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Seminar Objectives
Define and Discuss Range of Motion (ROM) and
Associated Terminology
Discuss and Compare Passive ROM (PROM) and
Active ROM (AROM)
Compare tools utilized to measure ROM
Compare different ways to document ROM
Discuss factors affecting ROM
Describe and Discuss ROM Technique Procedures
ROM Definitions
ROM: is the term that is used to describe the amount of
movement you have at each joint.
l AROM is performed by patient alone.
l PROM is performed by therapist without any patient help
Endfeel:
l The resistance to movement that the therapist perceives at
end-range of motion when testing PROM (more to come in
future lectures)
Goniometer
l An instrument that measures angles. In PT, it is the most
common instrument utilized to measure ROM
ROM Definitions
Hypomobility:
l significant decrease from the normal expected ROM for
subject age and gender.
Hypermobility:
l Significant increase in ROM from the normal expected for
subject age and gender
Joint ROM vs. Muscle Length Measurements
l For joint ROM tests, the motion is measured with bi-
articular muscles shortened. For muscle length tests, the bi-
articular muscles are lengthened to assess muscle tightness.
Axis of motion
l Imaginary point where the joints pivot to form the angles
that are recorded with goniometers.
ROM Definitions
Physiological or osteokinematic motion :
l Refer to the gross movements of the shafts of bones
rather than joint surfaces (next slide)
Accessory or arthrokinematic motion :
l Refer to the small movements that occur
involuntarily between joint surfaces during
physiological motions
l They may also be used therapeutically in manual
therapy techniques
l Examples: approximation, separation, slide, glide,
spin.
Rotation Abduction/Adduction
Flexion/extension
Transverse Plane Frontal plane
Sagittal plane
Accessory Movements or
Arthokinematic
B : Se paration C: Glid e
A : resting position
D: Approximation F : Spin
E: Roll
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GONIOMETRY PROCEDURE
position joint in zero position and stabilize proximal joint
component.
move joint to end of range of motion (to assess quality of
movement)
determine end-feel at point where measurement will be
taken (at the end of available range of motion)
identify and palpate bony landmarks
align goniometer with bony landmarks while holding joint
at end of range
read the goniometer
record measurement (e.g. elbow flexion = 130)
GONIOMETRY
Validity and Reliability
VALIDITY
Goniometric measurements can be invalid; usually because of
poor stabilization (see positioning and stabilization ), but also
because the joint axis always moves during measurement.
With universal goniometer (not fluid or gravity goniometer)
RELIABILITY
Upper extremity measurements are more reliable than lower
extremity measurements.
to maximize reliability always use the same:
Instrument, positioning, procedure, examiner
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