ROM GONI

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Author:
prestoncas
ID:
185952
Filename:
ROM GONI
Updated:
2012-11-29 00:34:58
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ROM GONI
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Description:
Baker Flint Fall 2012 TherEx ROM GONI
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  1. Shoulder Horizontal Abduction
    • TP: Supine č the hips & knee bent & the shoulder abducted 90° & the elbow flexed 90°
    • Stabilization: @ the thorax to prevent lateral lumbar flexion or trunk roll
    • Fulcrum: Superior surface of the acromion
    • Stationary Arm: Perpendicular to the floor projecting towards the floor
    • Moving Arm: // to the longitudinal axis of the humerus pointing toward the lateral epicondyle
    • Expected ROM: 45°
    • Substitutions: Trunk Rotation
  2. Shoulder Extension
    • TP: Prone, the face turned away from shoulder being tested. *pillow is not used. Palm of hand faces the body.
    • Stabilizeation: @ the inferior angel of the scapula or @ the aceromion  to prevent elevation & anterior tilting
    • Fulcrum: Lateral aspect of the of the greater tubrical
    • Stationary Arm: // to mid-axillary line of the trunk
    • Moving Arm: // to longitudinal axis of the humerus pointing toward the lateral epicondyle
    • Expected ROM: 60°
    • Substitutions: scapular elevation & anterior tilting
    • *Maintain slight elbow flexion so that long head of triceps does not restrict motion
  3. Shoulder Abduction
    • vTP: Supine č the hips & knees bent. Arm is in the anatomical position č the shoulder externally rotated
    • Stabilization: @ the scapula/thorax
    • Fulcrum: Anterior aspect of the shoulder, close to the acromion process
    • Stationary Arm: // to mid-line of the sternum
    • Moving Arm: Anterior aspect of the upper arm // to longitudinal axis of the humerus
    • Expected ROM: 90° of pure GH abd; 150° č GH, AC, SC, & scapulothoracic contribution; 180° if lumbar lateral flexion is allowed
    • Substitutions: Lumbar lateral flexion
    • *Excessive scapular ↑ rotation contribution to movement
  4. Shoulder IR
    • vTP: Supine č the shoulder & elbow abd 90°. The forearm is midway between pronation/supination č the entire humerus supported by the table.
    • Stabilization: @ the distal humerus through the full ROM & @ the thorax/scapula @ the end ROM
    • Fulcrum: The olecranon process of the ulna projecting through the humeral shaft toward the humeral head
    • Stationary Arm: // to the supporting surface or perpendicular to the floor
    • Moving Arm: // to the longitudinal axis of the ulnar pointing toward the styloid process
    • Expected ROM: 70° internal rotation; 90° external rotation
    • Substitutions: Elbow extension, scapular elevation, tilting, or protraction
    • *The amount of motion available is influenced by the position of abd in the frontal plane & whether the measurements are performed in the scapular or frontal planes. Specifically record the position during measurement.
  5. Shoulder Flexion
    • TP: Supine č hips & knees bent & lumbar spine flat. Arm is @ the side č the palm in & the thumb ↑
    • Stabilization: Body weight should stabilize scapula but manual stabilization may be required to prevent excessive scapular rising & tipping posteriorly
    • Fulcrum: Lateral aspect of the of the greater tubrical
    • Stationary Arm: // to mid-axillary line of the trunk
    • Moving Arm: // to longitudinal axis of the humerus pointing toward the lateral epicondyle
    • Expected ROM: 120° of pure GH flexion; 150°  č GH, AC, SC, & scapulothoracic contribution;180° if lumbar hyperextension permitted
    • Substitutions: Lumbar hyperextension, Scapular tipping
    • *Maintain slight elbow flexion so that long head of triceps does not restrict motion
  6. Elbow Flexion
    • TP: Supine or sitting č the arm // to the midline & the forearm in the anatomical position
    • Stabilization: @ the humerus
    • Fulcrum: Over the lateral epicondyle of the humerus
    • Stationary Arm: // to the longitudinal axis of the humerus pointing towards the tip of the acromion
    • Moving Arm: // to longitudinal axis of the radius pointing toward the styloid process of the radius
    • Expected ROM: 150°
    • Stabilization: Prevent shoulder flexion
    • *Note: If he forearm cannot be placed in full supination, note the position of testing
  7. Elbow Extension
    • TP: Supine or sitting č the arm // to the midline & the forearm in the anatomical position.
    • Stabilization: Examiner manually stabilizes the humerus
    • Fulcrum: Over the lateral epicondyle of the humerus
    • Stationary Arm: // to the longitudinal axis of the humerus pointing towards the tip of the acromion
    • Moving Arm: // to the longitudinal axis of the radius pointing towards the styloid process of the radius
    • Expected ROM: 0° in males; 10-15° in females is common.
    • Stabilization: Prevent scapular tilting
    • *Note: if hyperextension range is available, a towel roll can be placed under the humerus
  8. Forearm Pronation/Supination
    • TP: Sitting č the shoulder add to the side & the elbow flexed 90° č the forearm in the neutral “hand shake” midposition.
    • Stabilization: @ the humerus & does not allow abd or add
    • Fulcrum: Just medial & posterior (supination) or lateral & posterior (pronation) to the ulnar styloid process
    • Stationary Arm: // to the long axis of the humerus
    • Moving Arm: // to the dorsal forearm surface in pronation & volar surface in supination
    • Expected ROM: 80-90° of pronation and supination
    • Substitutions:
    • Supination: wrist extension & or radial deviation, add & ER of the shoulder, & ipsilateral trunk lateral flexion
    • Pronation: wrist flexion &/or ulnar deviation, abd & IR of the shoulder, &/or contralateral trunk lateral flexion
  9. Wrist Flexion-Extension
    • TP: Elbow flexed 90°; Wrist over edge of table č forearm in full pronation
    • Stabilization: Forearm stabilized to prevent pronation or supination
    • Fulcrum: Lateral placement over the triquetrum
    • Proximal Arm: // č the ulna bisecting the ulnar styloid, radial head, & lateral epicondyle
    • Distal Arm: // to longitudinal axis of the 5th metacarpal
    • Expected ROM: 75° for both flexion & extension
    • Substitutions: Excessive radial or ulnar deviation
  10. Wrist Radial-Ulnar Deviation
    • TP: Elbow flexed 90°; Wrist over edge of table č forearm in full pronation
    • Stabilization: @ Forearm to prevent pronation, supination, or shoulder rotation
    • Fulcrum: Dorsal aspect over the capitate
    • Proximal Arm: Dorsal midline of the forearm
    • Distal Arm: // to longitudinal axis of the 3rd metacarpal
    • Expected ROM: 20° radial deviation & 30° ulnar deviation
    • Substitutions: MCP abduction or adduction
  11. Hip Flexion
    • TP: Supine č hips & knees in neutral rotation
    • Stabilization: Trunk stabilized by body position
    • Fulcrum: Femoral Greater Trochanter
    • Proximal Arm: // to mid~axillary line of the trunk
    • Distal Arm: // to longitudinal axis of the femur in line č lateral femoral condyle
    • Expected ROM: 120°
    • Substitutions: Lumbar Spine flexion
  12. Hip Extension
    • TP: Prone č hips & knees in neutral & feet extending off end of the table
    • Stabilization: @ Pelvis through straps or manual fixation
    • Fulcrum: Greater Trochanter
    • Proximal Arm: // to mid-axillary line of the trunk
    • Distal Arm: // to longitudinal axis of femur in line č lateral femoral condyle
    • Expected ROM: 30°
    • Substitutions: Lumbar spine extension
  13. Hip Abduction
    • TP: Supine č hips & knees in neutral & pelvis level
    • Stabilization: Opposite hip
    • Fulcrum: ASIS on measured side
    • Proximal Arm: Along a line between the two ASIS’s
    • Distal Arm: // to the long axis of the femur
    • Expected ROM: 45°
    • Substitutions: Hip external rotation, knee flexion/internal rotation, or lateral pelvic tilt
  14. Hip Adduction
    • TP: Supine č the opposite extremity abd
    • Stabilization: prn
    • Fulcrum: ASIS on measured side
    • Proximal Arm: Along a line between the two ASIS’s
    • Distal Arm: // to the long axis of the femur
    • Expected ROM: 30°
    • Substitutions: Hip IR or lateral pelvic tilt
  15. Hip Internal & External Rotation
    • TP: Sitting č the hip & knee flexed 90°. Opposite extremity abd & resting on a foot stool
    • Stabilization: prevent thigh abd/add
    • Fulcrum: mid-patella
    • Proximal Arm: Perpendicular to the floor
    • Distal Arm: // to long axis of the tibia
    • Expected ROM: 45° internal and external ROM
    • Substitutions: thigh abd/add
  16. Knee Flexion
    • TP: Supine or reclined č hip & knee in neutral rotation
    • Stabilization: Trunk & pelvis stabilized by body weight & position
    • Fulcrum: Lateral epicondyle of the femur
    • Proximal Arm: // to the long axis of the femur & pointing @ the greater trochanter
    • Distal Arm: // to the long axis of the fibula & pointing @ the lateral malleolus
    • Expected ROM: 135°
  17. Knee Extension
    • TP: Supine č hips & knees in neutral rotation; distal leg on bolster
    • Stabilization: Trunk & pelvis stabilized by body weight & position
    • Fulcrum: Lateral Epicondyle of the femur
    • Proximal Arm: // to the long axis of the femur & pointing @ the greater trochanter
    • Distal Arm: // to the long axis of the fibula & pointing @ the lateral malleolus
    • Expected ROM: 0°. Hyperextension may be present up to 10-15°
  18. Tibial Internal/External Rotation
    • TP: Prone č knee flexed 90°
    • Stabilization: @ the femur
    • Fulcrum: //to the long axis of the tibia
    • Stationary Arm: // to the long axis of the tibia
    • Moving Arm: // to & in line č the bisection of the heel & the 2nd metatarsal shaft
    • Expected ROM: 30° internal & 40° external ROM. It is difficult to establish neutral rotation & it may be more test-retest reliable to record the total ROM
  19. Dorsiflexion
    • TP: Prone č ankle off edge of table & knee extended
    • Stabilization: @ tibia against the supporting surface
    • Fulcrum: Lateral calcaneus @ bisection of fibula & 5th  metatarsal
    • Proximal Arm: // to the long axis of the fibula & pointing towards the fibular head
    • Distal Arm: // to the long axis of the 5th  metatarsal
    • Expected ROM: 10° č knee extended; increased to 20° č the knee flexed
    • Substitutions: Therapist must monitor for subtalar pronation. Watching for calcaneal eversion can monitor this.
  20. Plantarflexion
    • TP: Prone or supine č the knee in slight flexion
    • Stabilization: @ the lower leg
    • Fulcrum: Lateral calcaneus @ bisection of fibula & 5th  metatarsal
    • Proximal Arm: // to the long axis of the fibula & pointing towards the fibular head
    • Distal Arm: // to the long axis of the 5th  metatarsal
    • Expected ROM: 30-50°
  21. Inversion/Eversion
    • TP: Standing č bilateral stance
    • Stabilization: Not necessary
    • Fulcrum: Just proximal to the achilles insertion on the calcaneus
    • Proximal Arm: // to the distal bisection of the lower leg
    • Distal Arm: // to the bisection of the calcaneus
    • Expected ROM: Approximately 10° of calcaneal eversion (pronation) & 20° of calcaneal inversion (supination) from the subtalar neutral position

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