Assessment of Joint Movement
examination of the musculoskeletal system. The nurse should inspect and palpate the joint for any evidence of abnormal positioning, deformity, or swelling before putting the joint through any range of motion exercises. Range of motion is classified as active or passive. Active range of motion is performed by the patient without any assistance from others. With passive range of motion, the nurse moves the joint through the range of motion for the
patient. When performing passive range of motion, the nurse should be careful not to move the joint past the point of pain or resistance, or damage to the joint may occur. Each joint should be completely exposed during examination and range of motion. A goniometer is used to accurately measure the range of motion of each joint when a limitation of movement
is detected (Ruda, 2000a).
Any joint movement limitations or deformities are documented. Limitations to joint movement are frequently due to the development of contractures or to dislocations or subluxation of the joint. In addition to any limitation of joint movement, the nurse should also palpate the joint for effusion and any crepitus during movement. Crepitus is a grating or crackling sound in the joint that can be felt or heard; it indicates that the joint surfaces are no longer smoothly articulating, most likely due to degenerative joint disease (Liddel, 2000a). The nurse should also assess the joint for heat, pain, or tenderness (Casteel, 2003).
Orthopedic Nursing : Caring for Patients with Musculoskeletal Disorders
Dr. Judith A. Halstead