Motion Position Stabilization Axis of Rotation Stationary Arm Movable Arm Normal Values
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1 Motion Position Stiliztion Axis of Rottion Sttionry Arm Movle Arm Norml Vlues Shoulder Flexion/Extension Supine note. Pronte hnd during Shoulder Extension to line up with terl Epicondyl (supintion/prontion will not ffect extension) Hed of Humerus Bisect Ri Cge Bisect Humerus towrd terl Epicondyl Shoulder Aduction Supine Acromeum Bisect Sternl Notch Bisect Humerus & Antecuitl Foss Shoulder Internl/Externl Rottion Elow Flexion/Hyperextension Supine Need towel; Plm Down Olecrnon Process Perpendiculr to Floor/Ceiling Bisect Uln towrd Ulnr Styloid 0-70 Supine note. No Overpressure on Extension; towel under distl humerus; plm up terl Epicondyle Mid Humerus to Acromium Rdiostyloid Forerm Supintion/Prontion Seted Elow flexed 90 & Supported terl to Ulnr Styloid IN INE/prrllel to Humerus Rests on Dorsl Surfce of Forerm, Proximl to Styloid Process 0-80 Wrist Flexion/Extension Seted Elow flexed 90 & Supported; During Flexion keep fingers stright & Extension ent Triquetrum = lterl ump on wrist (proximl to 5th metcrpl) terl Border of Uln; Ulnr Styloid nd Olecrnon terl Border of 5th Metcrpl 0-75 Wrist Rdil/Ulnr Devition Seted Neutrl Wrist to Strt; Overpressure = grp hnd nd go through motion only in tht plne (no flex/ext) Cpitte = divot off 3rd metcrpl Dorsl Midline of Forerm Midline of 3rd Metcrpl 0-35 MCP Joint 2-5 Flexion Seted Through MCP Joint Metcrpl Proximl Phlnx MCP Joint 2-5 Extension MCP Joint 2-5 Aduction Seted Through MCP Joint Metcrpl? Seted note. Middle Finger = Center, ut do not cctully use this during mesurement Through MCP Joint Metcrpl Proximl Phlnx 0-20 PIP Joint Flexion Seted Stilize Proximl Phlnx; Do not usully do extension. Through PIP Joint Proximl Phlnx Middle Phlnx DIP Flexion Seted Stlize t Middle Phlnx Through DIP Joint Middle Phlnx Distl Phlnx 0-90 DIP Extension Seted Esier on Plmer Side 0 = only hve hyperextension
2 Motion Position Stiliztion Axis of Rottion Sttionry Arm Movle Arm Norml Vlues 1st CMC Flexion* Seted Seted Elow Flexed, Plm Up, Wrist & Elow Supported; Requires MATH = mesure eginning ngle & mesure when they stop & sutrct - - stops when you hve to duct to go further CMC Joint Through Rdius 1st Metcrpl st CMC Extension* Seted Seted Elow Flexed, Plm Up, Wrist & Elow Supported; Requires MATH = mesure eginning ngle & mesure when they stop & sutrct CMC Joint Through Rdius 1st Metcrpl st CMC Aduction Seted Seted with Wrist in Neutrl RdioStyloid for Thum 2nd Metcrpl 1st Metcrpl Opposition Seted Finger Tips - to - Finger Tips; Pds - to- Pds 1st MCP Joint Flexion Seted Stilize Metcrpl MCP?? st IP Flexion Seted IP Joint Proximl Phlnx Distl Phlnx 0-80 TMJ Opening Short Good Posture Stilize ck of neck to prevent ptient from extending neck Screen Test: Fit 3 Knuckles in Mouth mm TMJ Protrusion Short Good Posture Ruler flt, strting t top teeth 6-9 mm TMJ terl Devition Short Good Posture Right devition = mndile moving to the R (nd vice vers); ccount for strting position of teeth mm
3 6 C-Spine Flexion C-spine Extension Sitting, with T& spine supported on ck of chir Sitting, with T& spine supported on ck of chir Stilize to prevent flexion of T& spine Stilize to prevent flexion of T& spine NO OVERPRESSURE --> for flex/ext cn use tpe mesure from chin to sternl notch Externl uditory metus Perpendiculr to the floor Align with se of the nose. Externl uditory metus Perpendiculr or prllel to the floor 0-50 (cn pply overpressure) Align with se of the nose C-spine Sideending Sitting, with T& spine supported on ck of chir Stilize to prevent flexion of T& spine. Bring ptient's hed lterlly towrd the shoulder. Mesure BOTH sides --> mesure from mstoid process to cromion Over the spinous process of the c7 vertere With the spinous processes of the thorcic spine, so it is perpendiculr to the ground Bisecting the Bck of the Hed Right & eft 0-45 (cn pply overpressure) C-spine Rottion Sitting, with T& spine supported on ck of chir Stilize to prevent flexion of T& spine. Tke pt's chin nd rotte towrd shoulder (In horizontl plne). Mesure BOTH sides --> mesure from chin to cromion Over the center of the crnil spect of the hed Prllel to n imginry line etween the two cromil processes Align with the tip of the nose 0-70 (cn pply overpressure)
4 Motion Position Stiliztion Axis of Rottion Sttionry Arm Movle Arm Norml Vlues 8 Trunk Flexion Trunk Sideending Trunk Rottion Schoer technique (Flexion/Extension) Forwrd Bending C7-S1 Distnce (Flexion/Extension) Stnding, with PT's foot inside ptient's feet - - NO Shoes Stnding, with PT's foot inside ptient's feet. Keep rms relxed -- NO Shoes Seted with feet on floor. No ck support -- NO Shoes Stnding, with PT's foot inside ptient's feet Stnding (PT foot etween pt) Stnding, with spine in neutrl position Ptient ends to touch floor. Stop ending when ptient strts to nterior tilt. Stop the test when pelvis egins to lterlly tilt or when heel comes off floor. Stilize pelvis to prevent rottion. Ptient's rms crossed on chest. Mrk spot directlly inetween PSIS. Mrk nother spot 15 cm ove 1st mrk Stilize the pelvis to prevent nterior tilting Mesure distnce from tip of ptient's middle digit to the ground - Block pelvic tilt Ptient should end s fr to one side s possile. Mesure distnce from tip of ptient's middle digit to the ground - Do NOT let hnd slide down thigh Over the center of the crnil spect of the hed Ptient ends forwrd without Ant. Tilt. Mesure the distnce etween the points. *Use pencil to mrk C7 nd S1. Align tpe mesure etween the two processes nd note the distnce Prllel to n imginry line etween the two prominent tuercles on ASIS. Need to plpte! For flexion- keep tpe mesure directly on skin. For extension, just mesure the distnce, not necessry on the skin. Hve ptient end forwrd (Flexion ROM). Record the second distnce. With n imginry line etween the two cromil processes. The difference etween the two distnces is the mount of flexion tht is present Flexion: Mles = 6.7 cm Femles = 5.8 cm Extension: 1.6 cm umr Distnce Thorcic Distnce **there should e significntly less thorcic motion
5 Bckwrd Bending 15cm -x = # Mle & Femle 1.6 cm C7-S1 Distnce umr Distnce Stnding; Cervicl - Thorcic - umr Spine in 0-deg of lterl flex & rottion Stilize the pelvis to prevent posterior tilting (the end ROM occurs when the pelvis eings to tilt post.) - use tpe mesure Instructions: 1. Plce mrk on the Right nd eft PSIS - use ruler to locte nd mrk midline point on the scrum t the level of the PSIS & mke mrk 15cm ove the mrk on the scrum. 2. Align the tpe mesure etween the superior nd inferior mrks on the spine - sk pt to end ckwrd s fr s they cn. 3. At the end ROM, note the distnce etween the superior nd inferior mrks. The ROM is the difference etween 15cm nd the length mesure t the end of the motion. Thorcic Distnce
6 Motion Position Stiliztion Axis of Rottion Sttionry Arm Movle Arm Norml Vlues Hip Flexion Supine; knees extended nd hips in 0-deg ABD, ADD, nd rot. Stilize pelvis with one hnd to prevent posterior tilting or rottion; contrlterl E flt on tle in neutrl to provide dditionl stiliztion terl spect of the hip joint - Greter Trochnter of the Femur terl Midline of the Pelvis terl Midline of the Femur - use lterl epicondyle s reference Hip Extension Prone; knees extended nd hip in 0-deg ABD, ADD, nd rot. Stilize pelvis with one hnd to prevent nterior tilt; contrlterl E flt on tle in neutrl to provide dditionl stiliztion terl spect of the hip joint - Greter Trochnter of the Femur terl Midline of the Pelvis terl Midline of the Femur - use lterl epicondyle s reference 0-20 Hip ABD Supine; knees extended nd hips in 0-deg ABD, ADD, nd rot. Keep hnd on the pelvis to prevent lterl tilting nd rottion. CAUTION: wtch trunk for lterl trunk flexion ASIS Align with n imginry horizontl line extending from one ASIS to the other Anterior midline of the femor - use midline of ptell s reference Hip ADD supine Pelvis to prevent lterl tiliting ASIS Horizontl line cross oth ASIS s Anterior midline of femur, using midline of ptell for reference 0-30 Hip IR knees hnging off edge Distl end of femur to prevent motion Anterior spect of ptell Perpendiculr to floor Anterior midline of lower leg, using crest of tivi nd point w mlleoli 0-40 Hip ER knees flexed to 90 nd supporting Distl end of femur to prevent duction or further flexion of the hip Anterior spect of ptell Perpendiculr to floor Anterior midline of lower leg nd point etween mlleoli 0-50
7 Knee Flexion Supine Femur to prevent rottion, duction nd dduction of hip terl epicondyle of femur Proximl rm with lterl midline of femur, in line with greter trochnter terl midline of fiul, using lterl mlleolus nd fiulr hed s reference Knee Hyperextension Ankle Dorsiflex with Knee Flexed 90 nd neutrl foot Stilize the tii nd fiul to prevent knee motion nd hip rottion terl spect of lterl mlleolus terl midline of fiul Prllel to lterl spect of 5 th mettrsl 0-12 Ankle Dorsiflex with Knee Extended 1 0 Ankle Plntrflexion Trsl Joint Inversion 2nd Mettrsl Trsl Joint Inversion Mettrsl Hed Plne nd leg supported 90 nd leg supported Tii nd fiul to prevent knee flexion nd hip rottion Tii nd fiul to prevent medil rottion nd extension of knee Stilize the heel to prevent dorsiflexion of nkle/inversion of sutlr join terl spect of lterl mlleolus terl midline of fiul terl spect of 5 th mettrsl 0-50 Anterior spect of nkle etween mlleoli terl spect of 5 th mettrsl hed Anterior midline of lower leg, using tiil tuerosity for reference prllel to nterior midline of lower leg Anterior midline of 2 nd mettrsl 0- Plntr spect of 1-5 mettrsl heds 0-37
8 Motion Position Stiliztion Axis of Rottion Sttionry Arm Movle Arm Norml Vlues Trsl Joint Eversion 2nd Mettrsl Trsl Joint Eversion Mettrsl Hed Plne Sutlr Eversion 90 nd leg supported 90 nd leg supported Prone, foot hnging off the end of the tle Tii nd fiul to prevent lterl rottion nd dduction of hip Clcneus nd Tlus to prevent plntrflexion nd eversion of sutlr joint Tii nd fiul Anterior spect of nkle midwy etween mlleoli Medil spect of 1st mettrsl hed Posterior spect of ndle midwy etween mlleoli Anterior midline of lower leg, using tiil tuerosity for reference Prllel to the nterior midline of the lower leg Anterior midline of 2 nd mettrsl Plntr spect from the 1st to 5th mettrsl heds Posterior midline of the lower leg Posterior midline of the clcneus Sutlr Inversion Prone, foot hnging off the end of the tle Tii nd fiul Posterior spect of ndle midwy etween mlleoli Posterior midline of the lower leg Posterior midline of the clcneus 0-5 1st MTP Joint Flexion Supine or sitting with knee fleced to 90 mettrsls Dorsl spect of the MTP joint Dorsl midline of the mettrsl Dorsl midline of the proximl phlinx st MTP Joint Extension Supine or sitting with knee fleced to 90 mettrsls Dorsl spect of the MTP joint Dorsl midline of the mettrsl Dorsl midline of the proximl phlinx Hllux Vlgus eg ength
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