurements of motion available
What is observed in a range of motion assessment?
How the patient is moving the joint/joints
Protective positioning
Is there edema, pain or spasticity
When would you use the range of motion assessment?
Need to assess joint range to identify strengths and limitations that will impact occupation
What are some causes of limitation when measuring joints?
Tight joint structure (PROM vs AROM)
Weakness (PROM vs AROM)
Edema
Soft tissue adhesions
- *Passive Range of Motion**
- *(PROM)**
Arc of motion through which a joint passes when moved by an outside force
External force is moving joint
- *Active Assistive Range of Motion**
- *(AAROM)**
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
True/False
Activities can impact the mobility of joints
True
True/False
Health status does not impact joint mobility
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.
Edema
a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body
Structural changes in , , , and affect ROM or wear and tear from a profession or repetitive occupation.
Structural changes in bone*, *cartilage*, *tendons*, and *joints affect ROM or wear and tear from a profession or repetitive occupation
Client Factors of Pain
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.
Active Range of Motion (AROM)
Arc of motion through which a joint passes when moved by muscles acting on a joint.
Functional ROM
Amount of motion necessary to complete essential ADL tasks
Total Active Range of Motion (Total AROM)
Combination of MCP, PIP and DIP measurements.
What do you use to measure ROM in joints?
Universal Goniometer
What is end feel in ROM?
End feel is resistance to further motion
This can be normal or abnormal depending on the circumstances
What are the types of end feel?
- 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”
How are ROM results usually recorded?
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
In a ROM assessment one needs to observe quality of motion AND….
- Speed
- Stiffness
- Joint swelling
- Coordination
- Alignment
- Assess joint motion proximally to distally
Passive Insufficiency
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.
Active Insufficiency
multi-joint muscle shortens over BOTH joints simultaneously, and hence, creates so much slack, that muscle tension is almost completely lost.
Metacarpophalangeal (MCP) Joints
located where the hand’s fingers and thumb meet the palm
Proximal Interphalangeal (PIP) Joints
commonly known as the middle knuckles of the fingers
Distal Interphalangeal (DIP) Joints
Synovial joints located where middle and distal phalanges meet
the joints closest to the tips of the toes, fingers, and thumbs
