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Elbow Passive Range of Motion / Movement | Clinical Physio Premium
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hey guys and welcome back to clinical
physio with me Karlin Mader
in today's video we're going to be
taking you through all you need to know
about passive range of movement testing
of the elbow joint and the purpose
behind these tests is to analyze what
happens to your patients movement when
active contractile structures are not
involved and if you'd like more
information behind passive range
movement testing head on over to our
video titled why test passive agent
movement which takes you through the
full clinical reasoning behind these
tests so as to not slow your video down
we're not going to be comparing the
tests on the affected and unaffected
sites but of course it's vitally
important that you do this in practice
so remember that whilst you're watching
and as with all passive range of
movement testing we're going to be
considering pain range and Enfield so
let's get into our main video let's get
clinical so now we're going to test libs
arm in terms of elbow passive range of
movement and we're going to look at
particular flexion and extension of the
elbow we're going to start with the
positioning of the patient and the
therapist which is the same for elbow
flexion as it is for elbow extension and
that position is where the therapist is
standing to the side of the patient so
you can accurately measure the degree of
movement of the elbow joint the patient
is sitting in a relaxed position in
terms of our handling one hand is going
to be supporting the joint underneath
the electron and the other hand is going
to be just proximal to the wrist joint
controlling movement at the forearm so
to test flexion passively we take the
patient's elbow from a completely
extended position to a completely flexed
position and then we can form the
opposite by taking the elbow into a
fully extended position like so so when
we're looking at passive range of
movement we're testing for pain range
and n feel if you elicit pain with
passive range of movement that tells you
that either joint structures have been
irritated or soft tissue has been
stressed in terms of elbow flexion and
extension the joint structures that
you're looking at in particular
are the radio humeral joint and the
ulnar humeral joint where a soft tissue
in a flexed position the triceps muscles
are on a full stretch and in an extended
position the biceps muscles are on a
full stretch so you might get pain
because of these reasons in terms of
range of movement we expect range to be
between 0 and 145 for each of them and
in terms of Enfield
we expect to have a soft and feel for
flexion this may change if your patient
has a condition such as osteoarthritis
where the end fee or may be more hard do
two things about osteophyte formation in
terms of extension we expect to find a
hard and feel on range of movement
however if your patients elbow is
hypermobile like we have with our model
here you may find that the end feel is
more spongy or elastic in nature so now
we're going to look at passive range of
munna in the elbow in terms of
supination and pronation the positioning
of the therapist and the patient is the
same for supination as it is for
pronation and that's going to be with a
therapist standing directly in front of
the patient so you can accurately
measure the movement occurring at the
joint the patient is sitting so that
they're relaxed in terms of handling one
hand is going to be underneath elbow
joint to provide support and the other
hand is going to be just proximal to the
wrist joint so you can control movement
at the forearm in terms of this video
you'll see me performing these movements
with the elbow over here where is a
natural practice you may want to do
these movements with the elbow tucked in
next to the ribs so that the shoulder is
in a completely neutral position as I
said for this video we're not going to
do that so you can see what's occurring
in the elbow so now we're going to
measure supination to do this movement
we start with the patient's wrist in a
neutral position like so so that the
thumb is facing the ceiling
we then use our uppermost hand to move
the forearm laterally so that the
patient isn't supination as if they were
holding a bowl of soup we're then going
to take their forearm medially to
so during the movement we're going to
look at pain range and end feel in terms
of pain if we elicit pain with passive
range of movement that can tell you that
either joint structures are being
irritated or soft tissue is being
stressed in particular supination and
pronation look at the superior
radioulnar joint so you can tell that
any any irritation of the joint is
occurring here also supination and
pronation is where you have full
rotation of the radial head so this is
the other joint structure that can be
affected in terms of soft tissue when we
have the elbow in a fully supinated
position this is where the wrist flexor
muscles are being stretched whereas in a
pronated position this is where the
wrist extensor muscles are being
stretched so pain in either of those
areas may be due to muscles being
stretched normal range of movement for
supination is 85 degrees
whereas normal range of movement for
pronation is 70 degrees in terms of end
field we expect end field of super
nation to be elastic in nature whereas
the pronation and field is expected to
so here are some key points to summarize
the video on passive range of movement
of the elbow joint completely recessive
a passive range of movement by looking
at flexion extension supination and
pronation of the elbow know the position
of the patient and the therapist with
each movement as well as the handling
used by the therapist make sure you
compare both affected and unaffected
sides and when testing passive range of
movement make a note of pain range and n
and that completes our video on passive
range of movement testing of the elbow
joint in practice you would now compare
your patients passive range of movement
with their active range of movement and
by doing so will allow you to make a
decision as to whether it's most likely
to be contractile or non contractile
structures which are at fault for their
condition this as well as your other
tests will help you clarify their
diagnosis if you're not quite sure on
how to interpret the differences have a
look at our videos titled why test
passive agent movement and whitest
active range movement and then join us
back again for the next video here on
clinical physio thank you so much for
watching as always and we'll see you
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