AROM Flashcards
Hip Flexion AROM
Supine, Knee to chest
Goniometer:
- Axis: Greater Trochanter
- Moving Arm: Femur towards lateral condyle
- Fixed Arm: Midline of Trunk
Overpressure - Through the thigh @ 90degrees
Hip extension AROM
Prone, Knee bent to 90 degrees, Lift knee off of the bed
Goniometer:
- Axis: Greater Trochanter
- Moving Arm: Femur to lateral condyle
- Fixed Arm: Midline of the Trunk
Trick Movement: Stabilise the lumbar spine to stop trunk rotation
Overpressure: Holding the knee and bring it up
Hip Abduction AROM
Supine, opposite leg over side of bed (for stability), slide leg into abduction (using a slider board if required)
Goniometer:
- Axis: ASIS
- Moving Arm: Femur
- Fixed Arm: Opposite ASIS
Trick Movement: Need to keep toes pointing to the sky
Overpressure: Stabilise pelvis, guide force lower to the knee
Hip External Rotation AROM
Sitting legs off of bed, Foot comes inwards towards other leg
Goniometer:
- Axis: Patella
- Moving Arm: Tibia
- Fixed Arm: Perpendicular to the floor
Overpressure: Delivered through the thigh
Hip Internal Rotation AROM
Sitting legs off of bed, Foot travels outwards
Goniometer:
- Axis: Patella
- Moving Arm: Tibia
- Fixed Arm: Perpendicular to the floor
Overpressure: Delivered through the thigh
Knee Flexion AROM
Supine, Heel slides towards the bum
Goniometer:
- Axis: Lateral Femoral Condyle
- Moving Arm: Down the fibula to lateral malleolus
- Fixed Arm: Up the femur towards the greater trochanter
Overpressure - Through the tibia to compress the knee, 90 degrees to the part (greatest leverage at distal end)
Knee Extension AROM
Supine, Towel under knee, patient contracts quads to get into full knee extension
Goniometer:
- Axis: Lateral Femoral Condyle
- Moving Arm: Down the fibula towards the lateral malleolus
- Fixed Arm: Up the femur towards the greater trochanter
Overpressure: Can either stabilise above or below the knee, gently pull through underneath the lower leg
Knee Medial & Lateral Rotation AROM
Supine, Hip & Knee at 90 degrees, have patient turn lower legs inwards and outwards without moving the hip
- Easier to manually demonstrate
Goniometer: No measurement required
Overpressure: Stabilise above the knee, apply rotational force through the lower leg (just above the ankle)
Dorsi Flexion AROM
Supine Or prone w/ knee at 90. Towel Under Knee (if in supine), Foot Hanging off the end of the bed. Patient brings toes back up towards the body
Goniometer:
- Axis: Lateral Malleolus
- Moving Arm: Parallel to the 5th Metatarsal
- Fixed Arm: Fibula
- Note that the measurement is taken from 90 degrees (Perpendicular to the line of the fibula) and dorsi flexion is only achieved after surpassing the 90 degree mark.
Overpressure: One hand stabilises the mortice, the other grabs the calcaneus and brings it up.
Towel required under the knee to prevent passive insufficiency as a result of Gastroc tension.
Plantar Flexion AROM
Supine Or prone w/ knee at 90. Towel Under Knee (if in supine), Foot Hanging off the end of the bed. Patient points toes away from the body
Goniometer:
- Axis: Lateral Malleolus
- Moving Arm: Parallel to the 5th Metatarsal
- Fixed Arm: Fibula
Overpressure: If in Supine one hand stabilises the mortice and the webspace of the other hand goes over the joint/talus and applies pressure from above. If in prone, then one hand stabilises the calcaneus and the above hand applies force through sole of the foot.
- Note that the measurement is taken from 90 degrees (Perpendicular to the line of the fibula) and plantar flexion is everything past the 90 degree mark.
Foot supination AROM
Supine, Foot off the end of the bed. Foot turns inwards
Goniometer: Not required
Over pressure: Need to achieve inversion, adduction and plantar flexion. Stabilise the calcaneus with one hand and broadly apply pressure with the other hand.
Foor Pronation AROM
Supine, Foot off the end of the bed. Foot turns outwards.
Goniometer: Not Required
Overpressure: Need to achieve eversion, abduction and dorsi flexion. One hand stabilises the calcaneus and the other hand applies force by grabbing the forefoot and pulling it outwards.
Lumbar Flexion AROM
Standing, Slide hands down the front of the legs (Bending forward as far as you can go).
Goniometer: Not Required
Overpressure: Bowing action with forearms (Fingers meeting in centre) - one forearm is through the thorax and the other is through the sacrum and posterior aspect of the pelvis
Trick: Knees need to be slightly bent to avoid hamstrings limiting the movement
Lumbar Extension AROM
Standing, Run hands down the back of the thighs (bending back as far as you can go)
Goniometer: Not Required
Overpressure: Gentle through the shoulders and pulling back.
Lumbar Lateral Flexion AROM
Standing, Sliding the hands down the lateral leg (Leaning as far as you can on both sides)
Goniometer: Not Required
Overpressure: Gentle force through the shoulders
Lumbar Rotation AROM
Sitting, Hands across the chest, feet on the floor and twisting to either side
Goniometer: Not Required
Overpressure: One hand on one scapula, and the other hand over the patients hand on the other shoulder, gently apply force
Thoracic Flexion AROM
Sitting, Arms across chest, Bend forward and Elbows sinking towards the hips
Goniometer: Not Required
Overpressure: Bowing action overpressure through the thoracic spine
Thoracic Extension AROM
Sitting, Arms clasped behind neck, Lean Forward slightly and then extend through the vertebrae.
Goniometer: Not Required
Overpressure: One hand on the thoracic spine and the other under the elbows and guiding them back into a greater extension
Thoracic Lateral Flexion AROM
Sitting, Feet on ground, arms behind head (as if getting arrested/elbows out to the side). Slowly move laterally to each side so one elbow is pointing towards the floor and the other up to the sky.
Goniometer: Not Required
Overpressure: One hand on top of the shoulder. The other hand under the armpit on the other side
Thoracic Rotation AROM
Sitting, Hands across the chest, feet on the floor and twisting to either side
Goniometer: Not Required
Overpressure: One hand on one scapula, and the other hand over the patients hand on the other shoulder, gently apply force
Shoulder Flexion AROM
Standing, straight arm is brought forwards and reaches up.
Goniometer (Performed from the side):
- Axis: Humeral Head
- Moving Arm: Along the midline of the humerus
- Fixed Arm: Mid-Axillary line of the thorax/chest
Overpressure: Performed from the front in the AP direction. One stabilises the scapula from behind, the other presses through the humerus.
** need to be careful of shoulder joint instability**
Shoulder Extension AROM
Standing, Elbow Bent, Elbow is pushed backwards.
Goniometer (Taken from the side):
- Axis: Humeral Head
- Moving Arm: Down the humerus
- Fixed Arm: Mid-Axillary Line of Thorax
Overpressure: One hand over the head of the humerus as it is vulnerable in this position. The other hand applies the force AP through the bicep.
Bent elbow prevents biceps tension from limiting the movement from taking place.
Shoulder Abduction AROM
Standing, Straight arm moves towards the side and above the head.
Goniometer:
- Axis: Posterior GHJ Line
- Moving Arm: Down the midline of the humerus
- Fixed Arm: Parallel to the trunk/spinous processes
Overpressure: Stabilize scapula with one hand and apply the force through the humerus towards the head. You may get the patient to move their head to the other side so you can get more ROM.
Shoulder Internal Rotation AROM
Supine, Shoulder abducted to 90 with arm off of the bed, elbow also at 90 with hand pointing to the roof. Elbow stays still, hand pushes down on the palmar side.
Goniometer:
- Axis: Olecranon Process
- Moving Arm: Down the ulnar to the styloid
- Fixed Arm: Perpendicular to the floor
Overpressure: One hand stabilises the scapula from behind and the other hand applies pressure at the wrist gently.
Towel: Covering Body
Shoulder External Rotation AROM
Supine, Shoulder abducted to 90 with arm off of the bed, elbow also at 90 with hand pointing to the roof. Elbow stays still, hand pushes down on the dorsal side.
Goniometer:
- Axis: Olecranon Process
- Moving Arm: Down the ulnar to the styloid
- Fixed Arm: Perpendicular to the floor
Overpressure: One hand stabilises the humeral head in front and the other hand applies pressure at the wrist gently. MUST BE EXTREMELY CAREFUL FO THIS MOVEMENT.
Trick movement: Make sure there is no movement at the elbow.
Towel: Covering Body
Shoulder Horizontal Flexion/Extension AROM
Supine, arm either pushing across the body or hanging laterally off the side of the bed.
Supine, Shoulder abducted to 90 with arm off of the bed, elbow also at 90 with hand pointing to the roof. Elbow stays still, hand pushes down on the palmar side.
Goniometer: Nil
Overpressure: Stabilize scapula and apply force 90 degrees to the humerus (closer to the elbow).
Towel: Covering Body
Shoulder Hand Behind the Back AROM
Combines shoulder extension with internal rotation & Abduction.
Recording: Done through how far they can reach up their back.
Elbow Flexion AROM
Typically in supine (but can be in standing or sitting). Hand is brought towards the shoulder.
Goniometer:
- Axis: Lateral epicondyle of the humerus
- Moving Arm: Down midline of radius towards the styloid process
- Fixed Arm: Along the midline of the humerus towards the acromion.
Overpressure: Stride stance, one hand under the humerus and the other hand applying pressure through the forearm @ 90 degrees.
Towel: Underneath Elbow
Elbow Extension AROM
Typically in supine (but can be in standing or sitting). Hand is taken away from the shoulder.
Goniometer:
- Axis: Lateral epicondyle of the humerus
- Moving Arm: Down midline of radius towards the styloid process
- Fixed Arm: Along the midline of the humerus towards the acromion.
Overpressure: therapist facing the foot of the bed. Forearm used to support the humeral head anteriorly and the hand is wrapped around under the humerus. The other hand applies a forces AP through the forearm.
Towel: Underneath Elbow
Elbow Supination AROM
Sitting with forearm over a table. Hand holding a pencil. Patient performs supination by twisting the arm so the palm is facing upwards.
Goniometer (Note - hand starts in neutral/pen is vertical)
- Axis: Head of third metacarpal
- Moving Arm: Parallel to the pen
- Fixed Arm: Perpendicular to the floor
Overpressure: Hold the forearm in both hands and apply a rotational force
Elbow Pronation AROM
Sitting with forearm over a table. Hand holding a pencil. Patient performs pronation by twisting the arm so the palm is facing downwards.
Goniometer (Note - hand starts in neutral/pen is vertical)
- Axis: Head of third metacarpal
- Moving Arm: Parallel to the pen
- Fixed Arm: Perpendicular to the floor
Overpressure: Hold the forearm in both hands and apply a rotational force
Wrist Flexion AROM
Seated, Forearm on the table in mid-prone (arm sideways). Hand is brought towards the body (Fingers relaxed)
Goniometer:
- Axis: Just beyond the radial styloid
- Moving Arm: Along the line of the 2nd Metacarpal
- Fixed Arm: Along the line of the radius
Overpressure: Apply force to posterior aspect of the MCPs using your palm, stabilise the radius/ulnar with the other hand
Wrist Extension ROM
Seated, Forearm on the table in mid-prone (arm sideways). Hand is taken away from the body
Goniometer:
- Axis: Just beyond the radial styloid
- Moving Arm: Along the line of the 2nd Metacarpal
- Fixed Arm: Along the line of the radius
Overpressure: Apply force by practically holding the patients hand.
Radial Deviation AROM
Seated , forearm resting on table (towel under forearm). Forearm in prone. Laterally flex towards the thumb side.
Goniometer:
- Axis: Over the capitate
- Moving Arm: in line with the 3rd metatarsal
- Fixed Arm: Up the middle of the forearm
Overpressure: One hand holds the patients forearm just proximal to the wrist and the other hand is in the patients palm to apply the pressure
Ulnar Deviation AROM
Seated , forearm resting on table (towel under forearm). Forearm in prone. Laterally flex towards the small finger side side.
Goniometer:
- Axis: Over the capitate
- Moving Arm: in line with the 3rd metatarsal
- Fixed Arm: Up the middle of the forearm
Overpressure: One hand holds the patients forearm just proximal to the wrist and the other hand is in the patients palm to apply the pressure
Thumb Flexion/Extension AROM
Occurs in the frontal plane, done in sitting with forearm on the table.
Goniometer:
- Axis: Palmar aspect of the first carpometacarpal joint
- Moving Arm: Parallel to the 1st metacarpal
- Fixed Arm: Along and parallel to the radius
Thumb Abduction/Adduction AROM
Occurs in the sagittal plane, done in sitting with forearm on the table.
Goniometer:
- Axis: First carpometacarpal joint
- Moving Arm: Parallel to the first metacarpal
- Fixed Arm: Parallel to the second metacarpal
Cervical Flexion AROM
Seated, feet on floor. “Tuck your chin into your chest”.
Goniometer: NIL
Overpressure: Bowing action. One hand on cervical spine with forearm over the thoracic area, other hand on the head producing a very slight force.
Upper Cervical Flexion AROM
Seated, feet on floor. “Give yourself a double chin”
Goniometer: NIL
Overpressure: Not at this stage
Cervical Extension AROM
Seated, feet on floor. “Look up to the roof”
Goniometer: NIL
Overpressure: Not at this stage
Upper Cervical Extension AROM
Seated, feet on floor. “Stick your chin out”
Goniometer: NIL
Overpressure: Not at this stage
Lateral Cervical Flexion AROM
Seated, feet on floor. Take your ear towards your shoulder.
Goniometer: NIL
Overpressure: One hand stabilises the shoulder (but does the depress the shoulder girdle) and the other is on the head guiding it into lateral flexion
Cervical rotation AROM
Seated, feet on floor. “ Look over your right/left shoulder).
Goniometer: NIL
Overpressure: Stand on the side the patient is turning to, place both hands over the patients cheek bones (but do not cover the ears), gently turn until the forearm is along the patients back.
