contractile vs inert tissues:
contractile = muscle, tendons, nervous tissue
inert = anything not contractile or neurological ex: joint capsule, ligaments, blood vessels, etc
what is the “physiological barrier”?
range limitation during active examination
what can doing repeated/ sustained movements determine?
- if symptoms or movements change
- increased weakness - myotomes?
- vascular insufficiency
what barrier is reached during passive examination?
exceed physiological barrier to reach ANATOMICAL barrier
(or reach by overpressure at end AROM)
what does AROM test?
- willingness
- onset of/ change in pain
- motion control and coordination/ rhythm of movement
- swelling, tissue shortening
- muscle power
- movement of associated joints
- adopted adaptations
what does PROM test for?
- inert tissue integrity
- when/ where pain begins during motions
- limit of movement patter
- joint + associated joint movement
- joint end feel
- presence of capsular pattern
normal passive end feels:
- bone to bone (hard)
- soft tissue approximation
- capsular (firm)
abnormal passive end feels:
- early muscle spasm
- late muscle spasm associated w/ instability/ pain
- mushy tissue stretch
- hard/soft capsular
- empty
- springy block
- bone to bone??
why is resisted isometric examination used?
to determine if contractile tissue is involved
“dont let me move you”
1-4 grading:
1 = flicker of muscle contraction, no movement
2 = full ROM w/o gravity
3 = full ROM w/ gravity
4 = full ROM against resistance
4 classic movement patterns of contractile tissue:
(strong/weak, pain/free)
- strong and pain free = muscle and nervous tissue intact, not cause of discomfort
- strong and painful = local lesion in msucle/ tendon (1/2 degree strain)
- weak and painful = fracture, reflex inhibition secondary to pain
- weak and pain free = 3 degree strain or neural involvement
