Joint Movement

SECTION LEARNING OUTCOMES (6hrs) ONLY PRACTICE THIS SECTION WHEN ON THE PHYSIOTHERAPY PROGRAMME

You will understand the difference between Active and Passive Physiological ROM
When asked you should be able to demonstrate (passive) or direct (active) ROM with a model
Practice your basic handling skills

Kinesiology is phrase used to describe the study of joint movements.

Types of Joint Movement

Movement at joints are classified into two categories:

Physiological Movement: Is movement caused by voluntary muscle contraction at a joint. It can be either active (performed by the patient) or passive (performed by the therapist). Understanding these are important so the therapist can increase range to a specific joint using manual therapy (Passive Physiological Mobilisations eg Passive Physiological flexion of the shoulder). This link will take you to a summary of all Physiological movementsyou need to learn.
Accessory Movements cannot be performed by the individual. These movements include roll, spin and slide which accompany physiological movements of a joint. Understanding these are important so the therapist can increase range to a specific joint using manual therapy (Passive Accessory Mobilisations eg an Anterior - posterior glide on the GHJ).

Planes and Axis of motion

THE VIDEOS BELOW WILL GUIDE YOU THROUGH PASSIVE & ACTIVE PHYSIOLOGICAL MOVEMENTS OF THE PERIPHERAL JOINTS

Watch each video and practce your handling skills. These will be formatively assessed during the face to face sessions

THE KNEE JOINT

Active: meaning an individual must use their muscles to achieve the movement

Have a look at how this may look in a clinical environment by viewing this YouTube clip for simple knee movement.

Passive: meaning the movement is caused by an external force - e.g. another person or machine.

Now have a look at how this may look in a clinical situation with the clinican handling the limb and moving the joint without the patient helping.

THE SHOULDER JOINT

Active ROM of the Shoulder Girdle

Passive ROM of the Shoulder Girdle

THE WRIST JOINT

Active ROM of the Wrist and Hand

Wrist Active Movements.MOV

Passive ROM of the Wrist and Hand

THE FOOT & ANKLE JOINT

Active ROM of the Foot & Ankle

Passive ROM of the Foot & Ankle

THE ELBOW JOINT

Active ROM of the Elbow

Passive ROM of the Elbow

THE HIP JOINT

Active ROM of the Hip Joint

Passive ROM of the Hip Joint

Close Pack and open Pack positions

Depending on what movement (and weight bearing) is occurring at any given joint the joint surface will have more or less contact and stress placed upon them. The position of the joint for maximum congruency (contact) is called the close packed position. In all other positioned it is termed loose packed.

Close pack

- Is the position of maximum stability
- Maximum ligamentous and capsular tautness
- Maximum joint surface congruity
- Least ability to allow distraction or other joint play movements
- Least articular volume
- Least trans articular pressure

Open pack

- The position of least stability
- Minimal ligamentous and capsular tightness
- Maximum ability to allow joint play
- Maximum joint volume
- Maximum trans articular pressure in weight bearing
- Able to separate joints surfaces by distraction

Joint Surface Movement

The lack of congruency between joint surfaces in the loose pack position allows movement to occur between the articular surfaces. When one joint surface moves relative to the other, accessory movement of spin, roll, slide, or combinations occur.

Here is a summary of Open and Close Pack Positions

Spin: rotational movement around an axis.

Accessory movements

A: Physiological Movements

B: Accessory Movements

Accessory Movements:

Are movements which an individual cannot produce in isolation. There are accessory movements such as glide, slide, roll and spin that occur with a joints normal physiological movement. Passive accessory movements are very useful in clinical examination for assessing joint integrity, damage or abnormalities.

For normal physiological movement to occur, accessory movements must happen.

Spin: rotational movement around an axis

Roll: occurs when points on the surface of one bone contacts and rolls over another, usually flatter bone, for example like the rocking chair bottom rolls forwards and backwards.

Slide: occurs when only bone slides or glides against another surface

Roll and slide rarely occur in isolation in normal joints - below shows what would happen if they did.

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