The patient’s voluntary muscles actively perform active movements (AROM), possessing unique value as they integrate tests of joint range, control, muscle power, and the patient’s willingness to execute the movement.
These movements are occasionally denoted as physiological movements.
Sometimes, people refer to the end of active movement as the physiological barrier.
During active movements, the patient’s voluntary muscles engage and move contractile, nervous, and inert tissues.
when the active movement occurs, one or more rigid structures( bone ) move, and such movement result in movement of all structures that attach to or are in close proximity to that bone.
During fracture healing, active movements are either performed without caution or if the movement could stress newly repaired soft tissues.
In general, the examiner performs active movements once or twice in each desired direction while noting the pattern of movements and any discrepancies or cheating/substitution movements.
In some cases, weakness, pain, or tight structures may prevent the patient from actively moving the joint through the available range of motion. This inability to move through the available ROM is sometimes termed a lag.
Examiners Observation During Active Movement
- the examiner should note which movements, if any, causes pain or other symptoms and the amount and quality of pain that results
- for example, small, unguarded movements causing intense pain indicate an acute irritable joint
- The examiner should note the rhythm of movement, along with any pain, limitation, or unusual occurrences such as instability jogs or trick movements.
- The patient consciously or unconsciously utilizes trick movements, which are modified movements, to accomplish what the examiner has asked.
- whether the movement increases the intensity and quality of the pain
- the pattern of the movement
- the reaction of patient to the pain
Active movements may be abnormal for several reasons, and the examiner must try to differentiate the cause.
pain is the common cause of abnormal movement as is muscle weakness, paralysis, or spasm.
other causes include tight or shortened tissues, altered length-tension relationship, modified neuromuscular factors, and joint-muscle interaction