Ms. Nelson Joshua Griffith 12/0537/ /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 o ) 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 Motion There 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.

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