This document provides instructions for assessing range of motion and muscle strength of the hip joint. It describes patient positioning and examiner techniques for range of motion testing of hip flexion, extension, abduction, adduction, and internal and external rotation. It also explains how to grade hip muscle strength on the Oxford Scale from grades 0 to 5 during motions like extension, flexion, abduction, and adduction. References for more information on goniometry and pelvic floor physical therapy are provided at the end.

1. Khondokar Tazakka Tanzim
Md. Ismail hossain
Presentation about checking ROM & MS

2. MS : Oxford muscle scale brief explanation &
Position how to check grade 2 and 3 in every
motion of given joint.
ROM: Position when checking & position of
Goniometer axis and hands in every motion of
given joint.

4. Range of motion testing procedures:hip flexion
A lateral view of the hip showing
surface anatomy landmarks for
aligning the goniometer for measuring
hip flexion and extension.
The end of hip flexion passive ROM.
The placement of the examiner's hand
on the pe allows the examiner to
stabilize the pelvis and to detect any
pelvic motion.

5. We find on him: 120
degree
Normal:120-100
Hip flexion
At the end of the left hip flexion ROM, the examiner uses one hand to align the distal goniometer arm and to
maintain the hip in flexion. The examiner's other hand shifts from the pelvis to hold the proximal goniometer arm
aligned with the lateral midline of the subject's pelvis.

6. Range of motion testing procedures:hip extension
The subject's right lower extremity at the end of hip extension
ROM. The examiner use one hand to support the distal femur
and maintain the hip in extension while her other hand grasps
the pelvis at the level of the anterior superior iliac spine.
Because the examiner's hand is on the subject's pelvis, the
examiner is able to detect pelvic tilting.
Goniometer alignmment in the prone starting
position for measuring hip extension ROM.

7. Normal:30-20
We find:
20degree
Hip extension
At the end of hip extension ROM, the examiner uses one hand to hold the proximal nometer arm in alignment. The examiner's
other hand supports the subject's femur and keeps the distal c goniometer arm in alignment.

8. Range of motion testing procedures:hip abduction
The left lower extremity at the end of the hip abduction ROM. The
examiner uses one hand to pull the subject's leg into abduction.
(The examiner's grip on the ankle is designed to prevent lateral
rotation of the hip.) The examiner's other hand not only stabilizes
the pelvis but also is used to detect pelvic motion.

9. Range of motion testing procedures:hip abduction
In the starting position for
measuring hip abduction ROM, the
goniometer is at 90 degrees. This
position is considered to be the 0-
degree starting position. Therefore,
the examiner must transpose her
reading from 90 degrees to 0
degrees. For example, an actual
reading of 90 to 120 degrees on the
goniometer is recorded as 0 - 30
degrees.

10. We find:45
degree
Normal:40
Hip abduction
Goniometer alignment at the end of the abduction ROM. The examiner has determined the end-feel and has
moved her right hand from stabilizing the pelvis to hold the goniometer in correct alignment.

11. Range of motion testing procedures:hip adduction
At the end of the hip adduction
ROM, the examiner maintains the
hip in adduction with one hand and
stabilizes the pelvis with her other
hand.

12. Range of motion testing procedures:hip adduction
The alignment of the goniometer
is at 90 degrees. Therefore, when
the examiner records the
measurement, she will have to
transpose the reading so that 90
degrees is equivalent to 0 degrees.
For example, an actual reading of
90 to 60 degrees is recorded as 0-
30 degrees.

13. We find:20
degree
Normal:20
Hip adduction
At the end of the hip adduction ROM, the examiner uses one hand to hold the goniometer
body over the subject's anterior superior iliac spine. The examiner prevents hip rotation by
maintaining a firm grasp at the subject's knee with her other hand.

14. Range of motion testing procedures:hip lateral rotation
The left lower extremity is at the end of the ROM
of hip lateral rotation. The examiner places one
hand on the subject's distal femur to prevent hip
flexion and hip abduction. The subject assists with
stabilization by placing her hands on the
supporting surface and shifting her weight over
her left hip. The subject flexes her right knee to
allow the left lower extremity to complete the
ROM.

15. Range of motion testing procedures:
Goniometer alignment in the starting
position for measuring hip lateral
rotation.

16. We find: 40
degree
Normal:50
Hip lateral rotation
At the end of hip lateral
rotation ROM the examiner
uses one hand to support the
subject's leg and to maintain
alignment of the distal
goniometer arm.

17. We find: 40
degree
Normal:50
Hip lateral rotation
Hip lateral rotation in the prone
testing position with the
goniometer aligned at the end of
the motion. Note that a strap is
placed across the pelvis for
stabilization.

18. Range of motion testing procedures:hip medial rotation
The left lower extremity at the end
of the ROM of hip medial rotation.
One of the examiner's hands is
placed on the subject's distal femur
to prevent hip flexion and
abduction. Her other hand pulls the
lower leg laterally.

19. Range of motion testing procedures:
In the starting position for
measuring hip medial rotation,
the fulcrum of the goniometer is
placed over the patella. Both
arms of the instrument are
together.

20. We find: 42
degree
Normal:40
Hip medial rotation
At the end of hip medial
rotation ROM, the proximal
arm of the goniometer
hangs freely so that it is
perpendicular to the floor.

21. We find: 42
degree
Normal:40
Hip medial rotation
Hip medial rotation in the
prone testing position with
the goniometer aligned at
the end of the motion. Note
that a strap is placed across
the pelvis for stabilization.

23. Hip Extension: (All muscle)
Patient position :
Sidelying, test leg up with
knee Flexion.
Clinician :support weight
of leg stabilizes pelvis
Grade 2 :(ROM,WITHOUT GRAVITY) Testing
leg

24. Hip extension (All muscle)
Grade 3:(ROM,WITH GRAVITY)
Pt position :prone with
knee Flexion slightly.
Clinician force :down
for what the floor
Testing
leg

25. Hip flexion (psoas, illiacus)
Grade:2(complete ROM is sidelying test
leg upwith knee flexion.
Pt position :sidelying
with test leg up.
Clinician force:support
weight to test leg
Knee slightly flexion

26. Hip flexion (psoas,illiacus)
Grade 3:(ROM,WITH GRAVITY)
Pt position :sitting, leg
over edge,hands may
rest on table.
Clinician force:down
towards floor
Grade
4
Grade 3
Force
No force

27. Hip adduction (All muscle)
Grade 3:
Pt position :Sidelying, test
leg on table, non-test leg
held in abduction.
Clinician force:
toward the floor.
Testing
leg

28. Hip adduction (All muscle)
Grade 2(ROM,WITH GRAVITY MINIMIZED
Pt position :Supine
with non test leg in
abduction.
Testing
leg

29. Hip Abduction :(All muscle)
Grade 2:(ROM,WITHOUT GRAVITY)
Pt position :Supine
with knee straight.

30. Hip abduction (all muscle)
Grade 3:ROM,WITH GRAVITY
Pt position : sidelying,
test leg up, in slightly
hip extension.
Clinician force :
towards the floor.
Testing leg up

31. Hip Internal rotation :(all muscle)
Grade 2:
Pt position : sidelying
legs over edge.
Clinician force: into
external rotation.
Testing
leg

32. Hip Internal rotation :(all muscle)
Grade 3:MOVE FULL ROM WITH OUT RESISTANCE
Pt position : sitting,
legs over edge, hands
may on table.

33. Hip External rotation :(all muscle)
Grade 3:MOVE FULL ROM WITH OUT RESISTANCE
Pt position : sitting,
legs over edge, hands
may on table.
Clinician force:internal
rotation

34. Hip External rotation :(all muscle)
Grade 2:MOVE FULL ROM without gravity
Pt position : sidelying
legs over edge.
Clinician force:observes
motion.
Testing leg rotated internal

35. References
:
https://books.google.com.bd/books?id=aepKjwEACAAJ&dq=inauthor:%22D.+Joyce
+White%22&hl=en&sa=X&redir_esc=y
-Measurement of joint motion:a guide to goniometry
-Evidence-based Physical Therapy for the Pelvic Floor: Bridging Science

36. Thank you
Thank you for listening