Range Of Motion - Test for Massage Therapist

Principles of ROM
- Measuring tools : Universial Goniometer, OB goniomete, measuring tape
- Result of ROM is different depends on age and gender
- Order : Active Free –> Passive Free —–> Acteive resisted
- The most painful movements performed last.
- All testing is performed bilaterally, first on the unaffected side and then on the affected side

Types of ROM
- Active Free ROM
  - Client moves the joint through the cardinal plnaes of motion
  - The test assess what the client is willing or able to do
  - AF ROM gives only functional information about the client’s willingness to move the body part
  - If the client has pain : the problems could be from muscle, tendon, fascia, joint, bone, ligament, capsule or nerve
- Passive relaxed ROM
  - Therapist moves the joint passively through the cardinal planes of motion
  - The test assesses whether there is limitation(hypomobility) or excess(hypermobility) or range
  - Client fully relax the muscles while the tests are performed
  - PR ROM gives information about the joint capsule and ligaments
  - PR ROM will be slightly greater than AF ROM
  - If the client has pain: the problems could be from bone, ligament or capsule, but you can not rule out muslcem tendon or fascial problem
- Active resisted ROM
  - Client’s movement against gravity or therpist’s against force are performed on the vertical plane.Isometric resistance AR ROM assesses contractile tissue for pain or weakness with muscle, tendon or peripheral nerve injury
  - If the client has pain: the problems could be musclular(muscle, tendon) problem, but you can not rule out joint structure problem either.
  - If this test is negative, it rules out a muscular source of pain

End feel : https://healthworkstudy.com/end-feel/

Shoulder complex
1. GH joint
  1. flexion/extension
  2. abduction/adduction
  3. external rotation/ internal rotation
  4. horizontal abduction/horizontal adduction
  5. normal range
2. Scapulothoracic joint
  1. abduction/adduction
  2. elevation/depression
Elbow and Forearm
1. Elbow joint
  1. Flexion/extension
  2. normal range
2. Radioulnar joint
  1. Supination/Pronation
  2. normal range
Wrist joint
1. Wrist joint
  1. Flexion/Extension
  2. Radial deviation(=abduction=lateral deviation) / Ulnar deviation(=adduction=medeal deviation)
  3. Normal range
    1. flexion :80 / extension : 80
    2. ulnar deviation :30 / radial deviation : 20
Hand joint
1. 1st carpometacarpal joint (thumb)
  1. Flexion/extension ;coronal plane
  2. Abduction/adduction ; sagittal plane
  3. Opposition
2. 2nd to 5th fingers
  1. Flexion/extension
  2. Abduction/adduction
Hip joint
1. hip joint
  1. Flexion/extension
  2. Abduction/addction
  3. Medial rotation(IR)/Lateral rotation(ER)
  4. normal range
2. Position
  1. Active Free : standing
  2. Passive : supine position(flexion/abduction/adduction), prone position(extension/IR/ER)
  3. Active Resistence : supine(flexion/abduction/adduction), prone position(extension/IR/ER)
Knee joint
1. Tibiofemoral joint
  1. Flexion/Extension
  2. Medial rotation(IR)/lateral rotation(ER)
  3. normal range
Ankle joint
1. Talocrural joint
  1. Dorsiflexion/Plantarflexion
2. Subtalar joint
  1. Inversion/Eversion
3. normal range
Cervical joint
Thoracic/Lumbar joint

Narration for OSCE(Practical exam)
- Introduction
  - Today I am going to do range of motion of the _________ joint. So, just let me know when you feel any pain, any tingling or numbness during range motion test, You may stop me and I will stop right away. Do you understand? Can we start now?
- Actice free range of motion
  - First of all, let’s do the active free rang of motion. That means I will demonstrate the movement first, then I will ask you to copy my movement. Do you understand? So. I am going to work on your ___________
  - During test : Are you okay?
  - After test : So, Active free _________ joint movement shows you have fully ragng of motion without any pain or discomfort, which is very good and normal.
- Passive Relax range of motion
  - We are goingt to do passive relax rage of motion test, that means you don’t need to do anyting. I will move your joint for you. Do you understand? is it okay? May I place my hands on your __________? If you have any pain or numbness, just let me know.
  - During test : Are you okay?
  - After test : So, As passive relax range of motion, your _________ joint movement shows that you have fully ragng of motion without any pain or discomfort, which is very good and normal.
- Active Resistence range of motion
  - Now Let’s do movement active resistance rage of motion. That means I am going to ask you to do exactly same movement you did before, but this time you try to do aginst my hand. Do you understand?
  - During test : Are you okay?
  - After test : So, we finished all the range of motion ________ joint. Everything shows great.