ROM Assessment General Guidlines

Question 1

Define range of motion (ROM)

Answer 1

• arc of motion in degrees between the beginning and the end of a motion in a specific plane

Question 2

Define active range of motion (AROM)

Answer 2

• arc of motion produced by the individual’s voluntary unassisted muscle contraction

Question 3

Define active assisted range of motion (AAROM)

Answer 3

• arc of motion produced by the individual’s muscle contraction assisted by an external force

Question 4

What are some causes of an AROM limitation

Answer 4

• pain/discomfort during motion
• structural blocks
• joint effusion
• edema
• capsular tightness
• lack of muscle length
• excessive muscular or adipose tissue
• inadequate force production

Question 5

Define passive range of motion (PROM)

Answer 5

• arc of motion produced by the application of an external force by the examiner

Question 6

Define end-feel

Answer 6

End-feel: feeling of a barrier to further motion experienced by the examiner

Question 7

When should you perform a PROM assessment

Answer 7

• when AROM is limited or uncomfortable for the patient

Question 8

What are the normal end-feels

Answer 8

Bone to bone: hard, painless, & no give
Soft tissue approximation: mushy & forgiving sensation
Tissue stretch: elastic, soft, & significant give

Question 9

What are some abnormal end-feels

Answer 9

Springy block: rebound feeling & painful
Muscle spasm: brief involuntary muscle spasm in response to pain
Empty: no resistance but patient requests to stop the motion due to pain

Question 10

Define hypomobility

Answer 10

• decrease in ROM that is substantially less than normal values for that joint, given the individual’s age & gender

Question 11

Define hypermobility

Answer 11

• ability of one or more joints to actively or passively move beyond normal limits given the individual’s age and gender

Question 12

What are the general rules of thumb for motion assessment

Answer 12

• minimize position changes
• test unaffected side first
• test AROM
• test PROM of joints with below normal range or pain with the motion
• assess ROM of the affected joint & the joints immediately proximal & distal
• assess joints required for major functional motions
• begin with the patient in the best postural alignment possible
• stand directly in front of the patient & demonstrate the motion
• avoid using PT terminology

Question 13

Precautions for ROM & muscle length

Answer 13

• joint dislocation or subluxation
• unstable bone fractures
• rupture of tendon or ligament
• infectious or acute inflammatory process
• severe osteoporosis
• acute injury or recent surgery
• presence of pain or muscle spasms
• immobilized joints

Question 14

Normal ROM values for cervical spine

Answer 14

Flexion: 40 degrees
Extension: 50 degrees
Lateral flexion: 22 degrees
Rotation: 50 degrees