RANGE OF MOTION

THERA EX / LABORATORY
● Shoulder Internal Rotation - External
OUTLINE
Rotation
I. Spine ROM 1. Grasp the hand and the wrist with
II. Shoulder, Elbow, Forearm your index finger between the
III. Wrist and Hand patient’s thumb and index finger
IV. Lower Extremity 2. Place your thumb and the rest of your
fingers on either side of the wrist
thereby stabilizing the wrist
SPINE ROM 3. With the other hand, stabilize the
Cervical Spine ROM elbow. Then rotate the humerus by
● Cervical Flexion moving the arm like a spoke on a
o patient in supine wheel
● Cervical Extension
o patient in supine ● Shoulder Horizontal Adduction -
● Cervical Lateral Flexion Abduction
o patient in supine and do it in both sides 1. Hand placement is the same as with
● Cervical Rotation flexion but turn your body and face
o do in both sides the patient’s head as you move the
patient's arm out to the side and then
Lumbar Spine ROM across the body
● Lumbar Flexion
● Lumbar Rotation ● Shoulder Extension
● Lumbar Extension 1. To obtain extension past zero, position
the patient side-lying and move the
SHOULDER, ELBOW, FOREARM arm through the available range and
● Shoulder Flexion return. (can also be done supine at the
1. Grasp the patient’s arm under the edge of the bed, prone or sitting)
elbow with your lower hand
2. With the top hand, cross over and ● Elbow Flexion - Extension
grasp the wrist and palm of the 1. Hand placement is the same as with
patient’s hand the shoulder flexion except the
3. Lift the arm through the available motion occurs at the elbow as it is
range and return flexed and extended.
2. One can perform elbow flexion and
● Shoulder Abduction - Adduction extension with the forearm pronated
1. Use the same hand placement as with as well as supinated
flexion, but move the arm out to the
side. The elbow may be flexed ● Forearm Pronation - Supination
1. Grasp the patient’s wrist, supporting
the hand with the index finger, and
placing the thumb and the rest of the
fingers on either side of the distal
forearm

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 THERAPEUTIC EXERCISE – RANGE OF MOTION LABORATORY
2. Stabilize the elbow with the other
hand
3. The motion is a rolling of the radius
around the ulna at the distal radius
WRIST AND HAND
● Wrist Flexion - Extension
- Locate the wrist joint and Stabilize the
distal forearm
- Move the hand towards flexion 10
times
- Move the hand posteriorly (extension)
for 10 times
- Alternative: doing both extension and
flexion simultaneously
● Wrist Radial - Ulnar Deviation
- same hand placement and stabilize
the distal forearm
- Repeat each motion for 10 times
● Cupping and Flattening of the Arch of the
Hand
- trying to move the carpometacarpal
and intermetacarpal joint
- make sure to maximize the cupping
and flattening
● 1st CMC Joint Flexion - Extension -
Abduction - Adduction
- stabilize the trapezius while doing the
motion
● 1st MCP Joint Flexion - Extension
- stabilize the 1st metacarpal and move
the proximal phalanx of the first digit
● 1st IP Joint Flexion - Extension
- stabilize the proximal phalanx of the
first digit
- hold it on the lateral aspect
● 5th MCP, PIP, DIP Joint Flexion -
Extension (2nd - 4th MCP, PIP, DIP)
- MCP -> stabilize the 5th metacarpal
and move the 5th proximal phalanx
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- PIP -> Stabilize the 5th proximal
phalanx and move the 5th middle
phalanx
- DIP -> stabilize the 5th middle
phalanx and moving 5th distal
phalanx
- Alternative: Do the motions
simultaneously (stabilize all the joints
possible)
● Elongation of the Extrinsic Muscles of the
Wrist and Hand (Flexor/Extensor
Digitorum)
- make sure to follow the distal to
proximal patterns
- stabilize the distal forearm
LOWER EXTREMITIES
● Hip Flexion with Knee extension
- patient must be at the side of the table
and the PT must be at the middle of
the table (to be able to provide good
leverage)
- One hand under the heel and one on
the top of the knees
- Move the toes towards the ceiling
(until the available range of motion)
- Do it 2 - 3 times
● Hip Extension
- Prone position and sidelying position
Sidelying position
- try to slightly bend the legs and the
stabilization is under the legs
supporting the knee joint
- another hand is on the pelvic region
- try to sway the leg back
Prone position
- the stabilizing hand must be on the
pelvic area and the supporting hand
must cradle the leg and thigh
- extension
● Hip Abduction - Adduction
- patient on supine and PT on the side of
the table
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 THERAPEUTIC EXERCISE – RANGE OF MOTION LABORATORY
- the PT must be supporting the ankle
and the other hand is in the medial
aspect of the thigh
- make sure that the knee is in an
extended position

● Hip Internal Rotation and External

Rotation
- patient on supine
- dominant hand of PT must be
supporting the heel of the patient and
the non-dominant hand must be on
the distal part of the thigh
- hip is in 90 degrees hip and knee
flexion
- when the hip is unstable: cradle it

● Knee Flexion and Extension

- patient in prone position
- hold the distal part of the leg and
stabilize the pelvic region

● Ankle Dorsiflexion and Plantarflexion

- patient in supine position and at the
edge of the table
- hold the ankle and move it upward
(dorsiflexion)

● Subtalar Inversion and Eversion

- patient in supine
- dominant hand of PT supporting the
heel of the client
- non dominant hand of PT supporting
the distal part of the leg

● Toes Flexion and Extension

- patient in supine
- stabilize the metatarsalphalengeal
joint and hold the toe (and move it)

References:
● Maam Keith video presentation
● Maam Mheg video presentation
● Maam Ethley video presentation
● Sir ER video presentation

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