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OCT 720: Week 3: Range of Motion and Muscle Testing (ROM/MMT)
Jul 31, 2024
Lecture on Range of Motion Measurement and Manual Muscle Testing
Overview
Two main methods to determine muscle weakness or joint problems:
Range of Motion (ROM) Measurement
Manual Muscle Testing (MMT)
Types of Range of Motion
Osteokinematic Motion
: Movements such as hip flexion, elbow flexion, shoulder abduction.
Passive Range of Motion (PROM)
: Motion moved by an outside force (e.g., therapist).
Active Range of Motion (AROM)
: Motion controlled by the muscle contraction.
Comparison of PROM and AROM
Compare PROM and AROM to identify issues.
Equal PROM and AROM
: Generally no issue.
PROM > AROM
: Indicates possible muscle weakness.
Precautions Before ROM Evaluation
Referral Notes
: Check for contraindications (e.g., bone fractures, surgical procedures).
Pain, Edema, Swelling
: Avoid passive ROM if these are present.
End Feels in ROM
Types of End Feels
: Hard, soft, firm, empty.
Example
: Soft end feel in elbow flexion; firm or hard end feel indicates abnormality.
Tools for Measuring ROM
Goniometer
: Most commonly used tool.
Components
: Protractor (angle/number marked), stationary arm, movable arm.
Types
: Big circle for large joints, half circle for wrist, tiny for fingers.
Electronic Goniometer
: For continuous and dynamic joint motion.
3D Motion Analysis
: Most accurate, captures dynamic motion in real-time.
Using the Goniometer
Identify Movement Axis
: Align with the axis of motion (e.g., lateral side of the elbow for elbow flexion).
Starting Position
: Typically from an anatomical position (e.g., elbow fully extended = 0°).
Documentation
:
Date of measurement
Type of ROM (active or passive)
Side of the body (left or right)
Deviation from standard position
Signature
Norms for Joint Movements
: Different norms for various joints (e.g., knee flexion norms from AAOS and AMA).
Interpreting Measurements
:
0° to 150°: Normal knee flexion
20° to 150°: Limited knee extension
0° to 120°: Limited knee flexion
20° to 120°: Limited in both extension and flexion
Clinical Significance of ROM Differences
Clinical Difference
: Greater than 5° difference is significant.
Examples
:
PROM 150°, AROM 146°: No significant limitation.
PROM 150°, AROM 120°: Possible muscle weakness (joint is fine but muscle can't achieve full ROM).
Pain
: Always a factor; indicates a problem in joint or muscle.
Conclusion
Combining PROM and AROM assessments helps determine if the issue is muscular or joint-related.
Further pathology may need to be considered for comprehensive diagnosis.
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