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Active Range of Motion (AROM) is a term used in the context of fitness and rehabilitation to describe the range of motion that a joint is capable of when opposing muscles contract and relax, creating joint movement. AROM is often assessed as part of a physical therapy evaluation or course of treatment, with the goal of increasing the range of motion and preventing the development of contractures, adaptive muscle shortening, and shortening of the capsule, ligaments, and tendons.

There are various methods and instruments used to measure AROM, including goniometry, linear measures, and inclinometry. Goniometers, for example, use a stationary arm, fulcrum, and moving arm to calculate joint angles from the joint axis, but require training to obtain precise results. Inclinometry, on the other hand, incorporates the use of constant gravity as a reference point and has been found to possess good reliability and validity for measuring lumbar ROM.

Using a goniometer to measure AROM

A goniometer is a device used to measure the range of motion of a joint. It is a clinical tool used by doctors, osteopaths, physical therapists, and other health professionals. The word "goniometer" comes from the Greek words "gonia," meaning angle, and "metron," meaning measure.

There are three types of range of motion, each depending on the purpose of the assessment: passive, active, and active assistive. To measure the active range of motion (AROM), the patient moves their body part through its available range of motion.

Step 1: Familiarize Yourself with the Goniometer

The goniometer has two arms: a stationary arm attached to the circle with the angle degrees, and a movable arm that does the measuring. Understand how the moving arm points to the angle degrees to ensure an accurate measurement.

Step 2: Align the Center of the Goniometer with the Center of the Joint

Place the center of the goniometer, also called the fulcrum, on the fulcrum of the joint being measured. For example, if measuring the hip joint, place the center of the goniometer on the hip joint in the center of the patient's hip.

Step 3: Position the Stationary Arm

Hold the goniometer's stationary arm along the limb being measured. This is the limb that will remain in place while the other limb rotates. For instance, if measuring the knee's range of motion, align the stationary arm with the thigh while keeping the knee joint's fulcrum on the goniometer's fulcrum.

Step 4: Move the Joint Through its Range of Motion

While holding the goniometer and stationary limb in place, move the joint as far forward or backward as possible without moving any other body part. For example, when measuring wrist flexion, rest the elbow on a table and bend the hand forward while keeping the arm stable.

Step 5: Align the Moving Arm with the Moving Limb

Slide the moving arm of the goniometer to align with the limb that was moved. The moving arm should now be pointing at the angle degree on the stationary arm, indicating the range of motion. Ensure that the goniometer's moving arm is aligned with the center of the moving limb.

Step 6: Record the Angle

Write down the joint measured, the type of movement, and the range of motion in degrees. For example, when measuring the lateral rotation of the shoulder, the average range of motion is 170 degrees.

Using an inclinometer to measure AROM

An inclinometer is a tool used to determine angles of motion, especially when measuring the spine. It is also known as a tilt indicator, tilt sensor, or gradient meter, among other names. The spine has motion at both the top and lower segments, so two inclinometers are used simultaneously to record the dynamic motion. One inclinometer is placed at the top of the measured spine segment, and the other at the lower spine location. The measurement value of the lower spine is then subtracted from the upper spine value to get the "true angle".

There are two types of inclinometers: manual and digital. The manual inclinometer, also called a "bubble inclinometer", has a fluid-filled face in a circle, with a combination of coloured and clear fluid. The fluid interface moves with gravity, and the movement of the interface is used to read the measurement off a rotating 360-degree face dial. The user must hold the two inclinometers simultaneously on the spine while movement is measured. This can be challenging for first-time users. Manual inclinometers are inexpensive, but they can be difficult to read due to the small print face.

Digital inclinometers, on the other hand, are gaining popularity due to their ease of use and automatic calculation of the true angle. They consist of two electronic gravity sensors that can standardise a zero-measuring reference with the click of a button. The upside of digital inclinometers is their ease of use during the exam, but they may not have an auto-off feature, leading to a dead battery for the next exam. Additionally, digital inclinometers are expensive, ranging into the hundreds of dollars.

Regardless of the style of inclinometer used, understanding its function is essential for accurate and well-supported impairment report conclusions.

AROM in physical therapy

Physical therapy, also known as physiotherapy, is a health profession concerned with the assessment, diagnosis, and treatment of disease and disability through physical means. Range of motion (ROM) is a key concept in physical therapy, referring to how far a patient can move or stretch a body part, such as a joint or muscle, and it is different for each individual. Active Range of Motion (AROM) is a type of ROM where the patient performs stretching exercises, moving the muscles around a weak joint without any external aid.

AROM is an important indicator of a person's health, fitness, and mobility levels. It is one of the factors gauged for both medical and fitness purposes. For example, the AROM of the shoulder is determined by how far a person can reach their arm up above their head and the circumference of the circular motion they can make. AROM is controlled by muscle contraction and flexion, but it also depends on joint flexibility and other factors.

AROM is used in diagnosis, rehabilitation, and fitness. Doctors use AROM measurements to diagnose joint or soft tissue injuries. For instance, moving a joint with a sprained muscle or tendon will cause pain, and the point of pain limits the AROM and indicates the type of injury. Physical therapists also use AROM as a key indicator in rehabilitation. If a patient is recovering from an injury, surgery, or a serious condition, measuring the AROM helps gauge their recovery.

Additionally, many athletes use AROM to improve their fitness levels. Exercises that combine stretching with strengthening, such as yoga, can increase AROM. It is important to note that increasing the strength and flexibility of joints should be done in controlled, smaller movements to avoid injury to the joint or soft tissues. Overall, AROM plays a crucial role in physical therapy, helping to enhance a patient's mobility, flexibility, and overall health.

AROM in post-stroke hemiparesis patients

Active Range of Motion (AROM) is a measure of the range of motion for a specific movement that a patient can achieve without assistance. In the context of post-stroke hemiparesis, AROM is used to assess the patient's ability to move their upper extremity (UE) joints, such as the shoulder and wrist.

AROM measurements are important for predicting UE motor function post-stroke, which is crucial for planning rehabilitation services and patient discharge. However, the timing of these measurements is critical. In a study by Prager and Lang, initial AROM measurements of shoulder flexion and wrist extension taken within the first few days after stroke only predicted 28% of the variance in UE motor function at 3 months post-stroke. In contrast, Beebe and Lang found that AROM measurements of the shoulder and middle finger taken 3 weeks after stroke predicted 71% of the variance in UE motor function at 3 months.

Therefore, when assessing AROM in post-stroke hemiparesis patients, it is important to consider the timing of the measurements. While early AROM assessments can provide some prognostic information, measurements taken a few weeks after stroke may provide a more accurate prediction of long-term UE motor function.

AROM in sports

Active Range of Motion (AROM) is a category of therapeutic exercises related to joint range of motion. In sports, AROM is essential for athletes to achieve optimal performance, prevent injuries, and enhance recovery.

Quantifying AROM in sports typically involves measuring the angles and distances of specific movements. For example, when assessing shoulder flexion, the angle formed at the shoulder joint during the motion is measured using tools like goniometers or inclinometers. These tools help determine the range of motion in degrees, allowing for a quantitative analysis of the athlete's performance.

In addition to measuring angles, AROM can also be quantified by assessing the distance between starting and finishing positions. For instance, in a forward bending exercise, the distance between the athlete's toes and their fingertips provides a quantifiable value for their AROM.

It's important to note that AROM measurements should be specific to the athlete's sport and position. For example, the AROM requirements for a baseball pitcher will differ from those of a basketball player due to the unique demands of their respective sports.

By quantifying AROM, sports scientists, coaches, and athletes can set performance benchmarks, track progress, and design targeted training programs to improve performance and reduce the risk of injury. This data also assists in developing sport-specific rehabilitation programs for injured athletes, helping them regain their AROM and return to their sport safely.

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