Summary Passive movements and goniometry

RANGE OF MOTION
→ full movement or motion through which a joint can be moved either actively or passively

 Contraindications → shouldn’t be done
 Precautions → can be done but with caution
 Indications → can be done freely

 Movement through ROM affects and is affected by muscles, joint surfaces, capsules,
ligaments, fasciae & blood vessels, & nerves

TYPES OF MOVEMENTS:
Passive → external force
→ gravity, machine, therapist or self
 Movements of a segment of the body via external force
 Occurs without voluntary movement of the patient
Active → caused by muscle contraction (voluntary)
 Unrestricted movement of parts of the body as a result of active muscle contraction
Active assisted → caused by muscle plus external force
Physiological → movements under voluntary control (natural movement)
 Flexion of the elbow joint
Accessory → movements that take place in the joint that accompany physiological movements or
that can be obtained by an outside force (not under direct voluntary control)
 Rotation of finger
 Vertebral movements
 Gliding movements in joints

Normal ROM
 Varies from person to person ( some people are double jointed)
 Active ROM and Passive ROM varies

MEASURING ROM




AL1 = hypomobility (not Full ROM)
AL2 = hypermobility (beyond normal ROM)
BO = unstable ROM → pathology

e.g. knee joint

,  Movements & different starting positions affect the ROM at the knee
Knee flexion
 When supine position, the muscle only stretches over the knee joint
 Whereas pronate position, the muscle stretches over the knee joint & hip joint
o Range of motion is less → PASSIVE INSUFFICIENCY

ACTIVE INSUFFICIENCY
 2 joint muscles cannot contract maximally across both joints at the same time

PASSIVE INSUFFICIENCY
 Occurs with 2 joint muscles and refers to the fact that these muscles cannot stretch
maximally across both joints at the same time
o Wrist flexion & trying to clench fist, passive insufficiency around wrist joint & active
insufficiency at finger muscles → aren't able to contract (fist can't clench as tightly as
when wrist is at extension)

 In a seated position, flexion of the hip with extension & flexion of the knee results in
insufficiency when the knee is extended
o It known as passive insufficiency, when someone assists you → your hamstring
stretches over two joints
o It is known as active insufficiency, if you are contracting your quad to lift your leg →
because your quad extends over two joints
FUNCTIONAL EXCURSION
 Distance muscle can shorten after maximal elongation
o Full range of extensibility & contractility of a muscle
o It's amplitude
 Is dependent on
o arrangement of muscle fibres
o Whether muscle is a one- or two- joint muscle
o If active insufficiency or passive insufficiency is present

INDICATIONS FOR PASSIVE ROM
 Presence of acute inflamed tissue
 not able to move joint actively
o Paralysis → damage to spinal cord or nerves
o Comatose → coming out of a coma
 Teaching a movement or to get kinaesthetic input
o Kinaesthetic → a person's awareness of the position & movement of parts of the
body
 In some cases the patient is not able to move limb and other cases the patient isn't aware of
their limb moving, have to actually look at limb
 Preparing for stretching



EFFECTS OF IMMOBILISATION
 If a muscle is maintained in a shortened position for 2 or 3 weeks:
o Muscle shortens → no. sarcomeres (contractile part of muscle) decreases
o Connective tissue or collagen (which supports muscle) stops moving freely & sticks
to itself
o Muscle wastes away & becomes weak → atrophies
 If a joint is not moved regularly: