ROM should be evaluated in the following order:
1. Actively
2. Passively
3. Against resistence
ROM should be assessed for:
1. QUALITY of movement
2. QUANTITY of movement
3. PAIN associated with the movement
ROM testing useful in determining the type of structure injured:
Contractile and inert
ROM should always be tested ______________________
against the patients noninsured limb
AROM
active range of motion
(AAROM)
Active Assistive range of motion
The person does the exercises with some assistance from the nursing assistant
PROM (passive range of motion)
The nursing assistant assist the individual by moving the joints that require exercise
RROM (resistive range of motion)
movement made against the efforts of the therapist
Painful Arc
Pain located within a limited number of degrees in the range of motion.
inert tissue
bones, ligaments, joint capsules, fascia, nerves, bursae, nerve roots, and dura mater
contractile tissue
muscles and tendons
End feel
the quality of the movement a person senses when pressure is applied passively to a joint at the end of its available range of motion
Active ROM
evaluated first, assesess in all planes of motion, note painful arcs, note limitations
Active ROM indications
for patients who need to increase : ROM, muscular strength, neuromuscular control, flexability
Active ROM contraindications
1. if muscle contractions causes pain
2. if it places uneeded stress on healing
3. if abnmormal motion is present
4. if the structure is unstable
Passive ROM
evaluate with the joint in the most relaxed position, move the joint through available ROM, note quality of motion and pain, note limitations
Passive ROM indications
Patients who need to : regain ROM, increase ROM, Maintain ROM
Passive ROM contraindications
for patients with: connective tissue disorders, traumatic injuries, recent fractures
Normal End Feels - Capsular/ligamentous:
spasm, springy block, and empty
Normal End Feels - Bony:
hard, blocked by bone
Normal End Feels - Muscle stretch:
torn tendon or cartilage
Normal end feels
soft, firm, hard
Normal End Feels - soft tissue approximation:
soft, muscle or fat
Abnormal end feels
soft, firm, hard, empty
abnormal end feels - muscular spasm:
sudden and hard
Resisted ROM is used to determine:
general muscular weakness, pain in muscles performing motion, if and what specific manual muscle tests should be performed to identify the ininjured structure