Range of Motion (ROM) Testing
Testing range of motion is a bilateral procedure performed, passively, to assess joint restrictions. Using a universal goniometer you can examine and gather quantitative data to record degree flexion and extension in the knee. During assessment with this tool you can also collect qualitative information. Significant lack these motions will be easily observed with the eye.
Knowing how to administer this measurement tool is rather simple, as long as one is able to line up the stationary and moveable arms of a goniometer with appropriate segments and at the correct axis.
Knee Flexion-
7. Important Considerations- always remember to record the initial reading before the procedure (since it might not necessarily be at 0). Restrict the hip from flexing further than 90 degrees to gather an accurate range of motion for flexion of the knee. Always compare bilaterally!
Knee Extension-
7. Important Considerations- always remember to record the initial reading. In a relaxed position the knee will typically not be at 0 degrees but rather in some slight degree of flexion. After applying downward pressure, record the degree of extension following the neutral position.
(Norkin and White 2009)
Knowing how to administer this measurement tool is rather simple, as long as one is able to line up the stationary and moveable arms of a goniometer with appropriate segments and at the correct axis.
Knee Flexion-
- Testing Position- Have the subject lie supine, with the knee fully extended. Position the hip in 0 degrees of extension, abduction, and adduction. Placing a towel roll under the ankle will allow the knee to extend as much as possible.
- Stabilization- Stabilize the femur, preventing rotation, abduction, and adduction at the hip.
- Procedure- Hold the subject's ankle in one hand and the anterior thigh in the other. Guide the subject's thigh to approximately 90 degrees of flexion while moving the knee into flexion as well. Terminal knee flexion will occur when resistance is felt and the hip attempts to counter the resistance by flexing further than 90 degrees.
- Normal End-Feel- From the bulk of soft tissue of the calve and posterior thigh musculature, a typical end-feel will be soft.
- Goniometer Alignment-
- The fulcrum will be centered over the lateral epicondyle of the femur.
- Align the proximal (or stationary) arm with the lateral mid-line of the femur, using the greater trochanter as a reference.
- Align the moveable arm with the lateral mid-line of the fibula, using the lateral malleolus and fibular head as a reference.
7. Important Considerations- always remember to record the initial reading before the procedure (since it might not necessarily be at 0). Restrict the hip from flexing further than 90 degrees to gather an accurate range of motion for flexion of the knee. Always compare bilaterally!
Knee Extension-
- Testing Position- Have the subject lie supine with their knee's fully extended. Place a towel roll under the ankle's to allow them to full extend.
- Stabilization- Use one hand to stabilize the femur.
- Procedure- While stabilizing the femur, use the other hand to apply downward pressure on the tibia until resistance is felt.
- Normal End-Feel- The end-feel for knee extension is firm because of the tension from the posterior joint capsule, the oblique and arcuate popliteal ligaments, the collateral ligaments, and the anterior and posterior cruciate ligaments.
- Goniometer Alignment-
- The fulcrum will be placed over the lateral epicondyle of the femur
- The stationary arm will align with the mid-line of the femur, using the greater trochanter as a reference.
- The moveable arm will align with the fibula, using the lateral malleolus and fibular head as a reference.
7. Important Considerations- always remember to record the initial reading. In a relaxed position the knee will typically not be at 0 degrees but rather in some slight degree of flexion. After applying downward pressure, record the degree of extension following the neutral position.
(Norkin and White 2009)