AROM / PROM

Question 1

For the safety of yourself and the patient, which aspects do you need to follow?

Answer 1

• Wide base of support
• Appropriate bed height
• Bed brakes are on
• No excessive bending of your spine
• Towel is appropriately draped

Question 2

AROM - Definition

Answer 2

• 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.

Question 3

PROM - Definition

Answer 3

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

Question 4

Wrist ROM

Answer 4

Flexion: 80
Extension: 60
Ulnar deviation: 30
Radial deviation: 20

Question 5

Elbow/forearm ROM

Answer 5

Pronation: 80-90
Supination: 80-90
Flexion: 145
Extension: 0

Question 6

Shoulder ROM

Answer 6

Extension: 45
Flexion: 180
Abduction: 180
Adduction: 0
Internal rotation at 90°: 70
External rotation at 90°: 90

Question 7

Normal End feels - Cyriax vs Kaltenborn

Answer 7

Bone to bone - Hard
Tissue stretch, elastic (soft) - Firm
Tissue stretch, capsular (hard) - Firm
Soft tissue approximation - Soft

Question 8

Goniometry

Answer 8

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.

Question 9

Factors Contributing to Changes/Ability in AROM

Answer 9

• Capsule flexibility
• Fascia
• Bone obstruction or adhesion
• Muscle length
• Muscle strength
• Ligaments
• Fracture
• Pain
• Swelling/edema

Question 10

PROM - Passive Physiological

Answer 10

Movement attained when something or someone moves the

segment/limb while the patient is relaxed. E.g. hip flexion.

Question 11

PROM - Passive Accessory

Answer 11

• movement not under voluntary control

* a component of joints movement that contributes to the overall physiological movement.

Question 12

Special Questions

Answer 12

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?

Question 13

Hip ROM

Answer 13

Flexion: 120-140
Extension: 15-20
Abduction: 40-45
Adduction: 20-30
External rotation: 45
Internal rotation: 45

Question 14

Knee ROM

Answer 14

Flexion: 140
Extension: 0-5

Question 15

Ankle ROM

Answer 15

Dorsiflexion: 20
Plantarflexion: 50

Question 16

Contradictions for AROM/PROM of Spine

Answer 16

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)

Question 17

Thoracic Spine ROM

Answer 17

Flexion: 30-40
Extension: 15-25
Side bending: 15-20
Rotation: 20-35

Question 18

Lumbar Spine ROM

Answer 18

Flexion: 45-55
Extension: 15-35
Side bending: 20
Rotation: 5-10

Question 19

Variations of Lumbopelvic Rythm

Answer 19

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.

Question 20

Cervical Spine ROM

Answer 20

Flexion: 50
Extension: 60
Side bending: 45
Rotation: 80-90 (35-40 for C1-C2)