Question 1

A 45-year-old client comes to OT after receiving a burn to her upper extremity. The client has had multiple skin grafts and is having difficulty with full elbow flexion and extension. What would most likely be causing this issue?

Accepted Answer

Scar tissue can restrict movement and limit range of motion after a burn injury with skin grafts. The scar tissue can create adhesions and contractures, resulting in difficulty with full elbow flexion and extension. Muscle weakness and orthopedic issues could also play a role, but scar tissue is the most likely cause in this scenario. Fear of pain may also be present, but it is not a primary factor in limiting range of motion.

Question 2

An OT practitioner is setting up a self ROM program for an adult with hemiplegic cerebral palsy and high tone in his upper extremity. How should the OT practitioner instruct the client regarding elbow flexion/extension?

Accepted Answer

A

Question 3

An OTA is working with a client who had a shoulder replacement several weeks ago and has been cleared for OT services by the physician. While measuring shoulder flexion, the client winces as he approaches 90 degrees of flexion and then stops. What should the OTA inquire about and then document as a part of the assessment?

Accepted Answer

The OTA should inquire about the client's level of pain when they reach 90 degrees of flexion and document it as a part of the assessment. Pain can affect ROM and the therapist will need to consider pain management strategies when working with this client. While orthopedic issues, changes in muscle movement, and quality of movement all may be important considerations, the client's level of pain should be the OTA's immediate focus.

Question 4

An OTA is measuring joint ROM on a client. The client has been placed in a good position for measurement, and the OTA is conducting measurements. What should be the last step in this process?

Accepted Answer

The last step in measuring joint ROM is to read and record the numbers on the goniometer to document the range of motion achieved by the client. The other steps, such as positioning, holding the arms in place, and returning to a relaxed position, are important for accurate measurement but are not the last step in the process.

Question 5

As a part of a strengthening program after a CVA, a client is instructed to hold his affected limb with his stronger limb to take it through the full ROM. Which category would best describe this action?

Accepted Answer

Self ROM involves using the stronger limb to move the affected limb through its range of motion, which is what is described in the scenario.

Question 6

An elderly client with general deconditioning after a heart attack is being evaluated by the OT practitioner for ROM deficits. What would be the first step in this process?

Accepted Answer

The first step in assessing ROM deficits would be to place the client in a comfortable position with their extremity accessible for measurement. This ensures that the client is at ease and can perform the necessary movements, allowing the OT practitioner to assess the ROM deficits accurately. Laying supine or aligning the fulcrum and stationary arm of the goniometer come into play later in the assessment process.

Question 7

An OTA is working with an elderly client who has been diagnosed with dementia and is having shoulder problems. The client is having a difficult time following directions and cannot follow directions for ROM assessment. What can the OTA do to determine functional ROM?

Accepted Answer

Observing the client performing various daily living tasks allows the OTA to assess functional range of motion in a natural context, which is particularly useful when the client has difficulty following directions due to dementia.

Question 8

An OTA is measuring shoulder extension on a client. Once the client is positioned, how should the OTA instruct the client?

Accepted Answer

Shoulder extension involves moving the arm straight back behind the body with the elbow straight. Option B instructs the client to do just that. Options A, C, and D describe other movements that are not related to shoulder extension.

Question 9

An OT practitioner is instructing a client with cerebral palsy in the use of a mobile arm support to promote shoulder movement for self-feeding. Which category would this action best fall under?

Accepted Answer

Active assistive ROM involves the client actively participating in the movement with assistance from a device or therapist, which aligns with using a mobile arm support to promote shoulder movement.

Question 10

An OT practitioner is setting up a passive ROM program for a client who has had a CVA and does not have functional use of her right upper extremity. When preparing this program, what should the OT practitioner do first?

Accepted Answer

The first step the OT practitioner should take is to educate the client and all members involved in her care about the purpose, goals, and benefits of the passive ROM program. This will help ensure that everyone is on the same page and working towards the same goals. Additionally, this step can help address any concerns or questions the client or caregivers may have about the program. The other options (A, B, and C) may all be aspects of the passive ROM program, but they should only be implemented after the client and all involved parties have been educated on the program.

Question 11

Which of the following clients would be contraindicated for ROM assessment?

Accepted Answer

Range of motion (ROM) assessment on a recently dislocated shoulder could exacerbate the injury or delay healing, making it contraindicated until the shoulder has sufficiently healed and been cleared by a healthcare professional.

Question 12

An OTA is measuring wrist ulnar deviation on a client. Once the client is positioned, how should the OTA instruct the client?

Accepted Answer

Ulnar deviation refers to the movement of the wrist towards the ulnar side, which is the side of the wrist nearest the pinky finger. Therefore, instructing the client to move the wrist toward the pinky side of the hand accurately describes how to perform ulnar deviation.

Quiz 7: Range of Motion: Assessment and Intervention