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CHAPTER OBJECTIVES

CHAPTER OBJECTIVES

At the completion of this chapter, the reader will be able to:

  1. Define the various components of mobility and how they work together to produce functional movements

  2. List the different types of physiologic motions

  3. Describe the differences among active motions, active-assisted motions, and passive motions

  4. Describe the purpose of range of motion exercises

  5. List the different types of diagonal patterns of motion that can be incorporated therapeutically

  6. Interpret the findings of active and passive range of motion testing

  7. Perform a range of motion examination using a goniometer

  8. Apply passive range of motion techniques to the upper extremity

  9. Apply passive range of motion techniques to the lower extremity

OVERVIEW

Normal mobility is necessary for efficient movement. The terms range of motion, flexibility, and accessory joint motion are often listed as components of mobility1:

  • Range of motion. Range of motion (ROM) refers to the distance and direction (e.g., flexion, extension, abduction, adduction, internal rotation, and external rotation) a joint can move.

  • Flexibility. This refers to the passive extensibility of connective tissue that provides the ability for a joint or series of joints to move through a full, nonrestricted, injury-free, and pain-free ROM.

  • Accessory joint motion. The amount of the arthrokinematic glide that occurs at the joint surfaces also termed joint play.

Physiologic motions are joint and soft tissue movements that can be produced actively or passively. Active motions are those that can be produced by the patient alone, whereas passive motions are those motions that require full assistance to complete. Active-assisted motions are those that are a combination of active and passive motions (see Chapter 4).

CLINICAL PEARL

In order for a joint to function completely, both the osteokinematic and arthrokinematic motions have to occur normally (see Chapter 4).

  • Osteokinematic motions: movements that can be performed voluntarily, for example, flexion of the shoulder

  • Arthrokinematic motion: the motion(s) of the bone surfaces within the joint

As osteokinematic and arthrokinematic motions are proportional to each other, such that one cannot occur completely without the other, it follows that if an active motion is decreased compared to the same joint on the other side of the body, one or both of these motions may be at fault.

RANGE OF MOTION EXERCISES

ROM exercises are designed to move the joint and soft tissues through the available physiologic ranges of motion.

CLINICAL PEARL

The purpose of ROM exercises is to prevent the development of adaptive muscle shortening, contractures, and shortening of the capsule, ligaments, and tendons. In addition, ROM exercises provide sensory stimulation.

  • Active range of motion (AROM): performed by the patient independently. AROM exercises are used when the patient is able to voluntarily contract, control, and coordinate a movement when such a movement is not contraindicated. Contraindications to ...

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