ROM

AROM

Active range of motion: the client moves the joint through its range using their own muscle contraction, so it tests strength, motor control, and joint motion together

PROM

Passive range of motion: the therapist moves the joint with the client relaxed, so it tests joint and soft tissue mobility without muscle effort

AAROM

Active assisted range of motion: the client does part of the movement and gets help from the therapist, a device, or the other hand (used when muscles are weak or movement is painful)

Which ROM do you screen first

AROM first. If AROM is full, assume PROM is full. If AROM is limited, check PROM

AROM limited, PROM full

Problem is in the contractile tissue or nervous system: weakness, nerve injury, paralysis or flaccidity, tendon rupture, pain with muscle contraction, or poor effort or cognition

AROM limited, PROM also limited (about equal)

Problem is in the joint or non-contractile tissue: contracture, capsular tightness, adhesions, edema, bony block, or joint swelling

AROM full, PROM limited

Not expected, because PROM should equal or exceed AROM. Recheck the measurement, positioning, and goniometer alignment

Muscle weakness pattern

AROM is limited, PROM is full, and the end feel is normal

Contracture pattern

AROM and PROM are both limited, and the end feel is abnormal or firm

Tendon adhesion pattern

PROM is better than AROM, and the limitation shows up when the tendon has to glide (common after tendon repair or hand injury)

Flaccid paralysis (stroke)

AROM is absent or minimal, but PROM is usually full, so protect the joint and avoid overstretching

Spasticity (stroke)

PROM can be limited by increased tone and may worsen with fast movement, so move slowly

Capsular pattern of the shoulder

External rotation is limited most, then abduction, then internal rotation

Capsular pattern

A joint-specific, predictable pattern of limitation from capsular tightness or joint inflammation (arthritis, immobilization)

Capsular pattern of the hip

Flexion, abduction, and internal rotation are limited most

Exam tip: AROM vs PROM clue If the stem says the client cannot lift the arm but you can move it fully, think

weakness or neurological problem rather than joint limitation

Exam tip: both limited clue | If the stem says both active and passive motion are restricted, think

joint, capsule, or soft tissue contracture and expect interventions like stretching, positioning, or splinting

MMT grade 5 (Normal)

Full ROM against gravity with maximal resistance

MMT grade 4 (Good)

Full ROM against gravity with moderate resistance

MMT grade 3+ (Fair plus)

Full ROM against gravity with minimal resistance

MMT grade 3 (Fair)

Full ROM against gravity with no resistance

MMT grade 3- (Fair minus)

Moves against gravity through more than half of the range, but not full range

MMT grade 2+ (Poor plus)

Full ROM gravity-eliminated, plus moves against gravity through less than half of the range

MMT grade 2 (Poor)

Full ROM in the gravity-eliminated position, with no movement against gravity

MMT grade 2- (Poor minus)

Partial ROM in the gravity-eliminated position

MMT grade 1 (Trace)

Palpable or visible muscle contraction with no joint movement

Shoulder flexion gravity-eliminated position

Sidelying