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Questions and Answers

What does the assessment of Range of Motion (ROM) typically involve?

  • Gross and goniometric measurements in a planar manner (correct)
  • Only active motion measurements
  • Measurement of pain levels exclusively
  • Multiplanar assessments without testing for irritability

    • Which plane is shoulder abduction and adduction measured in?

  • Frontal plane (correct)
  • Sagittal plane
  • Transverse plane
  • Coronal plane

    • What can the presence of pain during active motion indicate?

  • Only muscle injuries
  • Full range of motion is expected
  • The condition is not acute
  • Possible inflammation or irritation of noncontractile tissues (correct)

    • What is a common misconception held by novice physical therapy students regarding pain during AROM assessment?

    <p>Both motions reproduce the patient’s symptoms</p> Signup and view all the answers

    Which of the following motions involves shoulder flexion, adduction, and internal rotation?

    <p>Reaching the hand to touch the opposite shoulder</p> Signup and view all the answers

    What is the primary characteristic of functional motion compared to planar motion?

    <p>It typically combines motions in all three planes</p> Signup and view all the answers

    Which factor is not typically assessed when evaluating limited Active Range of Motion (AROM)?

    <p>Patient's psychological state</p> Signup and view all the answers

    What implication does an evaluation of multiplanar motion have on patient treatment?

    <p>It indicates that pain might not be reproduced during isolated motion tests</p> Signup and view all the answers

    What is a significant consequence of lack of movement in patients?

    <p>Common functional impairments</p> Signup and view all the answers

    Which factor is generally associated with greater joint range of motion (ROM) in the population?

    <p>Female gender</p> Signup and view all the answers

    Why might a clinician choose to have a patient lie down during assessment?

    <p>To support the body part and improve patient relaxation</p> Signup and view all the answers

    How does age affect joint motion in elderly individuals?

    <p>Progressive loss of available joint motion occurs</p> Signup and view all the answers

    Which scale type does the outer scale of a goniometer NOT include?

    <p>One 0° point</p> Signup and view all the answers

    What is a potential source of pain during right lateral flexion in a patient?

    <p>Left-sided muscular tightness</p> Signup and view all the answers

    Excessive soft tissue in a joint may cause which of the following?

    <p>Impediment to reaching full range of motion</p> Signup and view all the answers

    What percentage of clinical instructors expected students to utilize goniometric measures primarily?

    <p>27%</p> Signup and view all the answers

    What factor may pose a challenge for patients during PROM assessment of the cervical spine in a seated position?

    <p>Difficulty in 'letting go' of the neck</p> Signup and view all the answers

    What component of a goniometer is aligned with a nonmoving reference point?

    <p>Stationary arm</p> Signup and view all the answers

    What can limit the range of motion aside from pain in a patient?

    <p>Intra-articular blocks and joint effusion</p> Signup and view all the answers

    Which of the following diseases is known to negatively affect joint motion?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is the primary purpose of conducting a gross screening assessment of range of motion?

    <p>To determine if detailed measurement is required</p> Signup and view all the answers

    How many scales does the inner scale of a goniometer consist of?

    <p>One 0° point and two 180°–360° scales</p> Signup and view all the answers

    How does the position of a patient (supine or seated) affect range of motion assessment?

    <p>Greater range of motion is often possible when supine</p> Signup and view all the answers

    What is an example of an intra-articular block that could limit range of motion?

    <p>Bony malformation or cartilage flap</p> Signup and view all the answers

    What is the primary purpose of a goniometer in a clinical setting?

    <p>To measure joint range of motion</p> Signup and view all the answers

    How should joint range of motion be quantified for accurate assessment?

    <p>Using a goniometer or other device</p> Signup and view all the answers

    Which part of the goniometer allows for free motion in a circular pattern?

    <p>Movement arm</p> Signup and view all the answers

    What typical changes in joint motion can occur in children under 2 years old?

    <p>Mean values differ considerably from those of adults</p> Signup and view all the answers

    What should a clinician be cautious of during PROM assessment?

    <p>Carrying out assessments with close attention to the patient</p> Signup and view all the answers

    Which of the following methods was expected to be used equally by 21% of clinical instructors?

    <p>Both estimated ROM and goniometry</p> Signup and view all the answers

    What plays a role in clinical decision-making regarding patient positioning during motion assessments?

    <p>Expected range of motion differences between positions</p> Signup and view all the answers

    What is the axis of rotation in a goniometer referred to as?

    <p>Fulcrum</p> Signup and view all the answers

    What is the primary consideration when maneuvering a patient's limbs for motion assessment?

    <p>Avoiding prolonged positions of pain or discomfort</p> Signup and view all the answers

    When is a standard goniometer not the ideal choice for measuring joint motion?

    <p>When assessing motion in the thoracolumbar spine</p> Signup and view all the answers

    What should be noted before the patient moves through their range of motion?

    <p>The starting measurement on the goniometer</p> Signup and view all the answers

    Which method provides adequate objective information for assessing thoracolumbar spine motion?

    <p>Utilizing a tape measure</p> Signup and view all the answers

    What should be documented if an alternate testing position is used?

    <p>The reason for the alternate position</p> Signup and view all the answers

    Which of the following statements about palpating bony landmarks is correct?

    <p>It is essential for proper goniometer alignment</p> Signup and view all the answers

    Which of the following is a recommended practice when assessing joint motion?

    <p>Ensuring the goniometer is repositioned between measurements</p> Signup and view all the answers

    What should be documented when documenting the goniometer's position?

    <p>The alignment of the fulcrum, stationary arm, and movement arm</p> Signup and view all the answers

    What is the primary purpose of assessing passive range of motion (PROM) in a clinical setting?

    <p>To evaluate the integrity of joint surfaces and local tissues</p> Signup and view all the answers

    Which statement regarding patient movements and limitations is accurate?

    <p>Critical evaluation of movement patterns can help identify the source of limitations.</p> Signup and view all the answers

    Why is it essential to avoid assumptions about the type and localization of pain during assessment?

    <p>Assumptions can lead to misdiagnosis and inappropriate treatment.</p> Signup and view all the answers

    What might cause a patient's perception of pain to differ during active and passive range of motion assessments?

    <p>Reflexive muscle resistance may influence perceived pain levels.</p> Signup and view all the answers

    How should outcomes of PROM assessments be interpreted when a patient experiences pain?

    <p>Specific focus should be placed on the location and characteristics of the pain.</p> Signup and view all the answers

    In the example given, why does the patient stop the knee flexion at approximately 75% of the expected normal range during active range of motion (AROM)?

    <p>The patient experiences significant anterior knee pain.</p> Signup and view all the answers

    What is the implication of observing moderate effusion in a patient's knee during an assessment?

    <p>Effusion suggests underlying inflammation or pathology.</p> Signup and view all the answers

    Why is it important to take note of how a patient describes their limitation in movement?

    <p>A patient's description can inform potential sources of their limitations.</p> Signup and view all the answers

    Study Notes

    Introduction to Range of Motion

    • Physical therapy frequently addresses movement limitations
    • Screening assessments gauge the quantity and quality of joint motion (regional, local, global).
    • Gross ROM screening is sometimes sufficient, while other times formal measurement (goniometry) is needed.
    • Normal ROM varies by age, sex, body mass index and cultural factors.
    • Active ROM (AROM) is movement by the patient; Passive ROM (PROM) involves assistance.

    Factors Affecting ROM

    • Age: Children (under 2 years) and elderly show different trends in loss of movement
    • Gender: Females generally exhibit greater tissue elasticity
    • Body mass index (BMI): Excessive tissue can limit possible motion
    • Disease: Inflammatory and degenerative diseases reduce ROM
    • Occupation/recreation: Repeated movements, stretching, result in ROM adaptation
    • Culture: Certain activities or postures are common in some cultures.

    Fundamental Concepts of Active Range of Motion (AROM)

    • Observation of AROM reveals a patient's motivation, coordi- nation, motor control, force production and potential limita- tions.
    • Painful or limited ROM requires further investigation.

    Fundamental Concepts of Passive Range of Motion (PROM)

    • Assessing a patient's PROM offers insight into joint integrity, tissues extensibility, and potential tissue irritability.
    • PROM is more useful than AROM in detecting sensitive tissue inflammation.

    Joint End Feels

    • Provides indications of possible pathology; used to determine the severity and acuity.
    • Classification systems detail normal and abnormal end feels (bone-to-bone, soft tissue approximation, tissue stretch).

    Quantifying Gross ROM

    • Goniometry provides precise and objective ROM measurement.
    • Visual estimation may be appropriate in some clinical situa- tions for specific types of assessments.

    Documentation

    • Using terms like “within normal limits” and “within functional limits” should be done cautiously and in adherence with clinical guidelines of the specific facility.

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