drgraber

FUNCTIONAL JOINT EXAMINATION METHODS

FUNCTIONAL JOINT EXAMINATION METHODS(Order of Least to Most Invasive)

 

METHOD RATIONALE STRENGTHS WEAKNESSES
Positional and Postural ~Misalignment creates joint and connective tissue stress ~Assesses muscle imbalance and tightness

~Positional dyskinesia demonstrated

 ~Difficult to assess anomalies

~Alignment doesn’t correlate     with kinetic disturbance

~Doesn’t identify unstable joints
ROM ~Altered instantaneous axis of rotation ~Easy to implement

~Quick screen

~Demonstrative to patient

 ~Assesses quantity but not quality of motion

~Global, not-specific
Reactive Muscle Testing

(Active MMT, Passive Reflex Testing)

 ~Mechanoreceptor dysfunction ~Neurological  indicator of joint stress

~Indicates neurological dysfunction

~Very demonstrative to patient

 ~Secondary indicator

~Poor validity and reliability

~Can’t gauge prognosis

~Highly skill dependent with questionable accuracy and reliability
Motion Palpation (Joint Play Testing) ~Connective, muscular, and articular tissue restrictions prevent normal arthokinematics ~Primary indicator

~Can assess quality of motion

~Can differentiate between acute and chronic conditions

~Can identify unstable joints

~Can monitor progress

~Can offer prognosis information

 ~Labor intensive

~Highly skill dependent requiring extensive practice

~Modest t o good intra-examiner reliability; fair to moderate inter-examiner reliability

~Best used in combination with other exam methods rather than as a stand-alone
Provocative Testing ~Pain on testing indicates tissue irritation or inflammation ~Most literature evidence support

~Demonstrative to patient

~Can be integrated with orthopedic exam (overpressure) and joint play end feel analysis

 ~Narrow scope of assessment (pain only)

Functional Joint Exam Methods

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