Motion Restrictions

Question 1

What are the types of motion?

Answer 1

Active-produced by contraction crossing joint line
Passive-produced by an external force w/o contraction
Physiological-motion of 1 body segment relative to another
Accessory-joint play (concave vs convex)

Question 2

How can active motion be restricted?

Answer 2

Muscle weakness
Abnormal muscle tone
Pain
Restrictions in PROM

Question 3

How can passive motion be restricted?

Answer 3

Soft tissue shortening
Edema
Adhesion
Mechanical block
Spinal disc herniation
Adverse neural tension

Question 4

What are the 2 types of accessory motion?

Answer 4

Intraarticular-(humerus moving on glenoid socket)

Extraarticular-(scapula moving with shoulder flexion)

Question 5

What is capsular pattern?

Answer 5

Pattern of motion loss caused by shortening of the joint capsule surrounding the joint

Question 6

What is noncapsular pattern motion restriction?

Answer 6

pattern of motion loss that does not follow the capsular pattern
Caused by: ligamentous adhesion, internal derangement, extra-articular lesions

Question 7

What are some pathologies that can restrict movement?

Answer 7

1 Contracture
2 Edema
3 Adhesions (scarring)
4 Mechanical Block (includes cartilage fragments or tears)
5 Spinal disc herniation (nerve root compression)
6 Adverse neural tension (abnormal response to stretch or ROM from PNS or spinal cord)
7 Weakness
8 Other (Pain, psychological factors, muscle tone)

Question 8

When would you see intra-articular fluid and extra-articular fluid?

Answer 8

intra-articular - follows capsular pattern

extra-articular - follows noncapuslar restriction

Question 9

What are some quantitative measures for ROM?

Answer 9

Goni, incinometers, tape measure, photographs

Question 10

What are some Qualitative measures?

Answer 10

Soft tissue palpation
Accessory motion testing
End-feel (hard, firm, soft, empty, spasm, etc…)

Question 11

What are some contraindications & Precautions to ROM testing?

Answer 11

Contraindications - dislocation, unhealed fracture, immediately after surgical procedures to tendons, ligaments, muscle joint, capsule, or skin
Precautions - Motion might aggrevate condition, (infection, hematoma, injury, hypermobile joints)

Question 12

What are some treatments for ROM restrictions?

Answer 12

Stretching
Motion
Surgery (bony mechanical block)

Question 13

Which stretching technique pins unaffected portion of the muscle against bony background?

Answer 13

Pin and Stretch

Question 14

How long do you hold a pin and stretch?

Answer 14

Until muscle tension releases