Which term does the nurse document when turning a joint inward while performing a range of motion exercise?

What is Musculoskeletal Range of Motion?

Range of motion (ROM) is the measurement of movement around a specific joint or body part. It involves both the distance a joint can move and the direction in which it can move. There are established ranges considered normal for various joints in the body. For a joint to have full ROM, it must have good flexibility. Flexibility is the ROM around a joint. Each joint has its own level of flexibility, expressed in degrees. Flexibility can refer to ligaments, tendons, muscles, bones, and joints. Limited flexibility may lead to pain, limitation, and compensation, all of which can result in increased dysfunction of the joint. If a joint has full ROM, it should be able to move in all planes and directions permitted to that joint. Joint movements include flexion, extension, abduction, and adduction.

Flexion is the movement that decreases the angle of the joint, bringing two bones closer together.

Extension is the opposite of flexion, involving movement that increases the joint angle, or the distance between two bones or parts of the body.

Abduction involves movement of the limb away from the midline of the body.

Adduction is the opposite of abduction, involving movement of the limb towards the body midline.

Limited ROM refers to a joint with decreased ability to move causing limited motion. A problem within the joint, swelling of tissue around the joint, muscle stiffness, or pain can lead to limited ROM. Joint ROM naturally declines as you age, but it can occur due to several conditions. Conditions that can result in these symptoms include arthritis, joint dislocation, joint injury, immobilization, and surgery.

The purpose of ROM exercises is to prevent the development of adaptive muscle shortening, contractures, and shortening of the capsule, ligaments, and tendons. In addition, ROM exercises provide sensory stimulation. ROM exercises are prescribed for a specific joint with limited ROM upon the outcome of a physiotherapy assessment. This assessment looks at the ROM and quality of movement of the joint. These exercises can be assisted by gravity, assisted by yourself, assisted by another person, done within water, and by an external machine. Strengthening exercises may be prescribed alongside or shortly after ROM exercises, as the increased movement at the joint without increasing the strength could cause a further injury.

The 3 types of ROM exercises include passive, active, and active assistive ROM.

Passive ROM is the movement applied to a joint by another person or motion machine. With passive ROM, the joint receiving the exercise is completely relaxed while the outside force moves the body part throughout the available range.

Active ROM is the movement of a joint provided entirely by the individual performing the exercise. Active ROM is done without an outside force aiding in the movement.

Active assisted ROM involves the joint receiving partial assistance from an outside force. Active assisted ROM may result from most of the motion applied by the individual performing the exercise or by the person assisting the individual.

ROM testing is important in determining the cause and severity of issues you may be having with joint movement. Testing ROM provides information as to whether or not joints are moving the full ROM expected of them. An Inclinometer is a device that measures the slopes of your joints, which is helpful in determining your body’s stability in different areas as you perform various movements. At Whole Body Healthcare, we can test your ROM with the use of an inclinometer every two weeks to ensure patient’s ROM is improving appropriately, or whether different or additional ROM exercises are needed.

Here is Arek, a Massage Therapist at Whole Body Healthcare, discussing Range of Motion: