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Test Positioning

It is important to palpate bony landmarks when measuring ROM to place the axis of the goniometer in the proper position and to point the arms of goniometer towards the proper bony landmarks, too. By placing the goniometer on the bony landmark, it increases interrater and intrarater reliability. If two therapists were to measure ROM on a client, it is important that both perform the measure in the same way, using the same landmarks to ensure that the measurement is the most accurate. 

Additionally, it is important to position the client in the proper position to measure the joint. If this is not done, the client’s full available range of motion may not be recorded or measured because it could not be obtained in that specific position. For example, when measuring knee extension, a towel should be placed under the client’s ankle to allow for the full extension to be obtained. If the initial therapist performs the measurement with the towel under the ankle, but the second therapist does not, it may appear the client has not made much improvement.

“Test position” is the position that the muscle or muscle group is able to produce optimal muscle contraction. The therapist will have the patient in this position before performing the manual muscle test (MMT) so the therapist can position themselves to apply resistance against the muscles in the proper place. Additionally the therapist will be able to palpate the contracting muscles in the test position to feel when they are contracting. The resistance of the therapist should be applied distally and the proximal segment should be stabilized. If the client is not placed in the test position, it may not allow their muscles to provide the best contraction, therefore not producing the most accurate response and reading.


The gravity eliminated position is for clients who are not strong enough to move through the full range of motion against gravity. In this position, the joint moves parallel to the ground. If a patient’s MMT is recorded in gravity eliminated, the best score they could received is poor (2). Poor (2) indicates the client has full available range of motion in the gravity eliminated position.

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Logan and I on our first day of OT school.

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