Joint Range of Motion Evaluation

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Questions and Answers

What is the main difference between passive range of motion (ROM) and active ROM?

Active ROM can only be measured with a goniometer while passive ROM cannot.

Passive ROM is produced entirely by external forces while active ROM is produced by muscle contraction. (correct)

Active ROM involves no external force while passive ROM always involves gravity.

Passive ROM requires muscle contraction while active ROM does not.

Which term best describes the limited range of motion due to tightness in a joint?

Physiological ROM

Functional ROM

Hypermobility

Hypomobility (correct)

In evaluating joint range of motion, why is it important to reassess a patient's status after treatment?

To measure changes in joint function compared to prior evaluations. (correct)

To determine if the joint has become hypermobile.

To assess the effectiveness of the goniometer used in measurement.

To establish the patient's age-related changes in ROM.

Which of the following factors is NOT typically associated with affecting range of motion?

Diet Signup and view all the answers

What does functional range of motion allow an individual to do?

Conduct activities of daily living effectively. Signup and view all the answers

Which muscle is NOT part of the rotator cuff that stabilizes the shoulder joint?

Biceps brachii Signup and view all the answers

What tool is commonly used to measure the range of motion of joints?

Goniometer Signup and view all the answers

How does age generally affect range of motion?

Younger individuals generally exhibit a greater range of motion. Signup and view all the answers

What is the primary difference between passive and active range of motion testing?

Passive motion gives information about joint integrity. Signup and view all the answers

Which type of joint is characterized by greater mobility?

Synovial joints Signup and view all the answers

What is the purpose of using a goniometer in joint measurement?

To determine the range of motion of joints. Signup and view all the answers

Which group of body types is generally associated with greater joint flexibility?

Ectomorph and mesomorph Signup and view all the answers

What effect does range of motion testing have on a patient?

It can motivate them by showing progress. Signup and view all the answers

What is the basic structure of a universal goniometer?

A protractor with two long arms for measuring angles. Signup and view all the answers

What external factors may influence an individual's joint mobility?

Genetics and body type Signup and view all the answers

What does the passive range of motion testing primarily assess?

The maximum potential movement of a joint. Signup and view all the answers

What type of end feel involves a hard stop to movement when bone contacts bone, such as in passive elbow extension?

Hard (Bony) Signup and view all the answers

Which abnormal end feel may indicate the presence of synovitis or soft tissue edema?

Soft Signup and view all the answers

What does a 'springy block' end feel indicate?

Internal derangement Signup and view all the answers

Which end feel is characterized by a firm sensation with give, indicating muscle or ligament shortening?

Firm Signup and view all the answers

What type of end feel might be described as a hard sudden stop to passive movement and is often associated with pain?

Spasm Signup and view all the answers

In what situation might an 'empty' end feel be present?

Significant pain requiring movement cessation Signup and view all the answers

What distinguishes a 'hard' abnormal end feel?

A bony grating sensation during movement Signup and view all the answers

Which end feel is described as a hard arrest with some give, similar to stretching leather?

Capsular stretch Signup and view all the answers

What may cause a patient to be unable to perform full active range of motion?

Soft tissue contractures Signup and view all the answers

Which goniometric measurement tool uses reflective dots to assess spinal motion?

Spinogram Signup and view all the answers

What is the primary purpose of comparative goniometry?

To use one limb as a standard for the other Signup and view all the answers

Which method is specifically designed to measure pelvic tilt?

Pleurical caliper Signup and view all the answers

What is a key requirement for reliable goniometric measurements?

The instrument should maintain light contact with the patient Signup and view all the answers

How is the universal goniometer structured?

It consists of a protractor and two arms connected by a fulcrum Signup and view all the answers

Which device is known for being sensitive to movement due to its connection to a potentiometer?

Electro-goniometer Signup and view all the answers

What starting position should extremity movements be measured from?

A specific starting or 0° position Signup and view all the answers

Study Notes

Movement of a Body Segment

Movements of a body segment occur when muscles or external forces move bones.
Bones move relative to each other at their connecting joints.
Joint range describes the extent of movement at a joint.
Terms like flexion, extension, abduction, adduction, and rotation are used to describe joint motion.
Goniometers measure range of motion and results are recorded in degrees.

Types of Range of Motion

Passive ROM: Movement produced entirely by an external force without any voluntary muscle contraction.
Active ROM: Movement produced by active muscle contraction.
Physiological ROM: Controlled voluntary motion between body segments.
Functional ROM: Range of motion needed for everyday activities.

Purpose of Joint Range of Motion Evaluation

Determine existing joint range of motion and compare to normal range.
Aid in diagnosis and determine joint function.
Reassess patient status after treatment.
Motivate patient interest in treatment program.

Factors Affecting Range of Motion

Age: Younger individuals typically have greater range of motion.
Sex: Differences in range of motion between men and women have been studied.
Functional needs: Upper limb joints are designed for mobility while lower limb joints are designed for stability.
Rotator cuff muscles: Stabilize the shoulder joint (Supraspinatus, Infraspinatus, Subscapularis, Teres minor).
Shoulder joint:
The Hip Joint:

Other Considerations

Types of joints: Synovial joints have greater mobility than cartilaginous and fibrous joints.
Type of motion: Passive range of motion is wider than active range of motion.
Joint structures: Genetics, posture, and body type can influence joint mobility. Ligament and tendon flexibility also play a role.
Body build: Mesomorphs and ectomorphs tend to have greater flexibility than endomorphs.
Personal exercise:
Neurologic or muscular diseases:
Surgical or traumatic insults:
Inactivity or immobilization:

Instruments

Goniometers or arthro-meters: Tools to measure range of motion.
Universal goniometer: Durable, washable, and applicable to most joints. It is a protractor with a stationary arm and a movable arm.

Goniometry

Aim:
- Educate medical, physical therapy, and occupational therapy students.
- Raise awareness of age and occupational related motion changes.
- Assess the effects of disease and injury.
- Motivate patients through progress.
- Evaluate functional abilities and self-help activities.
- Estimate strength, coordination, and endurance needs.

Construction of the universal goniometer

A: Circular or half-circle protractor with degrees.
B: Two arms connected by an axis (fulcrum).
- 1: Stationary arm.
- 2: Movable arm.

End Feel

End feel: Sensation experienced during passive range of motion at the end of its range.
Types: Can be normal (physiological) or abnormal (pathological).

Normal (Physiologic) End Feel

End feel	Description
Hard (Bony)	Hard stop when bone contacts bone.
Soft (Soft tissue opposition)	Compression of soft tissue felt when two surfaces come together.
Firm (Soft tissue stretch)	Firm sensation with give when muscle is stretched.
Capsular stretch	Hard arrest with some give when joint capsule/ligaments are stretched.

Abnormal Pathologic End Feel

End feel	Description
Hard	Hard stop with bony grating.
Soft	Boggy sensation indicating synovitis or soft tissue edema.
Firm	Firm sensation indicating muscular, capsular, or ligamentous shortening.
Springy block	Rebound indicating internal derangement.
Empty	Pain without sensation before end of ROM.
Spasm	Hard, sudden stop with pain indicating acute/subacute arthritis or fracture.

Active Range of Motion Limitations

Muscle weakness.
Soft tissue contractures.
Muscle contractures.
Bony blockage (fusion).

Dominance

Usually no significant difference in corresponding joints between left and right sides.
Contralateral limb can be used as a standard for comparison.

Basic Elements for Reliable Goniometric Measurements

Demonstrate instructions clearly.
Measure from a specific starting position.
Measure in degrees.
Apply goniometer laterally (except for certain motions).
Hold instrument lightly against the body.
Remove restrictive clothing.
Compare limbs bilaterally.

Different Methods of Measuring Range of Motion

Universal goniometer: Protractor with two arms.
Electro-goniometer: Universal goniometer connected to a potentiometer for more accurate reading.
Inclinometer: Fluid-based design for ease of use.
Spinogram: Measures spinal motion with reflective dots and video camera.
Pleurical caliper: Used to measure pelvic tilt and leg shortening.

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Description

This quiz covers the movements of body segments and the evaluation of joint range of motion. It includes definitions of passive, active, physiological, and functional ROM, as well as the purpose of joint evaluations. Test your knowledge on the terminology and practices related to joint mobility.