LL AROM/PROM

Question 1

Knee Flexion AROM

Answer 1

Supine
Fulcrum: Lateral femoral epicondyle
Stationary arm: GT
Moving arm: Lateral malleolus 
Normal ROM: 140°
Bring your heel as close to your bum as possible, foot slides on bed.

Question 2

Knee Flexion PROM

Answer 2

Supine
Holding the calcaneus, forearm under the foot. Other hand starts underneath the knee to lift it up and bring calcaneus closer to bum. Then put hand on top of knee so it’s not in the way and push calcaneus as close to bum as possible for overpressure.
End feel: soft.

Question 3

Knee Extension AROM

Answer 3

Supine, pillow under knee.
Fulcrum: Lateral epicondyle of femur
Stationary arm: GT
Moving arm: Lateral malleolus 
Normal ROM: 0-5°
Ask patient to lift up their lower leg as far as possible, keeping the knee on the pillow.

Question 4

Knee Extension PROM

Answer 4

Supine, can have pillow under the knee.
Hand under the heel and the other stabilising just above the knee. Push the heel up without pushing the knee up.
End feel: firm

Question 5

Knee Internal and External Rotation PROM

Answer 5

Seated, feet hanging down from the bed.
One hand stabilising above the knee, other hand holding distal tibia and rotating it externally or internally.
Make sure there is no hip rotation or pronation/supination of the ankle.
End feel: Firm

Question 6

Plantarflexion AROM

Answer 6

Supine, pillow under knee, calcaneus outside of the bed unsupported.
Ask patient bring foot as far down as possible.
Fulcrum: 1,5 cm below lateral malleolus
Stationary arm: head of fibula
Moving arm: aligned with 5th metatarsal
Goniometer starts in 90°
ROM: 50°

Question 7

Plantarflexion PROM

Answer 7

Supine, pillow under knee, calcaneus outside of bed, unsupported.
One hand on calcaneus pushing upwards, other hand on dorsum of foot pushing downwards.
End feel: firm or hard.

Question 8

Dorsiflexion AROM

Answer 8

Supine, pillow under knee, calcaneus outside of bed, unsupported.
Ask patient to bring foot as far upwards as possible.
Fulcrum: 1,5 cm below lateral malleolus
Stationary arm: head of fibula
Moving arm: aligned with 5th metatarsal
ROM: 20° (0-10° in this position)
Goniometer starts in 90°

Question 9

Dorsiflexion PROM

Answer 9

Supine with pillow under knee, calcaneus outside of bed, unsupported or prone with 90° knee flexion.
One hand stabilises distal tibia other hand surrounds calcaneus with forearm on the bottom of the foot.
Use body weight on forearm to push foot upwards.
End feel: firm

Question 10

Inversion/Eversion PROM

Answer 10

Supine, pillow under knee, calcaneus outside of bed, unsupported.
Practitioner can sit.
One hand stabilising distal tibia, other hand around calcaneus.
Move foot into inversion and eversion. Very little movement, make sure it’s only subtalar movement, not rotation.

Question 11

Hip Flexion AROM

Answer 11

Supine, opposite leg straight. 
Ask patient to bring his knee as close to his chest as possible, with a bent knee. Make sure pelvis is not rotating. 
Fulcrum: GT
Stationary arm: aligned with the trunk
Moving arm: lateral epicondyle of femur
ROM: 140° with a flexed knee.

Question 12

Hip Flexion PROM

Answer 12

Supine, opposite leg straight.
One hand below the knee, pushing it up, can bring it on top of the knee if it’s more comfortable. Other hand surrounding calcaneus with foot resting on forearm. Push leg up with both hands into full flexion.
End feel: soft

Question 13

Hip Extension AROM

Answer 13

Prone.
Ask patient to lift his whole leg up as far as possible without moving the hips so that the pressure on ASIS’s is the same.
Fulcrum: GT
Stationary arm: Aligned with the trunk
Moving arm: Lateral epicondyle of the femur
ROM: 15-20°

Question 14

Hip extension PROM

Answer 14

Prone, knee in 90°.
Hand underneath the knee/lower tight on medial side with lower leg resting on my shoulder. Can have our knee up on the bed. Other hand stabilising the pelvis. Lift leg up as far as possible.
End feel: firm

Question 15

Hip Abduction AROM

Answer 15

Supine with opposite leg hanging off the bed (if comfortable for the patient).
Leg in neutral when starting, make sure knee is always facing up and ask patient to slide his leg as far to the side as possible.
Fulcrum: Ipsilateral ASIS
Stationary arm: Aligned with contralateral ASIS
Moving arm: patella
ROM: 40-45°

Question 16

Hip Abduction PROM

Answer 16

Supine, opposite leg is hanging off the table.
One hand under the knee, the other under the ankle and move the leg as far out as possible, make sure opposite hip is not moving.
End feel: firm .

Question 17

Hip Adduction AROM

Answer 17

Supine with opposite leg hanging off table (if comfortable).
Ask patient to move leg as close to the other one as possible. Make sure other hip is not moving.
Fulcrum: Ipsilateral ASIS
Stationary arm: Aligned with contralateral ASIS
Moving arm: Patella
ROM: 20-30°

Question 18

Hip Adduction PROM

Answer 18

Supine, opposite leg hanging of table if comfortable, otherwise flex hip aswell (not pure adduction).
Stand on opposite side of the bed. Hold under ankle and knee, lift up slightly and bring leg as close to you as possible.
Make sure opposite hip is not moving.
End feel: firm if there is no soft tissue limitation.

Question 19

Hip Internal/External Rotation AROM

Answer 19

Seated, thighs fully supported on bed.
Ask patient to bring their leg outward (internal rotation) or inward (external rotation) as much as possible without lifting their hip up.
Fulcrum: patella
Stationary arm: perpendicular to the ground
Moving arm: between malleoli
ROM: 45°

Question 20

Hip Internal/External Rotation PROM

Answer 20

Supine with 90° hip flexion.
Knee stabilised with one hand on medial side of knee and trunk of therapist on lateral side. Other hand around calcaneus with foot resting on forearm. Therapist can have knee up on bed. Move lower leg outward (internal rotation) or inward (external rotation). Make sure knee stays above hip at all times.
End feel: firm.