20 Questions
What is the primary reason for assessing passive range of motion?
To determine the amount of movement possible at a joint
Why is passive ROM usually slightly greater than active ROM?
Due to the slight elastic stretch of tissues or decreased bulk of relaxed muscles
What is the purpose of determining the end feel during passive ROM assessment?
To indicate the structures that limit joint movement
What is necessary to isolate movement during end feel assessment?
The patient's relaxation and therapist's stabilization
What does a normal end feel indicate?
A normal full range of motion and normal anatomy of joints
What is an abnormal end feel indicative of?
Structures other than normal anatomy limiting joint movement
What is the purpose of stabilizing the site of attachment of the muscle origin during muscle testing?
To prevent substitutions and trick movements
What is a factor that affects the strength of a muscle?
Type of muscle contraction
Why is it important to assess the strength of the uninvolved limb first during muscle testing?
To know the patient's normal strength
What is a consideration when testing the flexor carpi ulnaris muscle?
Wrist flexion with ulnar deviation
What is the primary purpose of active range of motion testing?
To evaluate coordination of movement and functional ability
What is a contraindication for passive range of motion testing?
Dislocation or unhealed fracture
What is a factor that can increase muscle strength?
Previous training effect
Why is it important to consider the joint position during muscle testing?
To determine the muscle's length-tension relation
What is used to measure joint mobility?
Both Goniometers and Arthrometers
What is a precaution for assessing joint mobility in patients?
All of the above
What is the effect of age on range of motion?
Range of motion plateaus between 30-60 years
What is the difference between active and passive range of motion testing?
Active range of motion testing evaluates coordination of movement, while passive range of motion testing evaluates the integrity of the joint
What is a factor that influences range of motion?
All of the above
What is a contraindication for range of motion testing?
All of the above
Study Notes
Fatigue
- Muscle strength decreases as a patient fatigues
Contraindications and Precautions
- Contraindications: inflammation, presence of pain
- Precautions: patient with cardiovascular problems, abdominal surgery or herniation, malnutrition, malignancy, severe or chronic obstructive pulmonary disease
Factors Influencing Range of Motion
- Age:
- 1-20: ROM increases
- 20-30: ROM decreases
- 30-60: ROM plateau
- 60-die: ROM decreases
- Sex: women have a greater ROM than men
- Joint structures: body type influences joint mobility due to genetics or posture
Types of Motion
- Active range of motion testing: evaluates coordination of movement and functional ability
- Passive range of motion testing: provides information about the integrity of the joint but not about contractile tissue
Contraindications and Precautions for Range of Motion Testing
- Contraindications:
- Dislocation or unhealed fracture
- Immediately following surgical procedures
- In presence of myositis ossificans
- Precautions:
- Infections or inflammatory process in a joint or region
- Patient on medication for pain or muscle relaxants
- Region of marked osteoporosis
- Hyper mobile or subluxed joint
- Painful conditions
- Patient with hemophilia
- Region of hematoma
- Assessing joints with bony ankylosis
- Immediately after an injury of soft tissue
Assessment of Active Range of Motion
- The patient performs active movements and the therapist observes
- Level of consciousness, attention span, and joint ROM movements can cause or increase pain
- Active range of motion may be decreased
Muscle Testing Assessment Procedure
- Explanation and instruction: explains briefly the movement to be performed
- Assessment of normal muscle strength: initially assess and record the strength of the uninvolved limb
- Patient position: positions the patient to isolate the muscle or muscle group to be tested
- Stabilization: stabilizes the site of attachment of the origin of the muscle to prevent substitutions and trick movements
Muscle Grading
- Factors affecting strength:
- ATP
- Muscle size
- Joint position
- Angle of muscle pulls
- Length tension relation
- Previous training effect
- Speed of muscle contraction
Assessment of Passive Range of Motion
- Passive ROM is assessed to determine the amount of movement possible at a joint
- Passive ROM is usually slightly greater than active ROM
- The therapist takes body segments through a passive ROM to estimate each joint's range of motion and determine the quality of movement throughout the ROM
- End feel: the sensation felt by the therapist's hands at the extreme end of passive ROM, indicating the structures that limit joint movement
This quiz covers the factors that influence range of motion, muscle fatigue, and precautions and contraindications for physiotherapy treatments. Understanding these concepts is crucial for physiotherapists and healthcare professionals.
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