AROM / PROM Flashcards
For the safety of yourself and the patient, which aspects do you need to follow?
- Wide base of support
- Appropriate bed height
- Bed brakes are on
- No excessive bending of your spine
- Towel is appropriately draped
AROM - Definition
- Active ROM or active movement tests (AMT’s) provide information on the amount of movement produced actively by the joint.
- Each joint has a ‘normal’ range of motion.
PROM - Definition
Provide information on the amount of movement produced
passively by someone other than the patient. The limb is in a relaxed state, active (muscle component) does not contribute to the movement.
2 categories:
- Passive physiological
- Passive accessory - joint play
Wrist ROM
Flexion: 80
Extension: 60
Ulnar deviation: 30
Radial deviation: 20
Elbow/forearm ROM
Pronation: 80-90
Supination: 80-90
Flexion: 145
Extension: 0
Shoulder ROM
Extension: 45 Flexion: 180 Abduction: 180 Adduction: 0 Internal rotation at 90°: 70 External rotation at 90°: 90
Normal End feels - Cyriax vs Kaltenborn
Bone to bone - Hard
Tissue stretch, elastic (soft) - Firm
Tissue stretch, capsular (hard) - Firm
Soft tissue approximation - Soft
Goniometry
Objectively measures active and passive ROM.
Has a stationary arm and a moving arm.
Use anatomical landmarks for accurate measurements.
3 measurements for each motion and compare to other side.
Factors Contributing to Changes/Ability in AROM
- Capsule flexibility
- Fascia
- Bone obstruction or adhesion
- Muscle length
- Muscle strength
- Ligaments
- Fracture
- Pain
- Swelling/edema
PROM - Passive Physiological
Movement attained when something or someone moves the
segment/limb while the patient is relaxed. E.g. hip flexion.
PROM - Passive Accessory
- movement not under voluntary control
* a component of joints movement that contributes to the overall physiological movement.
Special Questions
Do you have a recent injury? History of bone disease? Diagnosed with rheumatoid arthritis? juvenile arthritis? Diagnosed with problems in the spine? Pins and needles in both hands and feet? Do you have paraesthesia/anaesthesia? Feel weakness or numbness in UL/LL? History of cancer? unexplained recent weight loss?
Hip ROM
Flexion: 120-140 Extension: 15-20 Abduction: 40-45 Adduction: 20-30 External rotation: 45 Internal rotation: 45
Knee ROM
Flexion: 140
Extension: 0-5
Ankle ROM
Dorsiflexion: 20
Plantarflexion: 50
Contradictions for AROM/PROM of Spine
Vertebral fracture, osteoporosis, or risk of pathological fracture
Acute soft tissue injury
Ankylosing spondylitis
Instability (lax ligaments) – particularly Cx!!
Anti-coagulant therapy
Long-term steroid use (risk of osteoporosis)
Spondylolisthesis
Vertebral Artery anomaly
Acute stage RA
If patient says yes to any of the Lx ‘special questions’
VBI (Cx! 5Ds and 3Ns)
Thoracic Spine ROM
Flexion: 30-40
Extension: 15-25
Side bending: 15-20
Rotation: 20-35
Lumbar Spine ROM
Flexion: 45-55
Extension: 15-35
Side bending: 20
Rotation: 5-10
Variations of Lumbopelvic Rythm
Normal: 45° lumbar flexion, 60° hip flexion.
Limited hip flexion with excessive lumbar flexion: ASIS not pointing down. Hip arthritis or tight hamstrings?
Limited lumbar flexion with excessive hip flexion: Lower back completely straight, ASIS facing downwards.
Cervical Spine ROM
Flexion: 50
Extension: 60
Side bending: 45
Rotation: 80-90 (35-40 for C1-C2)
