Range of Motion Measurement and Manual Muscle Tests

Introduction

• Purpose: Determine if issues are due to muscle weakness or joint problems.
• Methods: Range of motion (ROM) measurement and manual muscle tests.

Range of Motion (ROM)

• Osteokinematic Motion: Hip flexion, elbow flexion, shoulder abduction, etc.
• Types of ROM: Passive and Active
  • Passive ROM: Motion moved by an outside force (e.g., therapist).
  • Active ROM: Motion controlled by muscle contraction.

Precautions Before ROM Evaluation

• Review Data: Check referral notes for contraindications (e.g., bone fracture, recent surgery).
• Limitations: Avoid passive ROM if the client feels pain or shows signs of swelling or edema.

End-Feels

• Types of End-Feels: Hard, soft, firm, empty.
• Documentation: Note any abnormal or atypical end-feels.

Tools for Measuring ROM

• Goniometer: Most commonly used tool.
  • Parts: Protractor with angles, stationary arm, movable arm.
  • Types: Large (shoulder, hip, knee), half-circle (wrist, forearm), small (fingers).
• Electronic Goniometer: Measures continuous and dynamic joint motion.
• 3D Motion Analysis: Captures dynamic motion in real-time.

Goniometer Measurement Process

• Identify Movement Axis: Align the goniometer's axis with the joint's axis of motion.
• Stationary Arm: Parallel to the proximal segment (non-moving part).
• Movable Arm: Parallel to the distal segment (moving part).
• Starting Position: From an anatomical position (e.g., elbow fully extended is 0 degrees).
• Documentation: Date, type of ROM (active/passive), side of the body (left/right), non-standard positions, signature.

Interpreting ROM Data

• Norms: Different norms for knee flexion (e.g., 135 degrees from AAOS, 150 degrees from AMA).
• Examples:
  • 0 to 150 degrees: No limitation.
  • 20 to 150 degrees: No problem bending, limitation in extending.
  • 0 to 120 degrees: Limitation in flexion.
  • 20 to 120 degrees: Difficulty in both extension and flexion.

Comparing Passive and Active ROM

• Clinical Significance: Difference must be >5 degrees.
• If Passive > Active: Indicates muscle weakness.
• If Pain: Could be due to joint issues or muscle weakness; requires further investigation.