Normal End feels:
- soft
- firm
- hard
- soft tissue approximation
- muscular stretch, capsular stretch, ligamentous stretch
- bone contacting bone
abnormal end feels:
- soft
- firm
- hard
- empty
- occurs sooner or later in the ROM than is usual, or in a joint that is normally hard or firm, boggy (edema, synovitis)
- occurs sooner or alter in ROM, or in joint than normally is hard or soft
- occurs sooner or later in ROM, or in joint that is normally other- bony grating or bony block is felt
- no real end-feel because pain prevents reaching of ROM
steps for goniometry
- positioning
- stabilization
- ROM
- End feel assessment
- Visual Estimate
- Measure
Shoulder flexion (GH)
patient position: supine, palm facing the body
axis: acromion
stationary arm alignment: mid-axillary line
moveable arm alignment: lateral midline humerus (lateral epicondyle)
Shoulder flexion (complex)
normal range: 0-180 position: supine, palm facing the body Axis: acromion SAA: mid-axillary line MAA: lateral midline humerus (lateral epicondyle)
Shoulder Abduction (GH)
range: 0- ~120
position: supine, elbow extended, palm facing anteriorly
Axis: anterior acromion
SAA: parallel midline sternum
MAA: medial midline humerus (medial epicondyle)
Shoulder Abduction (complex)
range: 0-180
position: supine, elbow extended, palm facing anteriorly
Axis: anterior acromion
SAA: parallel midline sternum
MAA: medial midline humerus (medial epicondyle)
Shoulder medial rotation
range: *0-70
position: supine, shoulder abducted to 90, neutral forearm
Axis: olecranon
SAA: parallel to or perpendicular to floor
MAA: border of ulna; project to styloid
Shoulder lateral rotation
range: 0-90 in 90 degrees of abduction
position: supine, shoulder abducted to 90, neutral forearm
axis: olecranon
SAA: parallel to or perpendicular to floor
MAA: border of ulna; project to styloid
Shoulder extension
range: 0-50/60
position: prone, palm facing the body
axis: acromion
SAA: mid-axillary line
MAA: lateral midline humerus; project to lateral epicondyle
Shoulder horizontal adduction
range: 0-120
position: supine, shoulder abducted to 90, neutral forearm
axis: superior acromion
SAA: parallel to ground
MAA: midshaft of humerus; project to lateral epicondyle
Shoulder horizontal abduction
range: 0-30
position: supine, shoulder abducted to 90, neutral forearm
axis: superior acromion
SAA: parallel to ground
MAA: midshaft of humerus, project to lateral epicondyle
Elbow extension/flexion
range: 0-145/150 or 10-0-150
position: supine, arm close to side of body, forarm supinated
axis: over lateral epicondyle
SAA: lateral midline of humerus
MAA: lateral midline of radius; project to styloid
Pronation (R/U)
position: sitting, arm at side, elbow flexed to 90
Axis: 3rd MCP
SAA: midline of anterior humerus
MAA: dorsum of forearm at R/U joint or parallel to pen lightly held
Pronation (complex)
range: 0-75
position: sitting, arm at side, elbow flexed to 90
Axis: 3rd MCP
SAA: midline of anterior humerus
MAA: dorsum of forearm at R/U joint or parallel to pen lightly held
Supination (R/U)
position: sitting, arm at side, elbow flexed to 90
axis: 3rd MCP
SAA: midline of the anterior humerus
MAA: palmar forearm at R/U joint or parallel to pen lightly held
Supination (complex)
range: 0-85/90
position: sitting, arm at side, elbow flexed to 90
axis: 3rd MCP
SAA: midline of the anterior humerus
MAA: palmar forearm at R/U joint or parallel to pen lightly held
Wrist flexion
range: 0-80
position: sitting, elbow flexed to 90, forearm in neutral, wrist neutral deviation
axis: triquetrum/capitate
SAA: lateral midline of ulna; project to olecranon
MAA: 5th MC
Wrist extension
range: 0-70
position: sitting, elbow flexed to 90, forearm in neutral, wrist neutral deviation
axis: triquetrium
SAA: lateral midline of ulna; project to olecranon
MAA: 5th MC
Radial deviation
range: 0-20/25
position: sitting, elbow flexed to 90, forearm in neutral, wrist neutral flex/ext
axis: capitate
SAA: dorsal midline of forearm; project to lateral epicondyle
MAA: 3rd MC
Ulnar deviation
range: 0-30/35
position: sitting, elbow flexed to 90, forearm in neutral, wrist neutral flex/ext
axis: capitate
SAA: dorsal midline of forearm; project to lateral epicondyle
MAA: 3rd MC
thumb CMC flexion
range: record start and end # ~15 degrees of motion
position: sitting, forearm supinated, wrist neutral, MCP and IP thumb in neutral, CMC adducted
axis: CMC joint
SAA: anterior radius
MAA: Palmar 1st MC
thumb CMC abduction in plane palm
range: record start and end number
position: sitting, forearm supinated, wrist neutral, MCP and IP thumb in neutral, CMC adducted
axis: CMC joint
SAA: anterior radius
MAA: Palmar 1st MC
thumb CMC abduction perpendicular
range: record start and end number
position: sitting, forearm neutral, wrist neutral, MCP and IP thumb in neutral, CMC adducted
axis: between 1st and 2nd CMC joints
SAA: lateral 2nd MC
MAA: dorsal midline 1st MC
