“Joint ROM is an integral part of human movement. In order for an individual to move efficiently and with minimal effort, full ROM across joints is imperative. In addition, appropriate ROM allows joints to adapt more easily to stresses imposed on the body and decreases the potential for injury. Full ROM across a joint is dependent on two components: joint ROM and muscle length.”

From: Nancy Berryman, PhD, PT., Bandy, William D. PhD, PT., Joint Range of Motion and Muscle Length Testing, 2nd Edition, 2010, Page 3

This course is for practitioners who have completed the Muscle System Specialist Course either on-line or live. It is provided to improve practitioner understanding of the performance of the Phase 1 Limb/Trunk ROM assessments.

This course contains a video of each of the Phase 1 Limb and Trunk Range of Motion (ROM) Assessments. Each video begins with the actual body and then merges to the skeleton so that you can get a sense of what specific joint motion is being assessed. An accompanying document is provided listing all of the kinematics and the anatomically named muscles that are approximating their attachments for the given ROM. Feel free to download this document.

NOTE: In the kinematic description of each ROM assessment you will see the past participle suffix used (-ed) to denote a joint position and the present participle suffix (-ion) used to define the joint range of motion/action being assessed.

NOTE: There may be some videos for a given ROM missing.

A note about the visual estimation of angular displacement.

The use of a goniometer or inclinometer is optional. The use of these devices have some significant error and can be time consuming to set up. For the purposes of this assessment this level of precision is not required as we are seeking to identify angular displacements and comparing them left to right and looking for obvious asymmetries in displacement. Nitpicking for a few degrees in order to increase precision does not necessarily contribute much to what we are trying to accomplish.

“Historically, early reports on procedures for the examination of range of motion (ROM) suggested using visual approximation. In fact, as late as the 1960s, the initial edition (1965) of a text for measuring joint ROM published by the American Academy of Orthopaedic Surgeons (AAOS) suggested that visual estimation is as good as, or better than, goniometric measurement. This opinion was shared by Rowe, who suggested that visual estimation was especially important when bony landmarks were difficult to see or palpate. In contrast, Moore and Salter stated that goniometer measurements are more reliable than visual estimates.”

Reese, Nancy Berryman, PhD, PT., Bandy, William D. PhD, PT., Joint Range of Motion and Muscle Length Testing, 2nd Edition, 2010, Page 3

The key is being able to estimate the location of the axis of rotation for the specified joint/limb/trunk motion. It is always perpendicular to the plane of the the lever motion. Estimating the degrees of displacement is best performed when you can orient your line of site to look "down the axis" and perpendicular to the lever (limb/trunk) plane of motion and establish a zero degree starting position.

Here is an example diagram of the concept of looking down the axis:

Here is a diagram of an Apples-To-Apples ROM comparison and ROM Symmetry: Apples-To-Apples means that each of the two mirror image motions to be assessed and compared have the same relative starting position, the relative same joint axis, and that each structure has not been altered in any way by surgery, joint replacement, or congenital deformity.

Here is a diagram of an Apples-To-Apples Asymmetry of ROM between two mirror image joint motions:

Here is a diagram of a Non Apples-To-Apples ROM comparison: The axes are not the same and the starting positions are not the same between the two.

THE COMMENTS SECTION FOR EACH ROM IS TURNED ON. PLEASE PROVIDE ANY INPUT YOU CAN THINK OF THAT MAY MAKE THE DESCRIPTIONS BETTER AND EASIER TO UNDERSTAND.