Practical 2_ROM Flashcards
Patient position: sitting with the forearm resting in pronation on tabletop or forearm support; hand elevated or off table; fingers flexed
Ask patient to bend their hand towards the ground
Goniometer axis: adjacent to dorsal wrist over capitate (goniometer upright)
Stationary arm: directly against midline of dorsal forearm
Moving arm: directly against dorsal 3rd metacarpal
Passive end-feel: firm
Wrist Flexion
Typical ROM: 80 degrees
Patient Position: sitting with the forearm resting in supination on tabletop or forearm support; hand elevated or off table; fingers relaxed
Ask patient to bend their hand back away from their body
Goniometer axis: adjacent to volar wrist
Stationary arm: directly against midline of volar forearm
Moving arm: adjacent to volar 3rd metacarpal through web space between ring and middle finger
Passive end-feel: firm
Wrist Extension
Typical ROM: 70 degrees
Patient Position: sitting with the forearm resting in pronation on tabletop or forearm support; wrist neutral; hand elevated or off table; fingers and thumb relaxed
Ask patient to move their hand away from body
Goniometer axis: capitate bone (base of 3rd metacarpal)
Stationary arm: midline of dorsal forearm
Moving arm: 3rd metacarpal
Passive end-feel: firm
Ulnar Deviation
Typical ROM: 30 degrees
Patient Position: sitting with the forearm resting in pronation on tabletop or forearm support; wrist neutral; hand elevated or off table; fingers and thumb relaxed
Ask patient to move their hand towards their body
Goniometer axis: capitate bone (base of 3rd metacarpal)
Stationary arm: midline of dorsal forearm
Moving arm: 3rd metacarpal
Passive end-feel: firm
Radial Deviation
Typical ROM: 20 degrees
Patient Position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral; flexing fingers into a fist position
Ask patient to bend their fingers and make a fist
Goniometer axis: adjacent to dorsal MCP joint (goniometer upright)
Stationary arm: against midline of dorsal metacarpal
Moving arm: against midline of dorsal proximal phalanx
Passive end-feel: firm
MCP Flexion
Typical ROM: 90 degrees
Patient Position: sitting with hand elevated and forearm supported in supination or propped on elbow; wrist neutral
Ask patient to bend their hand back towards the table away from body
Goniometer axis: adjacent to volar MCP joint (goniometer upright)
Stationary arm: against midline of volar metacarpal
Moving arm: against midline of volar proximal phalanx
Passive end-feel: firm
MCP Extension
Typical ROM: 45 degrees
Patient Position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral
Ask patient to spread their fingers apart/bring them together
Goniometer axis: dorsal metacarpal head
Stationary arm: midline of dorsal metacarpal
Moving arm: midline of dorsal proximal phalanx
Passive end-feel: firm
MCP Abduction and Adduction
Typical ROM: 20 degrees
Patient Position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral; flexing fingers into a fist position
Ask patient to bend fingers into fist
Goniometer axis: adjacent to dorsal PIP joint (goniometer upright)
Stationary arm: against midline of dorsal proximal phalanx
Moving arm: against midline of dorsal middle phalanx
Passive end-feel: springy/soft
PIP Flexion
Typical ROM: 0-100 degrees
Patient Position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral
Ask patient to bend finger from fist out
Goniometer axis: adjacent to dorsal PIP joint (goniometer upright)
Stationary arm: against midline of dorsal proximal phalanx
Moving arm: against midline of dorsal middle phalanx
Passive end-feel: firm
PIP Extension
Typical ROM: 0-100 degrees
Patient Position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral; flexing fingers into a fist position
Ask patient to bend fingers into a fist
Goniometer axis: adjacent to dorsal DIP joint (goniometer upright)
Stationary arm: against midline of dorsal middle phalanx
Moving arm: against midline of dorsal distal phalanx
Passive end-feel: springy/soft
DIP Flexion
Typical ROM: 0-90 degrees
Patient Position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral
Ask patient to extend fingers from a bending position
Goniometer axis: adjacent to dorsal DIP joint (goniometer upright)
Stationary arm: against midline of dorsal middle phalanx
Moving arm: against midline of dorsal distal phalanx
Passive end-feel: firm
DIP Extension
Typical ROM: 0-90 degrees
Patient Position: sitting with the forearm and hand supported in neutral; wrist neutral; thumb resting against the lateral aspect of the 2nd metacarpal
Ask patient to bend thumb across palm
Goniometer axis: adjacent to CMC joint midway between frontal and sagittal planes
Stationary arm: parallel to midline of radius
Moving arm: parallel to midline of 1st metacarpal
Passive end-feel: firm
Thumb CMC Flexion
Typical ROM: 15 degrees
*won’t start at 0, so need to subtract
Patient Position: sitting with the forearm and hand supported in neutral; wrist neutral; thumb resting against the lateral aspect of the 2nd metacarpal
Ask patient to extend thumb out to the side
Goniometer axis: adjacent to CMC joint midway between frontal and sagittal planes
Stationary arm: parallel to midline of radius
Moving arm: parallel to midline of 1st metacarpal
Passive end-feel: firm
Thumb CMC Extension
Typical ROM: 20 degrees
*won’t start at 0, so need to subtract
Patient Position: sitting with the forearm and hand supported in neutral; wrist neutral; thumb resting against the lateral aspect of the 2nd metacarpal
Ask patient to move thumb down and to the front
Goniometer axis: adjacent to lateral CMC joint
Stationary arm: midline of lateral aspect of 2nd metacarpal
Moving arm: midline of lateral aspect of 1st metacarpal
Passive end-feel: firm
Thumb CMC Palmar Abduction
Typical ROM: 70 degrees
Patient Position: sitting with the hand elevated and forearm supported in pronation; wrist neutral; thumb resting against the lateral aspect of the 2nd metacarpal
Ask patient to move thumb out to the side
Goniometer axis: adjacent to dorsal CMC joint
Stationary arm: midline of posterior aspect of 2nd metacarpal
Moving arm: midline of posterior aspect of 1st metacarpal
Passive end-feel: firm
Thumb CMC Radial Abduction
Typical ROM: 70 degrees
Patient Position: sitting with the forearm and hand supported in neutral (thumb up); wrist neutral; thumb CMC supported in neutral
Ask patient to bend thumb across palm
Goniometer axis: adjacent to dorsal MCP joint (goniometer upright)
Stationary arm: against midline of dorsal aspect of 1st metacarpal
Moving arm: against midline of dorsal aspect of proximal phalanx
Passive end-feel: springy/soft
Thumb MCP Flexion
Typical ROM: 0-50 degrees
Patient Position: sitting with the forearm and hand supported in neutral (thumb up); wrist neutral; thumb CMC supported in neutral
Ask patient to straighten thumb from a bent position
Goniometer axis: adjacent to dorsal MCP joint (goniometer upright)
Stationary arm: against midline of dorsal aspect of 1st metacarpal
Moving arm: against midline of dorsal aspect of proximal phalanx
Passive end-feel: firm
Thumb MCP Extension
Typical ROM: 0-50 degrees
Patient Position: sitting with the forearm and hand supported in neutral (thumb up); wrist neutral; thumb CMC and MCP supported in neutral
Ask patient to bend thumb
Goniometer axis: adjacent to dorsal IP joint (goniometer upright)
Stationary arm: against midline of dorsal aspect of proximal phalanx
Moving arm: against midline of dorsal aspect of distal phalanx
Passive end-feel: springy/soft
Thumb IP Flexion
Typical ROM: 0-80 degrees
Patient Position: sitting with the forearm and hand supported in neutral; wrist neutral; thumb CMC and MCP supported in neutral
Ask patient to extend thumb
Goniometer axis: adjacent to dorsal IP joint (goniometer upright)
Stationary arm: against midline of dorsal aspect of proximal phalanx
Moving arm: against midline of dorsal aspect of distal phalanx
Passive end-feel: firm
Thumb IP Extension
Typical ROM: 0-80 degrees
Patient Position: supine on plith with knee in midrange flexion (to avoid restriction of the hamstrings as the hip flexes)
Ask patient to bend their knee and lift their leg up
Goniometer axis: greater trochanter
Stationary arm: lateral midline of trunk
Moving arm: lateral midline of femur
Passive end-feel: springy
Hip Flexion
Typical ROM: 120 degrees
Patient Position: prone on plinth with knee extended (to avoid restriction from the rectus femoris as the hip extends)
Ask patient to lift their leg up
Goniometer axis: greater trochanter
Stationary arm: midline of lateral trunk
Moving arm: midline of lateral femur
Passive end-feel: springy
Hip Extension
Typical ROM: 30 degrees
Patient Position: supine on plinth; hip and knee in neutral position and slightly elevated off plinth
Ask patient to move their leg out to the side
Goniometer axis: anterior superior iliac spine (ASIS)
Stationary arm: horizontal across pelvis in line with ASIS on opposite side of pelvis
Moving arm: midline of anterior femur
Passive end-feel: springy
Hip Abduction
Typical ROM: 45 degrees
Patient Position: supine on plinth; hip and knee in neutral position and slightly elevated off plinth; opposite leg abducted or off mat to allow for movement
Ask patient to move their leg in
Goniometer axis: anterior superior iliac spine (ASIS)
Stationary arm: horizontal across pelvis in line with ASIS on opposite side of pelvis
Moving arm: midline of anterior femur
Passive end-feel: springy
Hip Adduction
Typical ROM: 30 degrees
Patient Position: sitting with hips and knees in 90 degrees flexion and legs off plinth
Ask patient to move their foot/lower leg inward
Goniometer axis: patella
Stationary arm: perpendicular to floor
Moving arm: midline of anterior tibia
Passive end-feel: springy
Hip External Rotation
Typical ROM: 45 degrees
Patient Position: sitting with hips and knees in 90 degrees flexion and legs off plinth
Ask patient to move their foot/lower leg outward
Goniometer axis: patella
Stationary arm: perpendicular to floor
Moving arm: midline of anterior tibia
Passive end-feel: springy
Hip Internal Rotation
Typical ROM: 45 degrees
Patient Position: supine with hip neutral; may use towel or other support beneath thigh to elevate foot off mat
Ask patient to bend knee so foot is pulled towards backside
Goniometer axis: lateral epicondyle of femur
Stationary arm: midline of lateral femur
Moving arm: midline of lateral fibula
Passive end-feel: springy
Knee Flexion
Typical ROM: 0-135 degrees
Patient Position: supine with hip neutral; may use towel or other support beneath thigh to elevate foot off mat
Ask patient to extend knee from a bent position to straight
Goniometer axis: lateral epicondyle of femur
Stationary arm: midline of lateral femur
Moving arm: midline of lateral fibula
Passive end-feel: firm/hard
Knee Extension
Typical ROM: 0-135 degrees
Patient Position: supine or sitting, with foot off the end of plinth; knee supported with towel roll in slight flexion (to relax the gastrocnemius and avoid restrictions to ankle and foot mobility); ankle in neutral position (90 degrees relative to tibia)
Ask patient to bend their ankle to touch toes to the floor
Goniometer axis: lateral malleolus
Stationary arm: midline of lateral fibula
Moving arm: parallel to bottom of hindfoot (calcaneus)
Passive end-feel: springy
Ankle Plantar Flexion
Typical ROM: 50 degrees
*start at 90 (0) and subtract
Patient Position: supine or sitting, with foot off end of plinth; knee supported with towel roll in slight flexion (to relax the gastrocnemius and avoid restrictions to ankle and foot mobility); ankle in neutral position (90 degrees relative to tibia)
Ask patient to bend their ankle towards their chest
Goniometer axis: lateral malleolus
Stationary arm: midline of lateral fibula
Moving arm: parallel to bottom of hindfoot (calcaneus)
Passive end-feel: springy
Ankle Dorsiflexion
Typical ROM: 20 degrees
*start at 90 (0) and subtract
Patient Position: prone with foot off the end of the plinth
Ask patient to move their ankle inwards
Goniometer axis: superior calcaneus over the calcaneal (Achilles) tendon
Stationary arm: posterior midline of tibia
Moving arm: posterior midline of calcaneus
Passive end-feel: firm/hard
Ankle Inversion
Typical ROM: 35 degrees
Patient Position: prone with foot off the end of the plinth
Ask patient to move their ankle outwards
Goniometer axis: superior calcaneus over the calcaneal (Achilles) tendon
Stationary arm: posterior midline of tibia
Moving arm: posterior midline of calcaneus
Passive end-feel: firm/hard
Ankle Eversion
Typical ROM: 15 degrees
