OTHA 1409 Unit 2 Measurement of Joint Motion (Teresa)

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the measurement of angles created at human joints by the bones of the body.

Goniometry

an imaginary flat surface that divides the body into sections.

Plane

arc of motion that occurs at a joint or a series of joints.

Range of motion

a characteristic sensation perceived by the examiner when the end of joint range of motion is reached.

End-feel

same subject, same conditions yield same results.

Reliability

measures what it is purported to measure.

Validity

the study of the movement of bones associated with joints.

Osteokinematics

the study of movements between adjoining articular (joint) surfaces.

Arthrokinematics

The patient is moving the joint through its available range. No outside assistance.

Active range of motion

The therapist is moving the joint through its available range. The patient is not helping with the movement.

Passive range of motion

soft tissue approximation
example: knee flexion (contact between soft tissue of posterior leg and posterior thigh).

Soft end-feel

muscular stretch
example: hip flexion with the knee straight (passive elastic tension of hamstring muscles).

Firm end-feel

bone contacting bone
example: Elbow extension
(contact between the olecranon process of the ulna and the olecranon fossa of the humerus).

Hard end-feel

less than normal passive range of motion (PROM).

Hypomobility

more than normal passive range of motion (PROM).

Hypermobility

Explain and demonstrate the importance of testing procedures.

The examiner must have the knowledge and skill to properly perform the procedures in order to obtain an accurate measurement. A measurement that has good reliability aides in setting therapeutic interventions, and aides in clinical decision making process.

Explain the importance of testing positions.

Refers to the positions of the body that are recommended for obtaining goniometric measurements, helps to stabilize the subject's body and proximal joint segment.

Demonstrate the importance of testing positions.

Designed to do the following:
1. Place the joint in a starting position of 0 degrees.
2. Permit a complete ROM.
3. Provide stabilization for the proximal joint segment.

Explain and demonstrate the importance of stabilizations.

Isolating the motion to one joint helps to ensure that a true measurement of the motion is obtained, rather than a measurement of combined motions that occur at a series of joints.

Explain and demonstrate the importance of clinical estimates of range of motion.

Can be used when excessive soft tissue is covering the landmarks, and can be useful in the learning process. Examiner can compare ROM to values from similar people.
Although, not very accurate and yields only subjective info in contrast to the goniometer.

Explain and demonstrate the importance of palpating bony landmarks.

Ensures proper placement on the landmark and assures accuracy and consistency of the measurements.

Explain and demonstrate the importance of recording starting and ending positions.

To properly define the ROM it is important to include both starting and ending positions. Recordings with only the total ROM give no information as to where a motion begins and ends. This ensures that the measurement can be interpreted correctly.

Explain and demonstrate the steps to ensure reliability.

1. Use consistent, well-defined positions.
2. Use consistent, well-defined, and carefully palpated anatomical landmarks to align the goniometer.
3. Use the same amount of manual force to move subject's body part during successive measurements of passive ROM.
4. Urge subject to exert the same effort to move the body part during successive measurements of active ROM.
5. Use the same device to take successive measurements.
6. Use a goniometer that is suitable in size to the joint being measured.
7. If examiner is less experienced, record the mean of several measurements rather than a single measurement.
8. Have the same examiner, rather than a different examiner, take successive measurements.

Name and describe the motions of the shoulder girdle.

Protraction/Abduction - Movement of the scapula away from the midline of the body.
Retraction/Adduction - Movement of the scapula toward the midline of the body.
Upward Rotation - Movement of the inferior angle in a lateral and superior direction.
Downward Rotation - Movement of the inferior angle in a medial and inferior direction.
Elevation - Movement of the scapula in a superior direction.
Depression - Movement of the scapula in an inferior direction.
Scapular Tilt - Movement of the inferior angle in the posterior direction.

Identify and name the boney landmarks of the shoulder girdle.

Sternum
Clavicle
Scapula:
Spine of Scapula
Acromion process
Coracoid process

Identify and name the two main joints of the shoulder girdle.

Sternoclavicular Joint
Acromioclavicular Joint

Identify and name the three ligaments of the shoulder girdle.

Interclavicular Ligament
Sternoclavicular Ligament
Costoclavicular Ligament

Name and demonstrate motions of the shoulder joint.

Flexion/Extension
Abduction/Adduction
Internal Rotation/External Rotation
Horizontal Abduction/Horizontal Adduction

Identify and name boney landmarks of the shoulder joint.

Scapula:
Acromion Process
Coracoid Process
Glenoid Fossa
Supraspinous Fossa
Infraspinous Fossa
Subscapular Fossa
Vertebral Border
Axillary Border

Humerus:
Greater Tubercle
Lesser Tubercle
Lateral Epicondyle
Medial Epicondyle

What type of joint is the shoulder joint?

Ball and Socket (Triaxial)

What is the expected normal range of motion (according to AMA) of the shoulder joint?

Flexion: 180 degrees
Extension: 50 degrees
Abduction: 180 degrees
Internal Rotation: 90 degrees
External Rotation: 90 degrees

What is the expected normal end-feel of the shoulder joint?

Firm end-feel

Name and demonstrate motions of the elbow and forearm.

Elbow Flexion
Elbow Extension
Forearm Pronation
Forearm Supination

Identify and name boney landmarks of the elbow and forearm.

Humerus:
Lateral epicondyle of humerus

Radius:
Radial head
Radial styloid process

Ulna:
Olecranon process
Ulnar styloid process

Name the type of joint the elbow and forearm have.

Hinge Joint (uniaxial)
Pivot (synovial)

What is the expected normal range of motion (according to AMA) of the elbow and forearm?

Elbow flexion: 140
Elbow extension: 0
Forearm pronation: 80
Forearm supination: 80

What is the expected normal end-feel of the elbow and forearm?

Elbow flexion: Soft end-feel
Elbow extension: Hard end-feel
Forearm pronation: May be hard end-feel or firm end-feel
Forearm supination: Firm end-feel

Name and demonstrate motions of the wrist.

Flexion
Extension
Radial Deviation
Ulnar Deviation

Identify, name boney landmarks of the wrist.

capitate
triquetrum
5th metacarpal
3rd metacarpal
radial styloid process
ulnar styloid prcess
olecranon process
lateral epicondyle of humerus

What type of joint does the wrist have?

2 joints:
radiocarpal and midcarpal joint
both condyloid joints

What is the expected normal range of motion of the wrist?

Wrist flexion: 60 degrees
Wrist extension: 60 degrees
Wrist radial deviation: 20 degrees
Wrist ulnar deviation: 30 degrees

What is the expected end-feel of the wrist?

Wrist flexion: firm
Wrist extension: firm
Wrist radial deviation: usually hard, sometimes firm
Wrist ulnar deviation: firm

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