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
Thoracic Range of Motion
FREE SAMPLELearn when and why to use active, passive and resisted range of motion during a practical thoracic 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.
THORACIC MOVEMENTS
Thoracic movements to assess
Flexion
ACTIVE:
Ask the client to gently round the upper and mid back forward.
PASSIVE:
Support the client and gently guide the thoracic spine into flexion where appropriate.
RESISTED:
Client attempts thoracic flexion while gentle opposing resistance is applied.
Extension
ACTIVE:
Ask the client to gently extend the upper and mid back.
PASSIVE:
Support the client and gently guide the thoracic spine into extension where appropriate.
RESISTED:
Client attempts thoracic extension while gentle opposing resistance is applied.
Left Rotation
ACTIVE:
Ask the client to rotate the trunk to the left while keeping the pelvis as still as possible.
PASSIVE:
Gently guide the thoracic spine into left rotation where appropriate.
RESISTED:
Client attempts left thoracic rotation while gentle opposing resistance is applied.
Right Rotation
ACTIVE:
Ask the client to rotate the trunk to the right while keeping the pelvis as still as possible.
PASSIVE:
Gently guide the thoracic spine into right rotation where appropriate.
RESISTED:
Client attempts right thoracic rotation while gentle opposing resistance is applied.
Left Lateral Flexion
ACTIVE:
Ask the client to side-bend the trunk to the left.
PASSIVE:
Gently guide the thoracic spine into left lateral flexion where appropriate.
RESISTED:
Client attempts left lateral flexion while gentle opposing resistance is applied.
Right Lateral Flexion
ACTIVE:
Ask the client to side-bend the trunk to the right.
PASSIVE:
Gently guide the thoracic spine into right lateral flexion where appropriate.
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 thoracic mobility, posture, rib movement or a specific movement pattern requires closer review.
Thoracic Rotation
Compare left and right rotation for range, pain and compensation.
Thoracic Extension
Observe extension mobility and whether movement is limited or uncomfortable.
Rib / Thoracic Mobility
Assess breathing-related rib movement and thoracic mobility where appropriate.
Postural Observation
Observe thoracic kyphosis, shoulder position and trunk alignment.
QUICK REVIEW
Quick Review
History→Observation→Active ROM→Passive ROM→Resisted ROM→Focused Assessment→Treatment Planning
CHECK YOUR UNDERSTANDING
Test Yourself
1. Which thoracic movement turns the trunk to one side?
2. Which thoracic movement rounds the upper and mid back forward?
3. When comparing thoracic rotation, what should be observed?
4. Thoracic ROM findings should be interpreted:
Thoracic ROM findings should be interpreted together with the client’s history, symptoms and other assessment findings. This guide is for educational revision and is not a substitute for diagnosis or professional clinical judgement.
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