Intro to Goniometry

Question 1

What is goniometry?

Answer 1

The measurement of angles that are created at joints by the bones of the body

• Places the parts of the measuring instrument, a goniometer, along the bones immediately proximal and distal to the joint being evaluated
• An important part of a comprehensive examination of joints and surrounding soft tissue
• Measures and documents the amount of active and passive joint motion as well as abnormal fixed joint positions

Question 2

What is meant by “end feel’?

Answer 2

feeling of a barrier to further motion experienced by the examiner

Question 3

What is hypomobility and how are it related to capsular and non-capsular patterns?

Answer 3

Decrease in ROM that is substantially less than normal values for that joint, given the individual’s age and gender

• Capsular patterns of restricted motion: particular pattern of restriction involving all or most of the passive motions of the joint
• Noncapsular patterns of restricted motion: limitation of passive motion that is not proportioned similarly to a capsular pattern

Question 4

What is hypermobility and possible causes?

Answer 4

Ability of one or more joints to actively or passively move beyond normal limits given the individual’s age and gender
-Possible causes: laxity of soft tissue structures (e.g., ligaments, capsules, and muscles) that normally prevent excessive motion at a joint, abnormalities of the joint surfaces, or serious hereditary disorders of connective tissue

Question 5

What factors affect ROM?

Answer 5

Range of motion varies among individuals and is influenced by various factors
Age: Youngest age-groups have more hip flexion, hip abduction, hip lateral rotation, ankle dorsiflexion, and elbow motion
Gender: Females are more often reported to have slightly greater ROM than males
Whether the motion is active or passive

Question 6

What is meant by muscle length testing?

Answer 6

Maximal muscle length is the greatest extensibility of a muscle-tendon unit

Question 7

Why is it important to know the test position for goniometry and muscle length testing?

Answer 7

• Places the joints in a zero starting position when measuring range of motion (ROM)
• Lengthens a multi-joint muscle when measuring muscle length
• Helps to stabilize the proximal joint segment
• Important for the comfort of the examiner and individual being measured

Question 8

How does the testing position provide stabilization to the joint being assessed by goniometry or muscle length testing?

Answer 8

-Stabilizes the body and proximal joint segment
Isolates the motion to one joint to ensure that a true measurement of the motion is obtained
-May supplement positional stabilization with manual stabilization provided by the examiner

Question 9

What are the precautions to performing goniometry aor muscle length testing?

Answer 9

Suspected or confirmed
Joint dislocation or subluxation
Unstable bone fracture
Rupture of tendon or ligament
Infectious or acute inflammatory process
Severe osteoporosis
Acute injury or recent surgery
Presence of pain or muscle spasms
Immobilized joints (e.g., cast)

Question 10

What is the procedure for performing goniometry?

Answer 10

Steps

1. Position the individual in the recommended testing position and as close to the side of the bed or plinth as possible.
2. Stabilize the proximal joint segment.
3. Move the distal joint segment to the zero starting position. If the joint cannot be moved to the zero starting position, it should be moved as close as possible to the zero starting position. Slowly move the distal joint segment to the end of the passive ROM and determine the end-feel. Ask the individual whether there was any discomfort during the motion.
4. Make a visual estimate of the ROM.
5. Return the distal joint segment to the starting position.
6. Palpate the bony anatomical landmarks. (in lab practical - verbally state the landmarks)
7. Align the goniometer.
8. Read and record the starting position. Remove the goniometer. (in lab practical verbal state the starting number)
9. Stabilize the proximal joint segment.
10. Move the distal segment through the full ROM.
11. Replace and realign the goniometer. Palpate the anatomical landmarks again.
12. Read and record the ROM. (in lab practical verbally state the ROM assessed)

Question 11

What is meant by validity in goniometry assessments?

Answer 11

Validity of a measurement refers to how well it represents the true value of the variable of interest and how well it can be used for a specific purpose
-A valid goniometric measurement represents the actual joint angle that can provide data for use in clinical decision-making

Question 12

What is meant by reliability in goniometry assessments?

Answer 12

Amount of consistency between successive measurements of the same variable on the same individual under the same conditions
-A goniometric measurement is highly reliable if successive ROM measurements on the same individual and under the same conditions yield the same results
A highly reliable measurement contains little measurement error

Question 13

How can you make sure to maintain or improve reliability of goniometry assessments?

Answer 13

TABLE 3.1 Recommendations for Improving the Reliability of Goniometric Measurements
• Use consistent, well-defined testing positions.
• Stabilize the part of the body that is proximal to the joint being examined to prevent unwanted movements.
• Use consistent, well-defined, and carefully palpated anatomical landmarks to align the goniometer.
• Use the same amount of manual force to move the body part during successive measurements of passive ROM.
• Provide consistent direction, including asking that an individual exerts the same effort to move the body part during successive measurements of active ROM.
• Use the same device to take successive measurements.
• Use a goniometer that is suitable in size to the joint being measured.
• If the examiner is less experienced, record the mean of several measurements rather than a single measurement.
• Have the same examiner, rather than a different examiner, take successive measurements.
•Calibrate the measurement instrument at regular intervals.

Question 14

Why is it important for measurements, such as ROM, to be valid and reliable?

Answer 14

For goniometry to provide meaningful information, measurements must be valid. For example, a valid goniometric measurement must represent the actual joint angle and provide data for use in clinical decision-making. In order for a measurement to be valid, not only should the measurement represent the true variable of interest, but also the same value should be obtained when the measurement is repeated under the same conditions.