Range of motion

Question 1

what is range of motion?

Answer 1

• the amount of motion available at a joint

Question 2

what is the starting position for measurement of ROM ?

Answer 2

anatomical position

Question 3

what is osteokinematics?

Answer 3

• the study of movement of bones around joints

Question 4

what is arthrokinematics?

Answer 4

• study of movement of joint surfaces / accessory movements etc
  -ie the roll, glide and spin of joints

Question 5

what is the anatomical position?

Answer 5

• positioning of the body when standing upright
  -each arm hanging by the side - palms facing forward
  -legs parallel, with feet flat on the floor and facing forward

Question 6

what is a plane of motion?

Answer 6

• planes of motion describe the axis along which an action is performed

Question 7

what is an axis?

Answer 7

-a straight line around which an object rotates
-movement at a joint takes place in a plane around an axis

Question 8

what movement takes place in the sagittal plane?

Answer 8

flexion and extension

Question 9

what movement takes place in the frontal plane?

Answer 9

abduction and adduction

Question 10

what is arthrokinematics necessary for ?

Answer 10

-necessary for pain free range of motion

Question 11

what is a ‘roll’ movement, in terms of arthrokinematics?

Answer 11

• a rotary movement
  -one bone rolling on another

Question 12

what is congruency in terms of joints?

Answer 12

congruency = how well 2 surfaces fit together when they are superimposed on one another

Question 13

what is a ‘spin’ movement, in terms of arthrokinematics?

Answer 13

• rotary movement
• all points on the moving joint surface rotate at a constant distance around a fixed axis of motion

Question 14

what does congruent vs incongruent mean in terms of rolling and gliding etc ?

Answer 14

• congruent - more gliding
  -incongruent - more rolling

Question 15

what is a convex joint surface?

Answer 15

• rounded or arched

Question 16

what is a concave surface?

Answer 16

• concave means hollowed
• think of a cave as hollow

Question 17

what is a glide or slide movement?

Answer 17

-the slide of one joint surface oner another
-occurs when the 2 surfaces are congruent and either flat or curved
-eg tarsal bones in ankle and carpals in wrist

Question 18

what is the concave motion rule?

REWATCH VIDEO ON ONE NOTE

Answer 18

• the convex surface is stationary and the concave surface moves
• when the concave surface moves, the concave joint surface and the bone itself move in the same direction

Question 19

what is the convex motion rule?

Answer 19

• concave surface is stationary and convex surface moves
• when the convex surface moves up for eg, the convex joint surface is moving in a downward direction and vice versa
• opposite direction

Question 20

what is physiological movement?

Answer 20

• joint movement that can occur voluntarily

Question 21

what is accessory movement?

Answer 21

movement that accompanies physiological joint movement but cannot be performed voluntarily eg arthrokinematic motions

Question 22

what does AROM stand for?

Answer 22

• active range of motion

Question 23

what is active range of motion?

Answer 23

• unassisted (ie not assisted by physio) voluntary joint range of movement
  -occurs due to muscles contracting and relaxing
  -less than passive range

Question 24

what dies PROM stand for?

Answer 24

-passive range of movement

Question 25

what is passive range of movement?

Answer 25

- movement provided externally eg by a physio -usually the maximum available range at a joint

Question 26

what is a close-packed position of joints?

Answer 26

-the position in which the articulating bones have their maximum area of contact with each other - ie joint stability is greatest

Question 27

what is a loose packed position?

Answer 27

- the position in which the articulating bones are not maximally congruent and the surrounding bones and ligaments are not taut (ie not at max tension) - ie less stability in the joint

Question 28

what is an example of a joint in 'closed packed' position?

Answer 28

the knee joint in the extension position

Question 29

are accessory movements maximal or minimal for a closed packed joint position?

Answer 29

minimal

Question 30

are accessory motions maximal or minimal at a loose packed joint position?

Answer 30

maximal

Question 31

what factors influence joint ROM?

Answer 31

-genetics -age - ROM decreases as we age as joints become stiffer -gender- women more mobile -occupation -temperature - high temp loosens and improves mobility of joints -injury and diseases - eg osteoporosis

Question 32

what is 'end-feel'?

Answer 32

-the sensation transmitted to the therapist's hand when taking a joint to the end of range -can be normal or abnormal

Question 33

what are the contra-indications of joint assessment (ie in what situations would you not test ROM)?

Answer 33

- joint dislocation -unhealed/untreated fracture -immediately post op - tendons, muscle, joint capsule etc -acute joint flare up - eg rheumatoid arthritis - metabolic bone disease

Question 34

what kind of end feel does a knee flexion have (ie contact between posterior soft tissue of the calf and thigh)?

Answer 34

a soft end feel

Question 35

what are the precautions to keep in mind when undertaking a joint assessment?

Answer 35

- early stage of healing - less than 48 hours - if muscle relaxants or analgesics have been taken -bone fragility -hypermobile or subluxed joints -excessive pain or swelling -pregnancy -region of haematoma - bleeding within a muscle

Question 36

what is an example of a firm end feel?

Answer 36

- hip flexion with the knee straight

Question 37

what are examples of measurement tools to quantify ROM?

Answer 37

-inclinometer -goniometer -goniometer app on phone

Question 38

what does a universal goniometer measure?

Answer 38

-measures the beginning and end of the movement, not what happens in between -measures angles of the osteokinematic motion and not arthrokinematics

Question 39

what are the principles of ACTIVE ROM assessment using a goniometer?

Answer 39

- ask the patient to move actively throughout the full ROM -either move the movable arm of the goniometer through the entire range to the end of AROM or realign the goniometer at the end of AROM -ask the patient is that as far as you can go?

Question 40

what are the principles of passive ROM assessment using a goniometer?

Answer 40

- move the moveable arm of the goniometer, whilst passively moving the limb segment to be tested - eg arm or leg -if it is hard to move the limb and the goniometer eg large joints, you can move the limb first without the goniometer -ensure the joint is at the end of available range, by applying passive overpressure

Question 41

what is the capsular pattern of ROM limitation?

Answer 41

- when there is proportional loss of rom in specific directions -when a pathology involves the entire joint capsule eg joint effusion/synovial inflammation eg rheumatoid arthritis RA

Question 42

what is a non capsular pattern of ROM limitation?

Answer 42

- usually results from a condition involving structures other than joint capsules eg muscles and ligaments