Week 5 (ROM Assessment)

Question 1

Why measure ROM?

Answer 1

• To determine whether ROM permits normal function
• Assist in diagnosis
• An outcome measure to track progress
• Legal implications

Question 2

Tools for measuring ROM

Answer 2

Angular measures
- Goniometer
- Inclinometer
- Electronic goniometer
- Photography
- Motion analysis
Linear measures
- Tape measure
Eyeballing

Question 3

What do we need to standardise when measuring ROM?

Answer 3

• Patient position
• Landmarks
• Equipment
• Force/effect and instructions

Question 4

How do we measure ROM?

Answer 4

• Convention is to consider anatomical position to be 0 degrees for most joints
• Reduced movement often negative

Question 5

What do we record ROM?

Answer 5

Record final peak angle/measure

Question 6

Key principles of measuring PROM

Answer 6

• Standardise force you place on the joint
• You will never have enough hands
• Use gravity as a reproducible force
• Instructions must be standardised and clear

Question 7

Examples of two-joint muscles

Answer 7

Rectus femoris, hamstrings, gastrocnemius, long head of biceps and triceps

Question 8

How to determine two-joint muscle involvement in limiting ROM?

Answer 8

If releasing stretch at the first joint increases range at the second joint > the muscle was limiting ROM

If releasing stretch at the first joint does not change the range at the second joint > the muscle was not limiting ROM

Question 9

What are passive accessory movements?

Answer 9

Short, straight-lined passive movement of one joint surface relative to another

• Glide
• Distraction
• Compression

Question 10

Types of PAMs

Answer 10

• AP
• PA
• Caudal
• Cephalad

Question 11

What information do PAMS provide?

Answer 11

Assess quality and quantity of accessory movement

• Does it reproduce symptoms?
• It is hyper mobile, stiff, excessively mobile, painful, different quality?
• Compare to other side

Question 12

What are isometric muscle tests?

Answer 12

Sub-maximal isometric contraction of a muscle against appropriate resistance
- Pain provocation test rather than a strength test

Question 13

How to interpret IMTs?

Answer 13

Assists contractile vs non-contractile clinical reasoning
- Muscle is contracting but joint is not moving
Assess pain response
- Does it reproduce symptoms? Is this a possible source of symptoms? Should treatment target muscles?