Ms. Nelson

Joshua Griffith12/0537/110427/3/2015

Limitation in range of movement

What are the types of range of movement?

Range of Motion is the measurement of movement around a specific joint or body part.

Range of motion, also called ROM, is the distance or amount of freedom your joint can be moved in a certain direction. Range of motion is measured in angle degrees (e.g. shoulder flexion - 180o) using a goniometer.

The upper extremity has multiple joints and the total range of motion is a combination of all of

these joints working together.

Common upper extremity ranges of motions for the shoulder include 170 to 180 degrees of flexion, 50 to 60 degrees of extension, 170 to 180 degrees of abduction, 80 to 90 degrees of internal rotation, and 90 to 100 degrees of external rotation.

Ranges of motion in the elbow and forearm include

90 degrees of supination and pronation, or rotating the forearm.

145 to 155 degrees of elbow flexion and 0 degrees of extension due to the bony anatomy of

the joint.

Wrist range of motion includes

80 to 90 degrees of flexion 75 to 85 degrees of extension.

Lower extremity

ranges of motion for the hip include

120 to 130 degrees of flexion, 10 to 20 degrees of extension, 45 degrees of abduction, 30 degrees of adduction 45 degrees of internal rotation, 50 degrees of external rotation.

Knee range of motion flexion and extension arc of motion which totals 135

to 145 degrees.

Ankle range of motion includes

50 degrees of plantar-flexion, or toes pointing toward the ground,

20 degrees of dorsi-flexion with the toes pointing toward head

20 degrees of inversion and 5 degrees of eversion.

Types of Range of MotionThere are three primary types of exercises specific to range of motion.  Passive range of motion is typically practiced on a

joint that is inactive. The physical therapist may use this exercise on a client

who is paralyzed or unable to mobilize a specific joint. This type of exercise can help prevent stiffness from

occurring. During this exercise the patient does not perform any

movement, but the therapist is stretching the patient's soft tissues.

Active-assistive range of motion exercises are more progressive, intended for the client to perform movement around the joint, with some manual assistance from the physical therapist or from a strap or band.

These exercises can often feel painful and the muscles can feel weak. Increasing range of motion with these exercises should be a gradual advancement.

Active range of motion exercises are highly independent, performed solely by the client. The physical therapist's role may be simply to provide verbal cues.

What are the patterns of movement restriction?

List and explain

Pain Pain may restrict a persons ability to move

Contracture May lead to progressive loss of passive ROM (PROM)

and active ROM

Scar tissue forms as skin heals after an injury (such as an

accident) or surgery. The amount of scarring may be determined by the

wound size, depth, and location; the person's age; heredity; and skin characteristics, including color (pigmentation).

Reduced range of motion can occur if damage occurs to:

the soft tissues of the spine Extremities the lumbar discs,

weak or tight muscles affect the posture of the individual.

List some pathologies that restrict range of movement

Soft Tissue Approximation- Feeling soft tissue compressing tissue

Bony- Feeling bone impacting against bone Springy- Feeling the joint stopping or rebounding Capsular- Feeling a firm but slightly yielding stop (as

if two pieces of rubber were pressed together) Muscle Spasm- a sudden, abrupt cessation of

movement accompanied by pain Tissue Stretch- similar to the capsular end feel-

stretch is characterized by a firm yet slightly forgiving movement

Empty- A feeling that there is nothing mechanically restricting the ability to complete restricting ability to complete passive motion.

What methods can be used to evaluate movement restriction

A goniometer looks a bit like a protractor you may have used to measure angles in geometry class, but with arms, like the type of compass used for drawing circles. The arms of a goniometer intersect at a single axis or pin:

Inclinometers have dials or digital readouts that display the angle at which the inclinometer is situated relative to the line of gravity.

References

http://study.com/academy/lesson/what-is-range-of-motion-rom-definition-types-testing-exercises.html

http://www.physicaltherapynotes.com/2010/11/range-of-motion-types-of-range-of.html

http://study.com/academy/lesson/what-is-range-of-motion-rom-definition-types-testing-exercises.html

http://www.livestrong.com/article/257162-normal-human-range-of-motion/

http://emedicine.medscape.com/article/326828-overview

http://emedicine.medscape.com/article/326828-overview#a0104

http://cw.routledge.com/textbooks/9780415339940/downloads/sample.pdf

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