Examination of Joint Motion

Range of Motion
Joint Play

osteokinematics
degrees of freedom of the joint

when joint mobility may be contributing to individuals activity or participation limitations

determine health well being of a joint

before we measure strength of a muscle

if passive movement of a joint will cause injury
if limited by surgeon

standard testing position - stabilizing proximal segment
size and type of goniometer
boney landmarks

if you deviate from these - you ALWAYS record deviation

explain the test to the patient-using non-threatening language
postion the patient in the starting position (Standard Test)
Stabilize the proximal joint segment
Passively move through the ROM and determine the end-feel
Eyeball the degrees of freedom - say it out loud
return limb to the starting position
palpate the bony landmarks, align the goniometer and record starting position
move the limb passively through the ROM
repalpate and align the goniometer
read the value on the limb and record the reading

measurement in degrees
2 numbers - start and end position
normal ROM starts at 0
always document an end-feel

reliability and validity

3 numbers
middle number is starting point

arthrokinematics - motion of bones relative to other bones

convex bone surface

passive
muscle

anatomy and joint structure

parallel to the concave surface
perpendicular to the axis of rotation in the convex joint

parallel to the treatment plane

perpendicular and away from the treatment plane

point in the joint's range where the capsule and ligaments provide the least restraint to passive sliding

point in ROM where the ligaments and capsule are maximally taut
greatest joint stability

make inference about joint function
determine the type of resistance between joint surfaces
determine any tissue injury or inflammatory process
determine level of patients pain/tolerance to movement

fear on the part of the patient or therapist
red flags including signs of neoplasm, fracture, or systemic disturbance
rheumatoid collagen necrosis

available mobility of the capsule and supporting ligaments
pain provocation
pain alleviation

explain the test to the patient
position the patient comfortably to minimize muscle tension
stabilize the proximal joint segment with your stabiizing hand
grip the moving segment as close to the joint line as possible
position the patient in the resting position (loose pack) for the joint
perform the joint play assessment by moving the moving segment either parallel or perpendicular to the treatment pplane and determine the end feel
compare the opposite side and determine normal, hypo, or hypermobility

qualitative