Motion Commotion: A Station Lab

Transcription

1 Introduction: You arrive home after a hard day at school and trudge up the stairs to your room. You open the door, throw your backpack on the floor and sit down at your computer for a little quality time with your favorite video game. After a few minutes of torturing your thumbs with a grueling workout on the joystick your energy reserves start to fade so you race down the stairs to grab a snack. Food in hand you march up the stairs once more and settle back in front of the computer but exhaustion sets in. Just lifting a forkful of mac-n-cheese to your mouth requires monumental effort. Whether you realize it or not every action taken in this familiar teen scene requires movement of the joints in your body. Gymnasts aren t the only people who work their joints. Trudging up and racing down the stairs requires movement of your hip, knees, ankles, and various joints in your feet. Throwing down your backpack involves your shoulder, elbow, wrist, numerous joints in your hands and feet, and even some movement in your vertebrae (backbone). Once you finally find the energy to lift the mac-n-cheese to your mouth, the joint in your jaw goes to work so you can chew it! Normally, you don t give these movements a second thought but what if the motion in your joints was severely limited by an accident or illness? How would you get the mac-n-cheese to your mouth then? Range of Motion, or ROM, is the assessment of a person s joint movements, or flexibility. In this lab you measure your ROM for various joints using an instrument called a goniometer. The term goniometer comes from the Greek words gonia, meaning Motion Commotion: A Station Lab Student Activity 1B Station IV Gymnastic Joints angle, and metron, meaning measure. As a modified protractor the goniometer permits estimated s of the angles resulting from the movement of various joints in the body. When using a goniometer the arm that doesn t move is called the stationary arm because it is aligned with the part of the joint complex that doesn t move. Conversely, the movable arm is aligned with the part of the joint complex that does move. The (ROM) is determined by the angle made when the movement is complete when no further movement is possible. Thus if the movable arm is set at 0 o and the stationary arm is set at 180 o (the ROM of the joint is the angle made from the beginning to end of the movement). The ROM for an elbow joint is illustrated in Figure 1. Stationary arm Angle reading Movable arm Figure 1 Before conducting this lab make sure that all participants become familiar with the goniometer and understand how much each marked interval on the goniometer represents. Step-by-step instructions on how to properly align the goniometer to make accurate estimates are provided in the procedures. Materials: (per group) 1 large goniometer 1 small goniometer 4 colored dots (each person) 1 table and chair 11MO-BILITY

2 Procedures: (Read all instructions and check off each step as it is completed.) 1. Follow the rotation below to insure that each lab participant serves in every role at least once: Coop Group First Rotation Second Rotation Third Rotation Letter A Test Subject PT (Tester) PT (Tester) B PT (Tester) Test Subject Technician (Recorder) C Technician (Recorder) Technician (Recorder) Test Subject 2. Complete and record all the s indicated for each Test Subject before changing roles. 3. Figure 2 illustrates the various refeence points needed to make the required ROM s for the arm. The PT and Technician work together to find these approximate locations on the Test Subject s dominant arm (the arm you would throw a ball with). Mark the locations with the stickon dots provided. First place a dot in the middle of the upper arm directly beneath the shoulder joint (A). Locate the part of the elbow that protrudes when the arm is bent at a 90 o angle. Place another dot about 5 cms from this bone near the crease on the inside of the arm (B). Place a third dot on the bone that protrudes from the wrist near the little finger and a fourth dot directly across from the previous dot on the part of wrist nearest the thumb (C and D). 4. Stand the Test Subject subject with the dominant arm straight down and held close to the body with the palm of the hand facing up. Place the center point of the goniometer on the dot marking the elbow joint. Align the stationary arm of the goniometer with the dot marking the shoulder and the movable arm with the dot marking the wrist. See Figure 3 for reference. The Technician notes the beginning mark (0 o ) in the appropriate column on the Test Subject s Chart. A B C Figure 2 Figure 3 D Line up goniometer with dots and begin at 180 o MO-BILITY 12

3 5. As illustrated in Figure 4 the Test Subject raises his or her forearm as far as possible while the PT follows the movement with the movable arm of the goniometer. The Technician watches the movement to insure that the Subject s shoulder doesn t move from the starting position. The center point of the goniometer may not remain aligned directly with the dot marking the elbow joint as the arm movement proceeds. For accurate s it is more important to keep the movable and stationary arms aligned with the dots on the wrist and shoulder. 6. At the end of the movement (when the arm has been raised as far as possible) the PT reads the angle for the arc of movement while the Technician notes the in the appropriate column on the Test Subject s Chart. 7. Next, seat the Test Subject in a chair near a supporting surface (table or desk). Position the Test Subject s dominant arm on the supporting surface so that the hand extends over the edge with enough room for the hand to move freely (the wrist dot should extend about 5 cm past the edge of the surface). The Technician holds the Test Subject s forearm in place to prevent in any unnecessary movement. Place the center point of the goniometer on the wrist dot then align the stationary arm with the elbow dot and the movable arm with the tip of the little finger. See Figure 5 for reference. The Technician records the beginning (0 o ) on the Test Subject s Chart. 8. Holding the hand straight with the fingers together (what cheerleader s and dance teams call the blade position), the Test Subject flexes his or her hand downward (towards the table) as far as possible. As with the elbow movement, the PT follows the movement with the movable arm of the goniometer. At the end of the movement, the PT reads the angle and the Technician records the on the Test Subject s Chart. See Figure 6. Figure 4 Figure 5 Figure 6 Read the larger angle 150 o ) OR read the small angle and subtract from 180 o Line up goniometer with pivot point and start at 180 o Read the angle 90 o ) MO-BILITY 13

4 9. For the final of the upper limb the Test Subject remains seated with the forearm on the supporting surface but repositions it so it is lying on its side with the thumb facing up. Using the small goniometer, which is proportioned for smaller joints, the PT places the centerpoint of the goniometer across the knuckle of the second, or index, finger. Lay the stationary arm across the top of the hand and the movable arm across the top of the finger as illustrated in Figure 7. The Technician records the beginning (0 o ) in the appropriate column on the Test Subject s Chart. 10. As seen in Figure 8, the Technician holds the three remaining fingers gently to the table to allow maximum movement of the index finger. Then the Test Subject flexes the finger downward while the PT follows the movement with the goniometer. When the Test Subject has flexed the index finger as far as possible the PT reads the angle and the Technician records the on the Test Subject s Chart. 11. Figure 9 illustrates the various reference points needed to make the required ROM s for the leg. The PT and Technician should work together to find these approximate locations on the Test Subject s dominant leg (the one you would kick a ball with). Move the stick-on dots from the Test Subject s arm to the new positions on the leg. Place the first dot in the middle of the leg just beneath the hip joint (A). Bend the Test Subject s knee and locate the space beneath the knee cap. Position the dot to the side of the knee directly beneath the hip dot (B). Place the third dot directly on the bone protruding from the ankle (C). Discard the fourth dot as it is not used for the leg joint s. Read the angle 50 o ) Figure 7 Figure 9 Figure 8 Line up goniometer with pivot point and start at 180 o A B C 14MO-BILITY

5 12. Stand the Test Subject with a supporting surface near the side opposite from the leg being tested. The Test Subject should stand on both feet with the hand opposite the leg being tested resting on the table for balance. Place the center point of the goniometer on the dot marking the knee. Align the stationary arm with the dot on the hip and the movable arm with the dot on the ankle. The Technician notes the beginning angle in the appropriate column on the record sheet. See Figure 10 for reference. 13. As the Test Subject raises the lower leg (bending from the knee) as far as possible the PT follows the movement with the movable arm of the goniometer. At the end of the movement the PT reads the angle and the Technician notes the in the appropriate column on the record sheet (Figure 11). 14. Now sit the Test Subject on a table with his or her legs hanging over the edge from the knees. Place the center point of the goniometer on the dot marking the ankle on the dominant leg. Align the stationary arm with the dot on the knee and the movable arm with the tip of the little toe. As shown in Figure 12, position the Test Subject s foot so that the angle reading of the movable arm is at the 90 o mark on the goniometer. The Technician records this as the beginning (90 o ) in the columns for both dorsiflexion (flex foot) and plantar flexion (point toes). Line up goniometer with pivot point and dots, begin at 180 o Read the larger angle 130 o ) OR read the small angle and subtract from 180 o Figure 10 Figure 11 Line up goniometer with pivot point and start at 90 o Figure 12 15MO-BILITY

6 15. As shown in Figure 13, the Test Subject flexes the foot upward (towards the knee) while the PT follows the movement Read the angle with the movable arm. When the Test Subject reaches the end of the movement the PT reads the angle and the Technician records it in the ending 60 o ) and column for dorsiflexion on subtract from the Test Subject s Chart. Then the Technician subtracts the ending final measure- 90 o (making the from the beginning to record ment 30 o ) the actual reading for the ankle movement. Figure Using the same starting position and goniometer alignment as in Step 13 the Test Subject now points their toes as strongly as Read the angle possible while the PT follows the movement with the goniometer (Figure 14). At the completion of the movement the PT reads the angle and the Technician records it in 160 o ) and subtract the ending column for plantar 90 o (making flexion. This time the Technician subtracts the final the beginning from the ending to obtain and record the 70 o ) actual reading. 17. Change roles and repeat the entire exercise so that all participants obtain and record joint movement s. Figure 14 MO-BILITY 16