REHB1001 Chap.14 Range of Movement, Palpation and Resisted Contractions
Range of Movement, Palpation and Resisted Contractions
Practicals 1 to 6 and the principles manual teach the first hands-on techniques assessed in the Skills Demonstration.
This chapter covers active range with quality and overpressure, goniometry with its point of rotation, stationary arm and moving arm, passive range and end-feel, resisted static contractions and the contractile versus non-contractile matrix, selected lower-limb normal ranges, the principles of palpation, and the two symptom-monitoring scripts the examiner will listen for.
The worked example sets up a goniometer for knee flexion exactly as a skills card would ask, naming each landmark aloud.
What this chapter covers
- 01
Active range and quality of movement
- 02
Overpressure and when to use it
- 03
Goniometry and the zero position
- 04
Passive range and end-feel
- 05
Resisted static contractions
- 06
Palpation principles
- 07
Symptom monitoring scripts
Worked example · free
Setting up a goniometer for knee flexion
- +1Position: supine, close to the edge of the bed; instruction to bend the knee while the heel slides up the bed.
- +1Point of rotation: the lateral femoral epicondyle.
- +1Arms: stationary along the lateral midline of the femur towards the greater trochanter; moving along the fibula towards the lateral malleolus.
- +1Reading: measure from the straight-knee zero position and record range, end-feel if tested, symptoms and quality, compared with the other side and the normal of about 135 to 140 degrees.
Key terms
- Overpressure
- Passive movement applied at the end of active range to test for end-range symptoms.
- End-feel
- The quality of resistance felt at the limit of a passive movement.
- Resisted static contraction
- Isometric activation against gentle, graded resistance with no joint movement.
- R.E.S.Q
- The recording prompt of range, end-feel, symptoms and quality.
- Accessory movement
- A joint glide, roll or spin that a patient cannot perform actively.
- Point of rotation
- The goniometer axis, placed over the joint's centre of movement.
Range of Movement, Palpation and Resisted Contractions FAQ
When should overpressure be applied?
Only when the active movement is complete and pain-free and the condition is not irritable. The manual explains that an active movement only counts as normal if firm overpressure can be added without pain, so overpressure checks for symptoms at the very end of range.
How do I tell contractile from non-contractile problems?
Compare three tests. Active movement loads both tissue types, passive movement loads non-contractile tissue, and a resisted static contraction loads contractile tissue without moving the joint. Pain on active and resisted tests but not passive points to contractile tissue; pain on active and passive points to the joint.
What will the examiner listen for during monitoring?
The manual says basic monitoring is assessed in the Skills Demonstration. Ask whether the person has symptoms before starting, then use the matching script: watch for a change if symptoms are present, or for any onset if not, and ask again at the end of the movement and after returning to the start.
What is end-feel and what words describe it?
End-feel is the resistance the therapist feels at the limit of a passive movement, and it hints at what limits further motion. The practical handouts use soft, spongy, springy, tight and hard; knee flexion, for example, is spongy from soft tissue apposition, while elbow extension is hard from bone meeting bone.
How should palpation be progressed?
The manual starts with the back of the hand for temperature and sweating, then gentle effleurage to build the patient's confidence, then the tips of the middle three fingers for general tissue changes, and finally the index finger for specific structures. Compare sides and record tenderness, symptoms and tissue quality.
What is a resisted static contraction used for?
It activates a muscle isometrically against gentle, graded resistance with no joint movement. Practical 6 gives two uses: making palpation of the muscle's bulk and tendon more precise, and provoking symptoms from contractile tissue to separate them from joint, ligament or capsule sources. It is not a strength test.
Exam move
Practise every lower-limb goniometry set-up until you can say the landmarks without looking, and learn the normal ranges in the table. In threes, run active and passive tests with full consent and monitoring, then swap roles. Rehearse the palpation sequence on yourself and finish each practice with written R.E.S.Q documentation.
Time yourself running one active and one passive test with consent, monitoring and documentation, aiming to finish both well inside the 20 minutes.
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