ImpairMaster's range of motion forms provide many features that allow you to enter various range of motion conditions, while simultaneously providing feedback indicating whether your entries meet reproducibility guidelines. In this article, you'll learn about key features of ImpairMaster as well as how to:
- enter range of motion values and how ImpairMaster gives you feedback
- efficiently clear an entire series of numbers with one mouse click
- enter hyper movements (eg hyper flexion, hyper extension, etc.)
- enter ankylosis conditions
- rate impairment when the contralateral joint is impaired but considered "normal" or baseline.
Entering Range of Motion
A typical ROM input form is organized as shown in the following image:
- Region identifier
- General form instructions
- A selector to specify which side is being rated
- Rows for each movement
- Buttons to save or discard any changes made
Each motion row allows you to enter up to 3 measurements (6 for the spine). When a value has been accepted, the input box will turn green. If the value you entered is invalid or out of range, it will turn red. In the following image, 120 is a reasonable number for elbow flexion, while 200 is unreasonable.
If more than one value is entered, ImpairMaster will highlight the best motion and use that value when calculating impairment. In the following image, 120 is the best measurement.
In the previous image, notice that there is a green checkmark placed next to the red eraser. The green checkmark indicates that all three values meet reproducibility guidelines. If the values entered were erratic, a red X would be displayed:
Even though the form shows the red X indicating the numbers don't meet reproducibility guidelines, you can still save the values and ImpairMaster will select the highest value and use that for the rating. In other words, you have the final decision whether or not to rate the measurements.
Dual Inclinometer Measurements (Spine only)
Spinal ranges of motion are generally measured using dual inclinometers. ImpairMaster gives you the option to enter your measurements either as a single value or as two values representing the two inclinometer readings. The same guidelines as described above are in effect, however entry looks a bit different.
You can customize whether an exam use dual inclinometers or single measurements in the report properties page. For more information on this topic, please see the article: Spinal ROM Entry - Dual Inclinometers or Single Measurements
Clearing the Input Fields
Clearing a single input field is straightforward and can be done with the backspace key or the delete key, but sometimes it may be necessary to delete an entire row - for example, if you entered 3 flexion values and 3 extension values for the left elbow but then realized it should have been the right elbow. In this case, using the backspace key to erase the entries would be time-consuming and cumbersome.
To clear a series of values, use the red eraser button. Clicking the button will remove all entries for it's row.
Hyper motion
In some situations, you will need to specify that a joint was hyper flexed or hyper extended. The AMA Guides uses a plus sign to indicate hyper movement. Because ImpairMaster recognizes a plus sign as meaning a "positive" number, a minus sign is used instead. For example, when specifying that the thumb is hyperflexed at +20°, you would enter -20.
When ImpairMaster calculates this impairment, it will use the plus sign to align with the AMA Guides:
Ankylosis
To rate a joint that is ankylosed, enter the degree of ankylosis in the first input field, then click the "Anky" checkbox. Once the ankylosis checkbox is checked, the opposing motion within the same plane will become disabled. For example, if the elbow was ankylosed in 50 degrees of flexion, the form would look like the following image:
Notice that you can only enter one measurement for the ankylosed motion, and the opposing motion is completely disabled.
Contralateral Normal
If a contralateral "normal" joint has a less than average mobility, the impairment values corresponding to the uninvolved joint can serve as a baseline and are subtracted from the calculated impairment for the involved joint. Using ImpairMaster, you can accomplish this by entering the uninvolved "normal" joint's motion measurement(s) and then checking the "Use as baseline" checkbox.. Then enter the involved joint's limited range of motion. When the report is generated, impairment from the uninvolved joint will be subtracted from the involved joint.
As an example, if active wrist extension is measured at 30° in the involved (left) extremity and at 50° in the contralateral, uninvolved (right) extremity, you would follow these steps:
Step 1: Navigate to wrist ROM in the navigation tree: Upper Extremities -> Range of Motion (ROM) -> Wrist
Step 2: For the left wrist (the involved side), in the extension row, enter 30 in the first input field.
Step 3: Click on the "Right wrist" button at the top:
Step 4: In the extension row, enter 50 in the first input field, then click "Use as baseline"
ImpairMaster will calculate and summarize the wrist impairment as follows:
