a characteristic sensation perceived by the examiner when the end of joint range of motion is reached.
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).
example: hip flexion with the knee straight (passive elastic tension of hamstring muscles).
bone contacting bone
example: Elbow extension
(contact between the olecranon process of the ulna and the olecranon fossa of the humerus).
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.
Spine of Scapula
Identify and name the two main joints of the shoulder girdle.
Identify and name the three ligaments of the shoulder girdle.
Name and demonstrate motions of the shoulder joint.
Internal Rotation/External Rotation
Horizontal Abduction/Horizontal Adduction
Identify and name boney landmarks of the shoulder joint.
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
Name and demonstrate motions of the elbow and forearm.
Identify and name boney landmarks of the elbow and forearm.
Lateral epicondyle of humerus
Radial styloid process
Ulnar styloid process
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
Identify, name boney landmarks of the wrist.
radial styloid process
ulnar styloid prcess
lateral epicondyle of humerus
What type of joint does the wrist have?
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