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Thread: Goniometric Measurements

  1. #1
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    Post Goniometric Measurements



    Neck Flexion

    Cervical spine flexes to just beyond point where convexity is straightened. (Greatest part of motion takes place in atlanto-occipital joint.)

    Neck Extension

    Cervical spine extends until head contacts dorsal muscle mass of upper limb.

    Trunk Flexion

    In supine flexion of thorax on pelvis is possible until scapulae are raised from table. Motion takes place primarily in the thoracic spine. (Trunk is carried to sitting position by reverse action of hip flexors with abdominal muscle acting as fixators.

    Trunk Rotation

    In supine, rotation of thorax is possible until scapula on side of forward shoulder is raised from the table.

    Trunk Extension

    Thoracic spine extends only to approximately a straight line. Lumbar spine extends freely.

    Elevation of Pelvis

    In standing position pelvis may be raised on one side until foot is well cleared of floor.

    Hip Flexion

    The normal range is 0 to 120-130 degrees.
    Supine, hip and knee are flexed. Contra lateral thigh is pressed strongly against table by patient to lessen posterior tilting of pelvis.
    Place stationary arm of goniometer on lateral longitudinal midline of trunk. Movable arm is placed on lateral midline of thigh. Reading is taken as thigh contacts pelvis. Any additional movement toward the knee chest position is brought about by a posterior tilting of pelvis and flexion in lumbar area of spine.

    Hip Extension

    The normal range is 0 to 10-20 degrees.
    Prone, both hips and knees are straight. Contra lateral thigh is pressed strongly against table by patient to lessen anterior tiling of pelvis as hip to be measured is extended.
    Place stationary arm of goniometer on lateral longitudinal midline of trunk. Movable arm is placed on lateral longitudinal midline of thigh. Do not allow the pelvis to be lifted from the table. Patient extends beyond the midline.

    Hip Abduction

    The normal range is 0 to 45 degrees.
    Supine, knee extended and hip abducted.
    Place stationary arm of the goniometer parallel to but below both anterior superior spines of the ilium at the level of hip joint. Movable arm is placed on the anterior longitudinal midline of thigh. Do not allow lateral hip rotation or movement of pelvis toward lower ribs.

    Hip Adduction

    The normal range is 0 to 20-30 degrees.
    Supine, uninvolved hip abducted. Limb to be measured adducted at the hip as far past zero position as possible.
    Place stationary arm of goniometer parallel to but below both anterior superior spines of the ilium al level of hip joint. Movable arm is placed on the anterior longitudinal midline of thigh. Do not allow medial rotation of the hip.

    Hip Lateral Rotation

    The normal range is 0 to 40-50 degrees.
    Sitting on side of table, hips and knees flexed about 90 degrees. Laterally rotate thigh. Place stationary arm of the goniometer perpendicular to the floor with the axis at centre of knee joint. Movable arm is placed on anterior longitudinal midline of thigh. Patient grasps side of table to stabilize pelvis. Do not allow hip flexion, abduction, adduction or a shift of the trunk laterally.

    Hip medial rotation

    The normal range is 0 to 35-45 degrees.
    Sitting on side of table, hips and knees flexed about 90 degrees. Medially rotate thigh. Place stationary arm of goniometer perpendicular to the floor with axis at centre of knee joint. Movable arm is placed on anterior longitudinal midline of thigh. Patient grasps side of table to stabilize pelvis. Do not allow hip flexion, abduction, adduction or a shift of the trunk laterally.

    Knee Flexion

    The normal range is 0 to 135-145 degrees.
    Supine, hip flexed 90 degrees, knees completely flexed.
    Place stationary arm of the goniometer on lateral longitudinal midline of thigh. Movable arm is placed on lateral longitudinal midline of leg. Do not allow hip abduction, adduction or rotation.

    Knee extension

    The normal range is 135-145 to 0 degrees.
    Supine, knee and hip straight.
    Place stationary arm of the goniometer on lateral longitudinal midline of thigh. Movable arm is placed on lateral longitudinal midline of leg. The heel may be raised from the table in the zero position because of the bulk of the gastrocsoleus. The hyperextension should be noted.

    Ankle Plantar Flexion

    The normal range is 0 to 45-55 degrees.
    Supine, knee and hip straight.
    Place stationary arm of the goniometer on lateral longitudinal midline of leg. Movable arm is placed parallel to the fifth metatarsal with axis over lateral maleolus of fibula. Do not allow inversion or eversion of the foot.

    Foot dorsiflexion and inversion

    The normal range is 0 to 15-25 degrees.
    Supine, knee partially flexed and supported by a pillow to lessen tension in the gatrocnemius.
    Place stationary arm of the goniometer on the lateral longitudinal midline of leg. Movable arm is placed parallel to fifth metatarsal with axis over lateral maleolus of fibula. Do not allow inversion or eversion of foot.

    Foot Inversion

    The normal range is 0 to 30-40 degrees.
    Sitting, on side of table with knees flexed. Foot is inverted.
    Place stationary arm of the goniometer on anterior longitudinal midline of leg. Movable arm is placed on dorsum of the foot parallel to lateral side of second metatarsal. The goniometer must be held forward and away from the ankle as it does not fit the contour of the joint.

    Foot eversion

    The normal range is 0 to 15-25 degrees.
    Sitting on side of table with knees flexed. Foot is everted.
    Place goniometer on anterior longitudinal midline of leg. Movable arm is placed on the dorsum of the foot parallel to lateral side of second metacarpal. Goniometer must be held forward and away from ankle as it does not fit the contour of the joint.

    Flexion of metatarsophalangeal joints of toes

    The normal range is 0 to 35-45 degrees.
    Supine, ankle dorsiflexed to lessen tension in the long extensors of toes. Metatarsophalangeal joints of the lateral four toes and hallux are flexed.
    Place stationary arm of goniometer on the longitudinal midline of the dorsal surface of each metatarsal of the joint to be measured. Movable arm is placed on the midline of the dorsal surface of proximal phalanx. Use a small goniometer.

    Flexion of interphalangeal joints of toes

    The normal range is 0 to 50-80 degrees.
    Supine, ankle dorsiflexed to lessen tension in long extensors of toes. Interphalangeal joints of lateral four toes are flexed.
    The midline on the dorsal surface of proximal, middle and distal phalanges is used for placement of the goniometer. Interphalangeal joint of the hallux is measured in the same way as the smaller toes. Use a small goniometer.

    Extension of metatarsophalangeal joints of toes and interphalangeal joint of hallux

    The normal range is 0 to 75-85 degrees.
    Supine, ankle plantarflexed to lessen tension in the log flexors of the toes. Metatarsophalangeal joints of the lateral four toes and hallux are extended.
    Place stationary arm of the goniometer on plantar surface of foot in line with each metatarsal. Movable arm is placed on the midline of plantar surface of proximal phalanx.

    Shoulder flexion

    The normal range is 0 to 170-180 degrees.
    Supine, knees and hips flexed to lessen extension of the lumbar spine, elbow in full extension to minimize tension in the long head of triceps. Shoulder flexed.
    Place stationary arm of the goniometer on midaxillary line of the thorax. Movable arm is placed on lateral longitudinal midline of the arm. Scapula must move anteriorly and laterally to allow full range of motion. Do not allow lower ribs to be lifted from table. With stabilization of scapula the above procedure may be used to isolate and measure glenohumarl motion.

    Shoulder extension

    The normal range is 0 to 50-60 degrees.
    Supine, arm over side of table, elbow flexed to minimize tension in the biceps muscle. Shoulder extended.
    Place stationary arm of goniometer on the midaxillary line of the thorax. Movable is placed on lateral longitudinal midline of the arm. Do not allow flexion of the thoracic spine or abduction at the shoulder joint.

    Shoulder Abduction

    The normal range is 0 to 170-180 degrees.
    Supine, shoulder abducted with lateral rotation of the humerus so that the greater tubercle may glide under rather than strike against the acromion. Elbow is extended to minimize tension in the long head of triceps.
    Place the stationary arm of goniometer on lateral aspect of the thorax parallel to the sternum. Movable arm is placed on the medial longitudinal midline of the arm. Do not allow lateral trunk flexion on the opposite site.

    Shoulder lateral rotation

    The normal range is 0 to 80-90 degrees.
    Supine, shoulder abducted to 90 degrees, elbow flexed to 90, forearm in mid position. Shoulder laterally rotated.
    Place stationary arm of goniometer perpendicular to the floor. Axis of motion is at the olecranon process. Movable arm is placed on lateral longitudinal midline of the forearm. Thorax should not be raised from the table. Examiner should steady the patient with a hand on his elbow before measurement is made.

    Shoulder medial rotation

    The normal range is 0 to 70-80 degrees.
    Supine, shoulder abducted to 90, elbow flexed to90, forearm in midposition. Shoulder medially rotated.
    Place stationary arm of goniometer perpendicular to the floor. Axis of motion is olecranon process. Movable arm is placed on the lateral longitudinal midline of the forearm. Thoracic spine is not flexed. Examiner should steady the patient with a hand on his elbow before measurement is made.

    Elbow Flexion

    The normal range is 0 to 145-155 degrees.
    Supine, arm at side and forearm in supination. Elbow flexed.
    Place stationary arm of goniometer on the lateral longitudinal midline of the arm. Movable arm is placed on lateral longitudinal midline of the forearm.

    Elbow extension

    The normal range is 145-155 to 0 degrees.
    Supine, arm at side and forearm in zero position between supination and pronation to partially eliminate the “carrying angle” at the elbow. Elbow extended.
    Place stationary arm of the goniometer on the lateral longitudinal midline of the arm. Movable arm is placed on the longitudinal midline of the dorsal surface of the forearm. Record hyperextension if present.

    Forearm supination

    The normal range is 0 to 80-90 degrees.
    Sitting, elbow flexed to 90 degrees, arm against thorax, forearm pronated.
    Place stationary arm of goniometer at the level of the dorsal aspect of the wrist and parallel to the anterior longitudinal midline of the arm. (The goniometer will be anterior to the body by the length of the forearm) Movable arm is placed across the dorsum of the wrist between the styloid processes of radius and ulna. Elbow should be kept close to the thorax. Do not allow abduction or rotation at the shoulder or lateral flexion of the trunk to the opposite side.

    Forearm pronation

    The normal range is 0 to 80-90 degrees.
    Supine, elbow flexed to 90 degrees, arm against thorax. Forearm supinated.
    Place stationary arm of goniometer at the level of the ventral aspect of the wrist and parallel to the anterior longitudinal midline of the arm. Movable arm is placed on the widest and most flattened area proximal to the wrist. Elbow should be kept at the lateral side of the thorax. Do not allow lateral flexion of the trunk to the same side as the extremity being measured.

    Wrist Flexion

    The normal range is 0 to 80-90 degrees.
    Sitting, forearm resting on table in mid position between pronation and supination, fingers loosely extended. Wrist flexed.
    Place stationary arm of goniometer on longitudinal midline of dorsal surface of forearm. Movable arm is placed on dorsal surface of third metacarpal. Do not allow abduction or adduction of the wrist.
    Abduction (radial deviation or flexion) and adduction (ulnar flexion or deviation) of wrist can be measured with the same placement of the goniometer.
    Abduction: 0 to 15-25 degrees
    Adduction: 0 to 30-40 degrees

    Wrist extension

    The normal range is 0 to 75-85 degrees.
    Sitting, forearm resting on the table in midposition between supination and pronation. Fingers loosely flexed. Wrist extended.
    Place stationary arm of goniometer on longitudinal midline of volar surface of forearm. Movable arm is placed parallel to the volar surface of the third metacarpal. (The goniometer will extend between the third and fouth finger.)

    Flexion of metacarpophalangeal joints of fingers

    The normal range is 0 to 85-105 degrees.
    Sitting, forearm resting on the table in midposition between supination and pronation. Fingers extended, metacarpophalangeal joints flexed.
    Place stationary arm of goniometer on the dorsal surface of the metacarpal of each joint to be measured. Movable arm is placed on dorsal surface of proximal phalanx. Range of motion is least in index finger and increase in each finger in turn. Use a small goniometer.

    Flexion of proximal and distal interphalangeal joints of fingers

    The normal range of motion
    Proximal: 0 to 110-120 degrees
    Distal: 0 to 80-90 degrees

    Sitting, elbow or forearm resting on the table, wrist partially extended to lessen tension in the long extensors of fingers. Proximal interphalangeal joints are first flexed for measurement, and then distal interphalangeal joints are flexed and measured. The midlines of the dorsal surface of the proximal, middle and distal phalanges are used for placement of goniometer.

    Extension of metacarpophalangeal joints of fingers

    The normal range is 0 to 20-30 degrees.
    Sitting, forearm resting on table in midposition between pronation and supination. Fingers partially flexed at interphalangeal joints. Metacarpophalangeal joints extended.
    Place stationary arm of goniometer on the dorsal surface of metacarpal of each joint to be measured. Movable arm is place on the dorsal surface of the proximal phalanx.

    Finger Abduction

    The normal range is 0 to 20-25 degrees.
    Sitting forearm resting on table in pronation, palm flat. Fingers are abducted. (Middle finger remains straight but can be actively abducted medially or laterally.)
    Place stationary arm of goniometer on the dorsal surface of each metacarpal. Movable arm is placed on proximal phalanx of each finger to be measured.

    Finger Adduction

    The normal range is 20-25 to 0 degrees.
    Sitting, forearm resting on the table in pronation, palm flat. Fingers are adducted.
    Place stationary arm of goniometer on the dorsal surface of each metacarpal. Movable arm is placed on proximal phalanx of each finger to be measured.

    Flexion of metacarpophalangeal and interphalangeal joints of thumb

    The normal range of motion
    Metacarpophalangeal flexion: 0 to 60-70 degrees
    Interphalangeal flexion: 0 to 80-90 degrees
    Sitting, forearm resting on the table in midposition between pronation and supination, wrist partially extended to lessen tension in the long extensors of thumb.
    The midline on the dorsal surface of first metacarpal, the proximal phalanx, and the distal phalanx is used for placement of the goniometer in measuring flexion of the metacarpophalangeal joint and distal joint of the thumb.

    Extension of metacarpophalangeal and interphalangeal joints of thumb

    The normal range of motion
    Metacarpophalangeal extension: 60-70 to 0 degrees
    Interphalangeal extension: 80-90 to 0 degrees
    Sitting, forearm in midposition, wrist partially flexed to lessen the tension in the long flexors of the thumb.
    The midline on the dorsal surface of first metacarpal, the proximal phalanx, and the distal phalanx is used for placement of the goniometer in measuring extension of the metacarpophalangeal joint and distal joint of the thumb.

    Thumb Abduction

    The normal range is 0 to 70-80 degrees.
    Sitting, forearm resting on the table in midposition between supination and pronation. Thumb is abducted.
    Place stationary arm of goniometer on lateral border of second metacarpal. Movable arm is placed on the medial border of the dorsal surface of the first metacarpal.

    Thumb adduction

    The normal range is 70-80 to 0 degrees.
    Sitting, forearm resting on the table in midposition between supination and pronation. Thumb is adducted.
    Place stationary arm of goniometer on lateral border of second metacarpal. Movable arm is placed on the medial border of the dorsal surface of the first metacarpal.

    Opposition of thumb and little finger

    Pad of thumb should be brought flat against that of little finger with opposition of first and fifth metacarpal bones.
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    thnx 4 u

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