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
 Establishes willingness and ability to move
 Helps determine damage to contractile tissue

AROM
 Assess all movements of joint
 Check for bilateral equality
 Assess fluidity & extent of movement
 Palpate joint throughout movement

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”

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

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
 Flexion/extension

Movement terminology
 ABDuction/ADDuction

Movement terminology
 Internal/external rotation
 Aka medial/lateral

Movement terminology
 Plantar flexion/dorsiflexion
 Inversion/eversion
 Radial/ulnar deviation

Movement terminology
 Horizontal ABDuction/ADDuction
 Lateral flexion
 L/R rotation

Manual muscle testing

Neurological testing
 Evaluate
 Sensation
 Motor function
 Deep tendon reflexes
 Identify
 Nerve root impingement
 Peripheral nerve damage
 CNS trauma
 Disease

Neurological testing
 Indicated by
 Numbness
 Paresthesia
 Muscular weakness
 Pain of unexplained origin
 Injury to cervical or lumbar spine

Neurological testing
 Spinal nerve roots & segmental nerves
 Roots supply area of skin & series of muscles
1. Dermatome
2. Myotome

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
 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 — 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

Ligamentous Stress 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 (-)

Special tests

Functional Testing
 Tests of motor coordination, proprioception, & sport specific skill
 Tests are sport specific--> performed during sport participation

Next...
 Legal concerns