Practical 2_ROM Flashcards by Danielle Pieri

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

Practical 2_ROM Flashcards

(31 cards)