Active ROM
Client moves the joint independently.
Use it to observe:
- available movement
- pain during movement
- movement quality
- willingness to move
Clinical clue: Pain during Active ROM may involve contractile or non-contractile structures.
FREE ROM GUIDE
Lumbar Range of Motion
FREE SAMPLELearn when and why to use active, passive and resisted range of motion during a practical lumbar assessment.
ROM TESTING OVERVIEW
Active, Passive & Resisted ROM
Passive ROM
Therapist moves the relaxed joint.
Use it to assess:
- available range
- end feel
- pain with passive movement
- joint or non-contractile restriction
Clinical clue: Pain during Passive ROM may suggest involvement of joint, capsule, ligament or other non-contractile structures.
Resisted ROM
Client contracts against resistance without needing large joint movement.
Use it to assess:
- muscle or tendon pain
- strength
- contractile tissue involvement
Clinical clue: Painful resisted contraction may indicate involvement of the muscle-tendon unit being tested.
LUMBAR MOVEMENTS
Lumbar movements to assess
Flexion
ACTIVE:
Ask the client to bend forward comfortably, allowing the trunk to move toward the floor.
PASSIVE:
Where appropriate and within scope, gently assist or guide lumbar flexion while monitoring symptoms.
RESISTED:
Client attempts trunk flexion while gentle opposing resistance is applied.
Extension
ACTIVE:
Ask the client to gently bend backward within a comfortable range.
PASSIVE:
Where appropriate and within scope, gently assist or guide lumbar extension while monitoring symptoms.
RESISTED:
Client attempts trunk extension while gentle opposing resistance is applied.
Left Lateral Flexion
ACTIVE:
Ask the client to slide the left hand down the side of the thigh while side-bending to the left.
PASSIVE:
Where appropriate, gently guide the trunk into left lateral flexion.
RESISTED:
Client attempts left lateral flexion while gentle opposing resistance is applied.
Right Lateral Flexion
ACTIVE:
Ask the client to slide the right hand down the side of the thigh while side-bending to the right.
PASSIVE:
Where appropriate, gently guide the trunk into right lateral flexion.
RESISTED:
Client attempts right lateral flexion while gentle opposing resistance is applied.
ASSESSMENT FLOW
A simple assessment sequence
Observe→Active ROM→Passive ROM→Resisted ROM→Compare sides→Focused Assessment
Use findings from the history, observation and ROM testing together rather than relying on a single test.
FOCUSED ASSESSMENT
When should you use focused assessment?
Use focused assessment when the history and ROM findings suggest that lumbar movement, neural symptoms or another specific structure requires closer review.
Straight Leg Raise
Used as part of assessment when lower-limb radiating symptoms or neural involvement are suspected.
Slump Test
Used as a neurodynamic assessment when symptoms suggest possible neural mechanosensitivity.
Lumbar Movement Comparison
Compare flexion, extension and lateral flexion for range, pain, stiffness and compensation.
Neurological Symptoms
Ask about radiating pain, numbness, tingling or weakness and refer when findings are outside scope or concerning.
QUICK REVIEW
Quick Review
History→Observation→Active ROM→Passive ROM→Resisted ROM→Focused Assessment→Treatment Planning
CHECK YOUR UNDERSTANDING
Test Yourself
1. Which lumbar movement bends the trunk forward?
2. Which movement bends the trunk backward?
3. Which test may be used when lower-limb radiating symptoms suggest possible neural involvement?
4. Which symptoms require particular attention during a lumbar assessment?
Lumbar assessment should be interpreted together with the client’s history, symptoms and other assessment findings. Pay particular attention to neurological symptoms and other red flags. Refer for appropriate medical assessment when findings are concerning or outside scope of practice. This guide is for educational revision and is not a substitute for diagnosis or professional clinical judgement.
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