Range of motion

Contents

Definition
Type of ROM
Components of range of motion
Goniometry
Measurement
 Definition

Range of motion (ROM) is the term

that is used to describe the amount
of movement you have at each joint.
 Type of ROM

Active Range of Motion

Passive Range of Motion
 Active Range of Motion

Dynamic flexibility
Physiological movements
Joint motion that occurs because of
muscle contraction
 Passive Range of Motion

Static flexibility
Movement that is performed
completely by the examiner
Endpoints in the range of motion
 Components of range of
motion
Sex
Age
Race
Shape of the bone and cartilage
Muscle power and tone
Muscle bulk
Ligaments and joint capsule laxity
Extensibility of the skin and subcutaneous
tissue
 Goniometry

measuring the available range of

motion or the position of a joint
typically this is a measure of PASSIVE
motion
If you are documenting active range
of motion, document that this is so
 Goniometry

Stationary arm : placed parallel with

the longitudinal axis of the fixed part
Movable arm : along the longitudinal
axis of the movable segment
Axis of rotation(pin) : at the
intersection of the stationary &
movable arms
Goniometry
 Goniometry procedure
position joint in zero position and stabilize
proximal joint component
move joint to end of range of motion (to
assess quality of movement)
determine end-feel at point where
measurement will be taken ( at end of
available range of motion)
identify and palpate bony landmarks
align goniometer with bony landmarks while
holding joint at end of range
read the goniometer
record measurement (e.g. elbow flexion =
130o)
 Type of Goniometer
full-circle manual
universal goniometer
most versatile &popular

Gonoimeters for single

joint motion
 Type of Goniometer
fluid inclinometer

pendulum inclinometer

electrogoniometer
 Measurement

Upper Ext.

Lower Ext.

Spine
Upper Ext.
Test Position
Subject supine
Flatten lumbar spine (flex knees)
Shoulder no abduction, adduction or
rotation
(note: to measure gleno-humeral
motion, stabilize scapula)
Shoulder flexion (0~180)
Goniometer Alignment
Axis center of humeral head near
acromion process
Stationary arm parallel mid-axillary
line
Moving arm aligned with midline of
humerus (lateral epicondyle)
Shoulder extension (0~60)
Test Position
Subject prone
Shoulder no abduction,
adduction or rotation
(note: to measure gleno-
humeral motion, stabilize
scapula)

Goniometer Alignment
Axis center of humeral head near acromion process
Stationary arm parallel mid-axillary line
Moving arm aligned with midline of humerus
(lateral epicondyle)
Shoulder abduction (0~180)
Test Position
Subject supine
Shoulder 0 flexion and extension
Shoulder laterally (externally) rotated
Shoulder abducted
Stabilize thorax (note: to measure
gleno-humeral motion, stabilize
scapula)
 Shoulder abduction (0~180)
Goniometer Alignment
Axis center of humeral head near
acromion process
Stationary arm parallel to sternum
Moving arm aligned with midline of
humerus
Shoulder external rotation (0~90)
Test Position
Subject supine
Shoulder 90 abduction
Forearm neutral
Elbow flexed 90
Stabilize arm

Goniometer Alignment
Axis olecranon process of ulna
Stationary arm aligned vertically
Moving arm aligned with ulna (styloid process)
Shoulder internal rotation (0~70)
Test Position
Subject supine
Shoulder 90 abduction
Forearm neutral
Elbow flexed 90
Stabilize arm

Goniometer Alignment
Axis olecranon process of ulna
Stationary arm aligned vertically
Moving arm aligned with ulna (styloid process)
 Elbow flexion (0~150)
Test Position
Subject supine
Shoulder neutral (arm at
side)
Forearm supinated
Elbow flexed
Stabilize arm

Goniometer Alignment
Axis lateral epicondyle of humerus
Stationary arm aligned with humerus (center of
acromion process)
Moving arm aligned with radius (styloid process)
 Elbow extension (150~0)
Test Position
Subject supine
Shoulder neutral (arm at side)
Forearm supinated
Elbow extended
Stabilize arm

Goniometer Alignment
Axis lateral epicondyle of humerus
Stationary arm aligned with humerus (center of
acromion process)
Moving arm aligned with radius (styloid process)
 Forearm pronation (0~80)
Test Position
Subject sitting
Shoulder neutral (arm at side)
Elbow flexed to 90
Stabilize arm
Pronate forearm

Goniometer Alignment
Axis lateral to ulnar styloid
Stationary arm parallel to humerus
Moving arm aligned with dorsum of radius
Forearm supination (0~80)
Test Position
Subject sitting
Shoulder neutral (arm at side)
Elbow flexed to 90
Stabilize arm
Supinate forearm

Goniometer Alignment
Axis medial to ulnar styloid
Stationary arm parallel to humerus
Moving arm aligned with ventral aspect of radius
 Wrist flexion (0~80)
Test Position
Subject seated
Forearm stabilized on table
Flex wrist
(fingers relaxed)

Goniometer Alignment
Axis lateral wrist (triquetrum)
Stationary arm aligned with ulna
Moving arm aligned with fifth metacarpal
 Wrist extension (0~70)
Test Position
Subject seated
Forearm stabilized on
table
Extend wrist
(fingers relaxed)

Goniometer Alignment
Axis lateral wrist (triquetrum)
Stationary arm aligned with ulna
Moving arm aligned with fifth metacarpal
 Radial deviation (0~20)
Test Position
Subject sitting with
forearm resting on table
Stabilize forearm to
prevent pronation or
supination

Goniometer Alignment
Axis capitate
Stationary arm aligned with forearm (lateral
epicondyle)
Moving arm aligned with metacarpal of middle
finger
 Ulnar deviation (0~30)
Test Position
Subject sitting with
forearm resting on table
Stabilize forearm to
prevent pronation or
supination

Goniometer Alignment
Axis capitate
Stationary arm aligned with forearm (lateral
epicondyle)
Moving arm aligned with metacarpal of middle
finger
 Lower Ext.
Test Position
Subject supine
Allow knee to flex (to avoid
limitation by tight
hamstrings)
Stabilize pelvis to prevent
rotation, Hip flex.

Hip flexion (0~120)

Goniometer Alignment
Axis greater trochanter
Stationary arm aligned with midline of plevis
Moving arm aligned with femur (lateral epicondyle)
 Hip extension (0~30)
Test Position
Subject prone
Stabilize pelvis to prevent
rotation
Extend hip

Goniometer Alignment
Axis greater trochanter
Stationary arm aligned with midline of plevis
Moving arm aligned with femur (lateral
epicondyle)
 Hip abduction (0~45)
Test Position
Subject supine
Stabilize pelvis to
prevent pelvic list
Abduct hip

Goniometer Alignment
Axis anterior superior iliac spine (ASIS)
Stationary arm aligned with opposite ASIS
Moving arm aligned with femur (center of
patella)
 Hip adduction (0~30)
Test Position
Subject supine
Stabilize pelvis to prevent
pelvic list
Abduct opposite hip (to allow
room for tested limb to adduct)
Adduct hip

Goniometer Alignment
Axis anterior superior iliac spine (ASIS)
Stationary arm aligned with opposite ASIS
Moving arm aligned with femur (center of patella)
 Hip internal rotation
(0~45)
Test Position
Subject sitting on table
knee flexed
Stabilize distal thigh
medially (internally)
rotate hip

Goniometer Alignment
Axis center of patella
Stationary arm aligned vertically
Moving arm aligned with leg (crest of tibia)
 Hip external rotation (0~45)
Test Position
Subject sitting on table
knee flexed
Stabilize distal thigh
hip laterally (externally)
rotated

Goniometer Alignment
Axis center of patella
Stationary arm aligned vertically
Moving arm aligned with leg (crest of tibia)
 Knee flexion (0~135)
Test Position
Subject supine
Allow hip to flex
Flex knee

Goniometer Alignment
Axis lateral epicondyle of femur
Stationary arm aligned with greater trochanter
Moving arm aligned with lateral malleolus
 Knee extension (135~0)
Test Position
Subject prone
Stabilize femur
Extend Knee

Goniometer Alignment
Axis lateral epicondyle of femur
Stationary arm aligned with greater trochanter
Moving arm aligned with lateral malleolus
 Ankle plantar flexion (0~50)
Test Position
Subject supine
Extend knee
Stabilize leg
Plantarflex ankle

Goniometer Alignment
Axis lateral malleolus
Stationary arm aligned with fibular head
Moving arm aligned with fifth metatarsal
 Ankle dorsiflexion (0~20)
Test Position
Subject prone
Flex knee
Stabilize sub-talar in neutral
Dorsiflex ankle by pushing
through 5th metatarsal head

Goniometer Alignment
Axis lateral malleolus
Stationary arm aligned with fibular head
Moving arm aligned with fifth metatarsal
 Ankle inversion (0~35)
Test Position
Subject prone
Stabilize tibia in sagittal
plane (rotate hip or
pelvis to align tibia)
Invert calcaneus

Goniometer Alignment
Axis automatically positioned by alignment of
goniometer arms
Stationary arm aligned with midline of leg
Moving arm aligned with midline of calcaneus
 Ankle eversion (0~15)
Test Position
Subject supine
Stabilize calcaneus
and talus
Evert forefoot

Goniometer Alignment
Axis automatically positioned by alignment of
goniometer arms
Stationary arm aligned with midline of leg
Moving arm aligned with plantar aspect of
metatarsal heads
 Spine
CERVICAL SPINE FORWARD BENDING (flexion)

Test Position
Subject sitting with lumbar
and thoracic spines
supported
Stabilize lumbar and
thoracic spines
Flex cervical spine

Goniometer Alignment
Axis external auditory meatus
Stationary arm vertical
Moving arm aligned with nostrils
CERVICAL SPINE BACKWARD BENDING
(extension)
Test Position
Subject sitting with lumbar and
thoracic spines supported
Stabilize lumbar and thoracic
spines
Mouth relaxed and slightly open
Extend cervical spine

Goniometer Alignment
Axis external auditory meatus
Stationary arm vertical
Moving arm aligned with nostrils
CERVICAL SPINE SIDEBENDING
Test Position
Subject sitting with lumbar
and thoracic spines supported
Stabilize lumbar and thoracic
spines
Sidebend cervical spine

Goniometer Alignment
Axis spinous process of C7
Stationary arm spinous processes of thoracic spine
Moving arm posterior midline of head at occipital
protuberance
 CERVICAL SPINE ROTATION
Test Position
Subject sitting with lumbar
and thoracic spines supported
Stabilize lumbar and thoracic
spines
Rotate cervical spine

Goniometer Alignment
Axis center of superior aspect of head
Stationary arm aligned with acromion processes
Moving arm aligned with tip of nose
 THORACO-LUMBAR SPINE
FORWARD BENDING (flexion)

Test Position Tape Measure

Subject standing Alignment
Flex thoracic and Spinous processes of
lumbar spines C7 and S1
 THORACO-LUMBAR SPINE
BACKWARD BENDING
(extenion)

Test Position Tape Measure

Subject standing Alignment
Extend thoracic and Spinous processes of
lumbar spines C7 and S1
 THORACO-LUMBAR SPINE
SIDEBENDING
Test Position
Subject standing
Stabilize pelvis
Sidebend thoracic and
lumbar spines

Goniometer Alignment
Axis - S1 spinous process
Stationary arm - vertical
Moving arm - C7 spinous process
 THORACO-LUMBAR SPINE
ROTATION
Test Position
Subject sitting
Stabilize pelvis
Do not allow sidebending, forward
bending or backward bending
Rotate thoracic and lumbar spines

Goniometer Alignment
Axis - center of superior aspect of head
Stationary arm - aligned with anterior superior iliac spines
Moving arm - aligned with acromion processes