Table 3 Recommendations to improve ROM measuring and reporting robustness in practice

Definition of terms

1. Agreement on terminology to report ‘lack of extension’ at a joint.

2. Agreed Fixed Flexion Deformity definition to enable consistency.

Protocol statement

3. Adherence to an agreed published ROM protocol to aid transparency

4. Zero or 180 degrees should be considered equivalent when describing full extension for reporting and analysis if previously described.

5. Universal agreement is required on the use of positive or negative values in hyperextension measurement for reporting and analysis.

Outcome reporting

6. Clear and consistent use of reporting active / passive ROM is required for comparison of data.

7. Flexion should be assessed and reported pre and post intervention to establish if extension was achieved at the expense of flexion.

8. When reporting composite measures (e.g. TAM, Tubiana) additional ROM measures for each joint should be recorded to identify where the change occurred.

9. Further clarity is required for Tubiana band definitions to avoid overlapping.

10. Percentage change should not to be used as the sole outcome measure without baseline data.

11. Outcomes presented as differences must be supported with at least one tabled data set for accurate reporting.

12. ROM presented in graphs must be supported by data for accurate reporting.