goniometry Flashcards
what are possible precautions for goniometry
fracture/ dislocation/ subluxation/ other joint instability
healing (stages)
myositis ossificans
hypermobility
pain
osteoporosis
what should be ensured before starting goniometry
joint should be visualised and model should be appropriately dress
ideally start in anatomical position
ensure position of patient is documented in clinical notes
what is the process of goniometry
estimate ROM eyeballing
measure joint in start position
stabilize proximal joint
compare sides
how is elbow goniometry measured
- Start position: Supine/sitting. Arm in anatomical position. Towel
under distal end of humerus to accommodate ROM - Therapist stabilises humerus
- Axis: Lateral epicondyle of the humerus
- Stationary arm: Parallel to the longitudinal axis of the humerus,
pointing toward the tip of the acromion process - Movable arm: Parallel to longitudinal axis of the radius, pointing
toward the styloid process of the radius.
how is shoulder flexion measured
Start position: Model is in crook lying or sitting. Arm is at their side,
palm facing medially.
* Stabilisation: Weight of trunk (in lying). Scapula is free to move
* Axis: Lateral aspect of the centre of the humeral head, about 2.5cm
inferior to the lateral aspect of the acromion process.
* Stationary arm: Parallel to lateral midline of the trunk
* Movable arm: Parallel to longitudinal axis of the humerus.
* End position: Humerus is moved in anterior and upward direction to
the limit of motion in elevation.
what trick movements may be observed at the shoulder?
Trunk extension and shoulder abduction
what moves during flexion and extension of the shoulder?
glenohumeral joint and scapula, if only measuring GH joint must stabilise scapula
how is shoulder elevation in abduction measured?
Start position: Model is supine or sitting. Arm is at the side in adduction and
lateral rotation
* Stabilisation: weight of the trunk
* Goniometer axis: Midpoint of the anterior or posterior aspect of the
glenohumeral joint, about 1.3 cm inferior and lateral to the coracoid process.
* Stationary arm: Parallel to sternum (or use posterior approach as appropriate)
* Movable arm: Parallel to longitudinal axis of the humerus
* End position: Humerus is moved laterally and upwards to the limit of elevation
(scapula and GH joint movement)
how is lateral rotation of the shoulder measured?
Start position: Supine. Shoulder abduction to 90°, elbow at 90°, forearm in mid
position. Towel under humerus.
* Stabilisation: Weight of trunk. Therapist hand over clavicle and coracoid process.
* Axis: Olecranon process of the ulna
* Stationary arm: Perpendicular to the floor
* Movable arm: Parallel to the longitudinal axis of the ulna, pointing towards the
ulnar stylod process.
* End position: Dorsum of hand moves towards the floor.
what is a contraindication to the start position for shoulder lateral rotation (starting in supine with abduction to 90 and elbow at 90) and what would an alternative position be?
Pt has history of anterior shoulder dislocation of GH joint
Start position: Sitting
To measure lateral rotation, arm is at the side in adduction, elbow flexed to 90°, forearm in mid position.
* Goniometer axis: Under the olecranon process
* Stationary arm: perpendicular to trunk
* Movable arm: Parallel to longitudinal axis of the ulna
* End position: Palm of hand moves away from abdomen
how is cervical spine movement measured for flexion extension, side flexion and rotation
pt should be sat in a chair with back support, feet flat and arms by side, head and neck in anatomical position
flexion: measure tip of chin to sternal notch
extension: tip of chin to sternal notch
side flexion: mastoid process to lateral aspect of acromion process
rotation: tip of chin to lateral aspect of acromion process
how is hip flexion measured in goniometry?
Start position: Supine. Hip and knee in neutral. Opposite hip can be flexed or extended (but be
consistent with this)
* Stabilisation: Trunk is stabilised through body positioning. Therapist can stabilise ipsilateral pelvis.
* Goniometer axis: Greater trochanter of femur
* Stationary arm: Parallel to mid-axillary line of the trunk
* Movable arm: Parallel to the longitudinal axis of the femur, pointing towards the lateral
epicondyle.
* End position: Hip is flexed to the limit of motion, with knee flexion
what substitute movements may be observed whilst measuring hip flexion?
posterior pelvic tilt, flexion of lumbar spine
Why should the knee be flexed when measuring hip flexion
due to the influence of hamstring length and the hamstrings working over two joint
How is hip abduction measured?
Start position: Supine, anatomical position. Ensure pelvis is level.
* Stabilization: Therapist can stabilise ipsilateral pelvis. If additional stabilisation required,
contralateral lower limb may be positioned in hip abduction with knee flexed over the
edge of the plinth and foot supported on a stool.
* Goniometer axis: The axis is placed over the ASIS on the side being measured.
* Stationary Arm: Along a line that joins the 2 ASIS’s
* Movable arm: Parallel to the longitudinal axis of the femur, pointing toward the midline
of the patella. In the start position the goniometer will indicate 90°. This is recorded as 0°
* End position: The hip is abducted to limit of ROM
