Deck 23: Intervention for Limited Passive Range of Motion

Question 1

A muscle has increased stiffness because it has not been moved recently.Decreased resistance is noted after the muscle has moved.This phenomenon is known as:

A)Spasticity
B)Hypertonicity
C)Microfibril formation
D)Thixotropy

Answer 1

D

Question 2

Which of the following functional limitations would most likely result from contracture?

A)Decreased ability to respond to balance perturbations secondary to ankle plantar flexion contracture
B)Inability to roll supine to sidelying due to hip flexion contracture
C)Difficulty performing toileting secondary to hip abduction contracture
D)Difficulty bringing food to mouth due to elbow flexion contracture

Answer 2

A

Question 3

Your patient has a recent diagnosis of traumatic brain injury (TBI) following a motor vehicle accident.Which of the following findings would be least likely to increase the risk of contracture development in this patient?

A)Trace muscle contraction felt with attempts at elbow flexion
B)Spasticity (Modified Ashworth Score of 3) in hamstrings
C)Inability to reposition self in bed due to decreased force production and motor planning deficits
D)Impaired balance during gait due to perceptual and vestibular deficits

Answer 3

D

Question 4

You are treating a patient who recently had an Achilles tendon lengthening procedure.What treatment choice would be most appropriate?

A)Focus intervention on increasing dorsiflexion range of motion with prolonged stretching,and home stretching program
B)Increase strength in the newly gained range of motion (ROM),promote functional mobility with walking up and down ramps,ROM program for prevention of contracture reoccurrence
C)Increase plantar flexion strength and address ROM limitations with prone positioning
D)Perform reaching activities in long sitting,perform heel and develop a ROM program for prevention of contracture reoccurrence

Question 5

During evaluation,your patient demonstrates decreased elbow flexion active range of motion (AROM) (0-80 degrees).What can you conclude about this patient?

A)This patient has an elbow flexion contracture
B)This patient has insufficient biceps brachii strength
C)This patient has poor motor control limiting elbow flexion range
D)This patient needs further testing to determine cause of AROM deficit

Question 6

You are working with a patient who had a spinal cord injury as a result of a motor vehicle accident.This patient has been progressing well with his ROM program but has recently developed decreased ROM into hip flexion with a bony end feel.The patient complains of pain with attempts at ROM at this joint.Which of the following is most likely to develop?

A)Hip extension contracture
B)Heterotopic ossificans
C)Soft tissue limitation
D)Hip flexor spasticity

Question 7

A joint contracture is:

A)Inability to generate sufficient force for active movement
B)Difficulty producing isolated movement at a joint
C)Tightness of the muscle,joint capsule,or other soft tissue
D)Increased resistance to stretch in mid-range when the person is not actively contracting the opposing groups

Question 8

Which of the following patients would be most likely to develop a contracture?

A)Patient with L4 incomplete spinal cord injury requiring bilateral Lofstrand crutches for household mobility
B)Patient status post cerebrovascular accident (CVA) with flaccid paralysis affecting the right side of the body
C)Patient status post traumatic brain injury (TBI) requiring min assist to perform sit to stand transfers
D)Patient with cerebral palsy who is able to walk with rolling walker but is unable to ascend/descend stairs

Question 9

You are treating a young child with a diagnosis of spastic diplegia (cerebral palsy).You are concerned about the patient's risk of developing a knee flexion contracture due to spasticity and decreased functional mobility.Which of the following treatment options would be most appropriate for this patient?

A)Position patient at end of knee extension range of motion for at least 30 min/day
B)Perform 10 stretches into knee extension for 5 sec each
C)Place the patient in a serial cast to promote knee extension for 6 weeks
D)Apply superficial heat to hamstring muscles

Question 10

The best intervention for a patient that has an existing contracture resistant to manual stretching would be:

A)Daily positioning in end range for 15-30 min per day
B)Heat modalities
C)Serial casting
D)Joint mobilization