Lecture #33 – Knee evaluation: ROM
Range of motion
• For the knee…
• ROM occurs at the tibiofemoral & patellofemoral joints
• Assessed as a unit
Movements
Primary movements
• Flexion
•
• Flexion –
Accessory movements
• Tibial internal rotation (IR)
• Tibial External rotation (ER)
• Sartorius *RROM
the joint angle between the femur and tibia
• Aka: bending your knee
• Normal: 135 o
• Extension– increasing the joint angle between the femur and tibia
• Aka:
• Normal: 0 o
Accessory movements
• Tibial internal rotation (IR) – occurs when the knee is “ ” and in NWB
• Tibial external rotation (ER) – occurs when the knee is “
Screw home mechanism
Summary:
” and in NWB
Range of motion
Definition:
• Range of motion refers to the distance and direction a joint can move between the flexed position and the extended position
In true clinical settings, we use a to measure ROM
• Types
• Active range of motion (AROM)
• Passive range of motion (PROM)
• Resistive range of motion (RROM)
• AROM
• The ability to move a joint under their own strength
• PROM
• The joint’s ability to be moved through a range of motion
• RROM
• Measurement of the of a joint through the ROM
Notes Handout
• Performed bilaterally on the uninjured side first
• Why??
Patient positioning
• For the knee…
• Flexion is assessed in the
• Extension & the sartorius are assessed in the
• So…
• Test AROM, PROM, RROM for extension
& the sartorius first, then have the patient move into a prone position to test for flexion
• The patient won’t have to flop around like a fish!
Active Range of motion
• Have the patient move their knee through the 2 movements
• Short seated:
• Lay face-down:
Passive range of motion
• The will move the knee through the ROMs to the extreme end – why??
• I am going to move your knee for you.
Just try to relax and let me know if you feel discomfort, pain, or anything unusual.
Resistive range of motion
• The athlete will move through each ROM as the
examiner places against the movement
• Extension – hold in a straightened position as I
• Flexion – hold in a bent position as I
• Sartorius: patient is seated, places the heel of the tested leg on top of the untested ankle
• Movement is and , like going into a figure-4 sitting position

Lecture #33 – Knee evaluation: ROM
Muscles & tendons
• Anterior aspect – extend the knee (and flex the hip)
• Quadriceps femoris group
• Vastus medialis
• Vastus intermedius
•
• Rectus femoris
• Sartorius*
• Posterior aspect – flex the knee* (and extend the hip)
• Hamstrings group
• Semitendinosis
•
• Biceps femoris
• Gastrocnemius
• Plantaris
• Popliteus
Items to note:
• When assessing, make note of:
• differences in AROM
• Pain during PROM
• Decreased strength during RROM
But WHY??
Grading ROM
• AROM & PROM are graded as
(WNL) or decreased/limited & why
• AROM: R = WNL, L = decreased DF due to pn
• RROM is graded on a 0-5 scale
• 0 =
• 1 =
• 2 =
• 3 =
• 4 =
• 5 =
Documenting rom
• When documenting ROM, each movement must be listed & .
AROM: R = WNL, L = WNL
PROM: R = WNL, L = WNL with Pn
RROM: R = 5/5DF, 5/5PF, 5/5INV, 5/5EV;
L = 5/5DF, 3/5PF due to Pn, 3/5INV due to Pn, 2/5EV due to Pn
Notes Handout