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