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Injury Assessment & Evaluation. Today’s topics. Principles of range of motion testing, neurological testing, and special tests Functional testing. Range of Motion Assessment. Categories & progression 1. AROM 2. PROM 3. RROM. AROM. Voluntary movement through muscle contraction

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Presentation Transcript
today s topics
Today’s topics...
  • Principles of range of motion testing, neurological testing, and special tests
  • Functional testing
range of motion assessment
Range of Motion Assessment
  • Categories & progression

1. AROM

2. PROM

3. RROM

slide4
AROM
  • Voluntary movement through muscle contraction
  • Establishes willingness and ability to move
  • Helps determine damage to contractile tissue
slide5
AROM
  • Assess all movements of joint
  • Check for bilateral equality
  • Assess fluidity & extent of movement
  • Palpate joint throughout movement
slide6
AROM
  • Causes of limited movement

1. Pain* 5. Joint contractures

2. Swelling 6. Nerve damage

3. Muscle spasm 7. Loose bodies

4. Muscle tightness

*Where in the motion does it hurt?

“Painful arc”

slide7
PROM
  • Movement of the part w/o assistance from the injured individual
  • Distinguishes injury to contractile tissues from non-contractile tissues
  • Position person lying down to relax muscles
  • Perform painful movements last
  • Note end feel
slide8
RROM
  • Assess muscle strength after injury
  • Detect injury to nervous system
  • Examples of results & implications:

1. Muscle weakness & pain--> strain

2. Muscle weakness & pain -> nn damage

  • Static & dynamic testing (pressure vs resistance)
  • Grading system
movement terminology
Movement terminology

Flexion/extension

movement terminology1
Movement terminology

ABDuction/ADDuction

movement terminology2
Movement terminology
  • Internal/external rotation
    • Aka medial/lateral
movement terminology3
Movement terminology

Plantar flexion/dorsiflexion

Inversion/eversion

Radial/ulnar deviation

movement terminology4
Movement terminology

Horizontal ABDuction/ADDuction

Lateral flexion

L/R rotation

neurological testing
Neurological testing
  • Evaluate
    • Sensation
    • Motor function
    • Deep tendon reflexes
  • Identify
    • Nerve root impingement
    • Peripheral nerve damage
    • CNS trauma
    • Disease
neurological testing1
Neurological testing
  • Indicated by
    • Numbness
    • Paresthesia
    • Muscular weakness
    • Pain of unexplained origin
    • Injury to cervical or lumbar spine
neurological testing2
Neurological testing
  • Spinal nerve roots & segmental nerves
  • Roots supply area of skin & series of muscles

1. Dermatome

2. Myotome

neurological testing3
Neurological testing
  • Assessment of dermatomes & myotomes
  • Reflex testing

1. Changes -->degeneration OR injury in specific regions of nervous system

2. DTR’s tend to be absent if specific nerve root damage

joint stability tests
Joint stability tests
  • Assess integrity of ligamentous & capsular tissues
  • Tests apply tension to specific ligaments
  • ALWAYS include tests for major ligament damage & fxs in “On-field” evaluations
laxity vs instability
Laxity vs instability

Laxity — clinical sign of the amount of “give” within a joint; identified by stress testing

Instability — joint’s inability to function under the stresses of function activity

special tests
Special tests
  • Specific procedures applied to a joint to determine presence of a particular pathological condition
  • Unique to each structure
  • Results are compared
    • Side to side
    • Cause provocation
    • Cause alleviation
  • Reported as positive (+) or negative (-)
functional testing
Functional Testing
  • Tests of motor coordination, proprioception, & sport specific skill
  • Tests are sport specific--> performed during sport participation
slide25
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