Measurement Principles and ROM Assessment Lecture

35 question-and-answer flashcards summarising key concepts of reliability, validity, ROM measurement, goniometry, and manual muscle testing from the lecture.

Why is it important to perform clinical measurements correctly the first time?

Because wrong measurements lead to incorrect diagnoses and sub-optimal treatment plans.

What is the difference between qualitative and quantitative data?

Qualitative data use descriptive categories; quantitative data use numerical values.

Give two common examples of quantitative variables measured in clinic.

Height and weight (others include mass, length, girth).

What distinguishes continuous variables from discrete variables?

Continuous variables can take any value on a spectrum; discrete variables are limited to set categories or counts.

Provide an example of a discrete clinical variable.

A 0–10 pain scale (others: alive/dead, pregnant/not pregnant).

Define reliability in the context of measurement.

The ability of a test or instrument to yield consistent results under unchanged conditions.

Define validity in clinical measurement.

The degree to which a tool measures what it is intended to measure (accuracy).

Explain systematic error and give an example.

Consistent deviation caused by the instrument or procedure, e.g., a scale that is always 5 lb off because it is un-calibrated.

Explain random error and give an example.

Unpredictable variation, e.g., caffeine intake temporarily raising resting blood pressure.

Can a measurement be reliable but invalid? Give an example.

Yes; a clock set 10 minutes fast is always consistent (reliable) but displays the wrong time (invalid).

What is test–retest reliability?

The extent to which the same instrument gives the same result when repeated under identical conditions.

Differentiate intra-rater and inter-rater reliability.

Intra-rater: consistency of one examiner; inter-rater: consistency between different examiners.

What is alternate-forms reliability?

Agreement between different validated instruments measuring the same construct.

Why should clinicians pilot-test their instruments?

To practice procedures, detect errors, and ensure consistent, accurate data before using them on patients or in research.

What are osteokinematics?

Visible joint motions such as flexion, extension, abduction, and rotation.

What are arthrokinematics?

Accessory motions within joint surfaces—roll, glide/slide, and spin.

Name the three cardinal planes of motion.

Sagittal, coronal (frontal), and transverse planes.

Name the three axes of rotation.

Medial-lateral, anterior-posterior, and superior-inferior axes.

Describe the zero-to-180° notation system.

Range of motion is recorded from anatomical neutral (0°) up to 180° for the measured movement.

What is meant by an “end feel” in ROM assessment?

The quality of resistance felt by the examiner at the end of passive movement.

List the three normal end feels and give an example of each.

Soft (tissue approximation, e.g., elbow flexion), Firm (muscle/ligament stretch, e.g., hip flexion), Hard (bony block, e.g., elbow extension).

What does an empty end feel indicate?

Pathology such as a ligament rupture or loose body where no normal resistance is felt.

How is 3-point notation used to document knee hyperextension?

Record hyperextension – 0 – flexion (e.g., 5-0-135 indicates 5° hyperextension and 135° flexion).

In goniometry, which arm is stationary and how is it aligned?

The arm with the dial (stationary/proximal arm); it is aligned with the proximal body segment.

State the landmark alignment for measuring ankle plantar flexion/dorsiflexion.

Axis on lateral malleolus; stationary arm toward fibular head; movement arm parallel to the 5th metatarsal.

What is the normal ROM value for ankle plantarflexion (AOS standard)?

50 degrees.

Distinguish active from passive ROM.

Active ROM is produced by the patient’s own muscles; passive ROM is produced by the examiner with the patient relaxed.

What is active-assistive ROM and when is it used?

Patient initiates movement with external assistance (e.g., dowel rod) during rehabilitation to regain motion.

Difference between manual muscle testing and manual resistance exercise.

MMT assesses strength; manual resistance exercise is used therapeutically to strengthen muscles.

Describe a break test in manual muscle testing.

Examiner positions limb and applies resistance; the patient attempts to hold the position without letting the examiner ‘break’ it.

Describe a make test in manual muscle testing.

Patient actively generates force through the movement while the examiner provides matching resistance.

List the MMT grades 5 through 0.

5 Normal: full ROM against gravity & full resistance; 4 Good: full ROM against gravity, moderate resistance; 3 Fair: full ROM against gravity only; 2 Poor: full ROM in gravity-eliminated position; 1 Trace: palpable contraction, no movement; 0 Zero: no contraction.

Why is gravity considered when positioning for an MMT?

Weak muscles may be unable to move against gravity, affecting accurate grading.

What is substitution during an MMT?

Compensatory use of other muscles or joints to complete the movement, masking the weakness of the target muscle.

Why are standard operating procedures critical for clinical measurement?

They ensure precision, reduce measurement error, and support valid, reliable clinical decisions.