GENERAL PHYSIOTHERAPY ASSESSMENT

RANGE OF MOVEMENT

Name: CHI:
History of complaint:

Obs:

Leg length (cm): (R) (L) Comments

Cervical Spine
Flex Comments/quality of Picture KEY
movement A) End Feel
L Rot’n R Rot’n
● Springy
■ Hard Block
LSF RSF
▲ Spasm
√ = Normal

B) P = Pain
Ext
І Minimal
Thoracic Spine ІІ Moderate
Flex Comments/quality of Picture
ІІІ Severe
movement
L Rot’n R Rot’n C) W = Weakness

LSF RSF + = Minimal

++ = Moderate
+++ = Severe
Lumbar Spine
PROM =
Ext Passive range of
Lumbar Spine movement
AROM =
Flex Comments/quality of Picture Active range of
movement
movement
L Rot’n R Rot’n HBH =
Hand Behind Head
LSF RSF
HBB =
Hand behind back

↑ = Raised
Ext ↓ = Depressed

Completed by: …………………………………. Signature: ………………………………….

Designation: …………………………………… Date: ………………………………….

ACPPLD Scotland, Version 2 2010

 GENERAL PHYSIOTHERAPY ASSESSMENT
RANGE OF MOVEMENT

Name: CHI:

Shoulder
L R MP Quality/Comments
(Oxford scale)*
ROM Arom Prom Arom Prom L R
Flex
Ext
Abd
Add
M Rot’n
LRot’n
HBH
HBB

Elbow
L R MP Quality/Comments
(Oxford scale)*
ROM Arom Prom Arom Prom L R
Flex
Ext
Pron
Sup

Wrist
L R MP Quality/Comments
(Oxford Scale)*
ROM Arom Prom Arom Prom L R
Flex
Ext
U Dev
R Dev
Pron
Sup

Completed by: …………………………………. Signature: ………………………………….

Designation: …………………………………… Date: ………………………………….

ACPPLD Scotland, Version 2 2010

 GENERAL PHYSIOTHERAPY ASSESSMENT
RANGE OF MOVEMENT

Name: CHI:

Hip
L R MP Quality/Comments
(Oxford Scale)*
ROM Arom Prom Arom Prom L R
Flex
Ext
Abd
Add
M Rot’n
LRot’n

Knee
L R MP Quality/Comments*
(Oxford Scale)*
ROM Arom Prom Arom Prom L R
Flex
Ext

Ankle
L R MP Quality/Comments*
(Oxford Scale)*
ROM Arom Prom Arom Prom L R
D/F
(0°KnFl)
D/F
(20°KnFl
)
P/F
Invers
Evers

(* See appendix 5)

Completed by: …………………………………. Signature: ………………………………….

Designation: …………………………………… Date: ………………………………….

ACPPLD Scotland, Version 2 2010

 GENERAL PHYSIOTHERAPY ASSESSMENT
RANGE OF MOVEMENT

Name: CHI:

GENERAL IMPRESSION:

PROBLEMS:

GOALS:

Completed by: …………………………………. Signature: ………………………………….

Designation: …………………………………… Date: ………………………………….

ACPPLD Scotland, Version 2 2010

GENERAL PHYSIOTHERAPY ASSESSMENT
 RANGE OF MOVEMENT

Guidelines
Obs = within this box you should be including any generalised observations. This can include the following.
 Bony landmarks; Clavicle, Shoulders (level, protracted, retracted) Straight spine, Pelvis, ASIS, PSIS, Q angle,
Greater Trochanter, Patella position, Scapula (distance from spine, Flat, raised / depressed)
 Body landmarks; Head centred, Nipple level, Gluteal level, Popliteal fossa level, Hindfoot vertical,
8 - 10° toeing out of feet, Muscle bulk, Muscle tone
 Stance; How does the person stand (observation in three planes), can they maintain one position, do they weight
bear equally,
 Gait; How do they walk (separate sheet for abnormal gait).This area should briefly highlight if everything is
within normal limits or if there is a potential problem linked to a MSK issue.
 Leg length discrepancy; check for true leg length discrepancy and functional leg length discrepancy.

Cervical Spine

Flex Within the attached box the patient could be described as having the
√ following symptoms. Normal range of movement in flexion, Left
L Rot’n R Rot’n
rotation and left side flexion (AROM). After requesting them to
√
extend their head with over pressure they were only able to achieve
■ PІ
just over half normal range with a springy end feel (no pain
LSF √ ■ P ІІ RSF
reported). Whilst carrying out right rotation (AROM) their was
● obvious restriction and with PROM a hard block at quarter
expected range was experienced with minimal pain. Similarly
whilst assisting with right side flexion during PROM the patient
Ext described moderate pain and a hard block at half expected normal
range.

Lumber Spine
Within this movement diagram the patient had no adverse
symptoms with flexion, left rotation and left side flexion on
Flex AROM. Whilst carrying out AROM on right rotation they
√ experienced moderate pain at half normal range and with right side
L Rot’n R Rot’n
flexion they experienced moderate pain at a quarter normal range.
√ PІІ
Whilst carrying out extension they experienced severe pain with
√ P ІІ
LSF RSF muscle spasm at half normal range.
▲ PІІІ

Ext

The movement diagrams above are just examples of how you can record information. Normal ranges can be subjective
and each therapist should remember this (i.e. someone with downs syndrome and hyper mobility would be able to reach
full range with no problems normally, whilst an elderly patient may have restricted ranges already). The key provided is
potential problems which you can experience with end feel. It has been broken down into 4 basic sensations; spasm, hard
block, springy and normal end feel. Again subjective information such as pain is different for each patient. Weakness can
be recorded with a combination of +.