Page 103 - Canine Lameness

5.2 ­Paasive Panve of os a 75

Step 1
Move joint through ROM
• Identify joint center
• Identify landmarks

Step 2
Place limb in testing position
• = all joints flexed if testing flexion
• = all joints extended if testing extension

Step 3

Place the goniometer
• Stationary arm on proximal bone segment
• Center of goniometer over center of joint
• Motion arm on distal bone segment

Step 4
Add overpressure
• Identify maximum motion
• Measure angle

Figure 5.5 Passive range of motion (PROM) for carpus extension is completed in a series of four steps. First,
the patient is relaxed in lateral recumbency and the joint is moved through range of motion to identify the
joint center and landmarks. Second, the limb is positioned for testing by placing the multi-joint muscles on
slack; in this, this case by ensuring the elbow is extended and the subjective end-feel is determined. Third, the
goniometer is placed over the joint with the stationary arm on the proximal bone, the axis on the point of
rotation of the joint, and the mobile arm on the distal bone. Fourth, with the goniometer in place, the joint is
moved into the testing range of motion applying overpressure at end range to achieve full range of motion of
the joint.

previously published landmarks for goniometer positioning (Jaegger et al. 2002; Freund et al.
2016) should be considered to standardize goniometric measurements (Table 5.5). In veterinary
medicine, all PROM measurements should be measured on the flexion side of the joint (i.e. on the
cranial aspect for the elbow, hip, and tarsus, and on the caudal aspect for the shoulder, carpus, and
stifle; Figure 5.3). Current evidence suggests that canine goniometric measurements are more
accurate when using a universal goniometer compared to digital, electronic, and smart phone
devices/apps (Thomas et al. 2006; Freund et al. 2016).
PROM testing of the peripheral limbs can be completed with the patient in a standing or recum-
bent position, but only if they are performed consistently when measurements between time
points are compared. If the patient reacts to any of the testing positions while standing, or if the
tester subjectively feels hypo‐ or hypermobility in any joint, PROM testing with the patient in lat-
eral recumbency is indicated. This position will allow the antigravity muscles to relax. The muscles