PROM is usually done when you can observe limited ROM during AROM. The goal of PROM is to obtain the end-feel of the joint to determine what is limiting full range of motion. The following table shows an overview of „normal“ and „abnormal“ kinds of end-feels:
End Feel |
Example |
NORMAL |
|
Hard (Ligamentous) Soft tissue approximation Tissue stretch |
Elbow extension Knee flexion Ankle dorsiflexion, shoulder lateral rotation, finger extension |
ABNORMAL |
|
Early muscle spasm
Late muscle spasm ‘Mushy’ tissue stretch |
Protective spasm following injury
Spasm resulting from instability or pain Tight muscle |
The normal end-feel for different movements in the knee is as follows:
Flexion: Soft tissue approximation
Extension: Tissue stretch
Medial Rotation: Tissue stretch
External Rotation: Tissue stretch
Patellar Movements: Tissue stretch (all directions)
Study |
Reliability |
Sn | Sp | LR+ |
LR- |
Magee et al. (2014) |
NA |
NA | NA | NA |
NA |