1. Physical Therapy
Technician Protocol:
Passive Range of Motion
Level 1
Technical Skill

2. Prerequisites
Physical Therapy
Technician Knowledge
Protocols
Anatomy
Canine Biomechanics
& Gait

3. Benefits of
Passive Range of Motion (PROM)
Relaxation
Decreases pain
Prevents joint contracture
Prevents adaptive muscle shortening
Enhances blood and lymphatic flow
Improves synovial fluid production and diffusion
Improves rate of recovery
Maintains mobility of the soft tissue layers

4. Joint Contracture
Permanent shortening
of a muscle,
resulting in
decreased range of
motion of a joint,
due to spasticity,
ischemia, or
prolonged
immobility.

5. Adaptive Muscle Shortening
When a muscle is
shortened for a
prolonged period of
time, it loses
sarcomeres and
loses length
permanently,
resulting in joint
contracture.

6. Passive Range of Motion
•PROM occurs when a joint is moved through its range
of motion WITHOUT the patient's muscular contraction
or effort.
•The motion occurs due to external force applied with
the hands of the therapist, technician, or owner.
•PROM occurs at the joint, while stretching is performed
to the muscle. (Stretching will be discussed in detail in a
subsequent protocol.)

7. I
Indications for PROM
Immediately post-operatively.
Within the range of
motion and in the
directions that are “safe”
based on the surgical
procedure.
Immobile patients, especially
those prescribed crate rest.
Paretic or paralyzed patients.

8. Contraindications for PROM
Unstable or
unstabilized
fractures.
Unstable ligament or
tendon injuries.
Pain due to PROM.

9. Method for PROM
•The patient should be relaxed.
•Be gentle.
– Your hands relay your level of stress, anxiety, or
relaxation to the patient.
•Support the bones proximal and distal to the joint.
– One hand is above and one hand is below the
joint that is passively moved.
– Consider the length of “lever arms” and keep
your hands comfortably close to the joint.
•Avoid handling painful areas such as wounds or incisions.
•The motion should be slow, smooth, and steady.
•Watch the patient for signs of discomfort.

10. Patient Positioning for PROM
•Sidelying or laterally recumbent
– This is the optimal position for both you and the
patient.
– Position yourself behind the patient, if possible,
for most efficient body mechanics.
•Standing
– For fractious, nervous, or dominant dog, this
may be the only option.
– Be sure to support your patient's body when
performing standing PROM as he/she will be
balancing on three legs.

11. PROM of the Carpus
Allow the elbow and
shoulder to be
flexed and relaxed.
Hold above the carpus
and below on the
paw.
Flex and extend gently
for 10 repetitions.

12. PROM of the Elbow
Allow the carpus and
shoulder to be
flexed and relaxed.
Hold above the elbow
on the brachium and
below on the
antebrachium.
Flex and extend gently
for 10 repetitions.

13. PROM of the Shoulder
Allow the elbow and
carpus to be flexed
and relaxed.
Hold at the shoulder
blade/scapula or
body and below at
the elbow.
Flex and extend gently
for 10 repetitions.

14. PROM of the Tarsus
Allow the hip and stifle
to be flexed and
relaxed.
Hold above the tarsus
and below on the
paw.
Flex and extend gently
for 10 repetitions.

15. PROM of the Stifle
Allow the hip and tarsus to be
flexed and relaxed.
Hold above the stifle on the
femur and below on the tarsus.
Flex and extend gently for 10
repetitions.
You might notice that the hip
and stifle move at the same
time.

16. PROM of the Hip
Allow the stifle and
tarsus to be flexed
and relaxed.
Hold at the back or
pelvis and at the
stifle.
Flex and extend gently
for 10 repetitions.

17. PROM Procedure
Invite the patient to lie down and relax.
Give positive feedback and prepare, relax, or
distract the patient through:
Petting or massage.
Treats.
Toys for distraction.
Position your body and your hands.
Perform PROM to the prescribed joint(s) for at
least 10 slow repetitions to each joint.