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Shoulder flexion norm
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Goniometry Exam

OTA assessments

QuestionAnswer
Shoulder flexion norm 0 - 170 degrees
Shoulder extension norm 0 - 60 degrees
Shoulder Abduction norm 0 - 170 degrees
Shoulder Horizontal Abduction norm 0 - 40 degrees
Shoulder Horizontal Adduction Norm 0 - 130 degrees
Shoulder Internal rotation norm 0 - 70 degrees
Shoulder External rotation norm 0 -90 degrees
Elbow Flexion - Extension norm 0 - 135 - 150 degrees
Forearm pronation norm 0 - 80 - 90 degrees
Forearm supination norm 0 - 80 - 90 degrees
Wrist flexion norm 0 - 80 degrees
Wrist extension norm 0 - 70 degrees
Wrist radial deviation norm 0 - 20 degrees
Wrist ulnar deviation norm 0 - 30 degrees
Thumb IP Flexion norm 0 - 80 degrees
Thumb MP flexion norm 0 - 50 degrees
Thumb Radial abduction norm 0 - 50 degrees
Thumb palmar abduction norm 0 - 50 degrees
Thumb opposition norm measured in centimeters
Digit MCP flexion norm 0 - 90 degrees
Digit PIP flexion norm 0 - 110 degrees
Digit DIP flexion norm 0 - 80 degrees
client factor that describes the extent of movement that occurs at a joint Range of motion (ROM)
arc of motion through which the joint passe when voluntarily moved by muscles acting on the joint Active Range of motion (AROM)
arc of motion through which the joint passes when moved by an outside force (another person, yourself, object) Passive Range of motion (PROM)
disease processes, trauma, periarticular changes, and age Factors that can decrease joint movement
normal joint movement and muscular strength required for effortless movement in occupation
part of assessment of client factors in individuals (CVA, arthritis, fx, and general debility) also motivation Purpose of measuring joint ROM
Improvements in ROM not significant unless person has gained in performance skills to enhance participation in occupation
Role of COTA based on competency level, legislation and restrictions
degree and type of motion (occurs at specific jt.), average normal ROM, positioning of self and client during measurement. before doing goniometry the therapist must understand;
always establish rapport with patient before beginning goniometry
ask patient to move extremity through comfortable ROM noting amount of movement, noise, or discomfort
predisposition to joint limitations (RA, old fx, fused joints, etc.) Always check medical record for
uninvolved extremity some patients do not have full ROM check _________ for an idea of what is 'normal' for your patient
anatomic position most measurements are performed in
3 cardinal planes of movement (sagittal, frontal, horizontal) motions occur in
angle goni =
a measure metron =
stationary arm -Small protractor or half/full circle -Degree numbers are on this bar
movable arm -Attached to center of axis -Acts as the dial -Read the degree
axis 1) Rivet that acts as the fulcrum is placed over the axis of the joint 2) Makes a semi circle of movement 3) Tight enough to hold the movable arm when being measured
full circle-360 degree, 180, finger, small various sizes of goniometer
position of pt. (sitting, supine, etc.) and if pain, spasticity, or abnormal pathology is noted (unable to stand, etc.) examiner should note
scapular mobility glenohumeral mobility depends greatly on
5 degree increments you will round down or up (unless 1 degree) ROM is measured in
Sitting or standing Shoulder Flexion patient position
Side of patient Shoulder Flexion Therapist Position
enter of humerus just distal to acromion process on lateral aspect of humerus Shoulder Flexion Axis Location
Forearm and wrist in neutral Shoulder Flexion Starting Position
Client’s arm is raised in front of body in a sagittal plane of movement (Palm facing head) Shoulder Flexion Ending position
parallel to trunk Shoulder Flexion Stationary arm
parallel to humerus Shoulder Flexion Mobile Arm
Trunk bending Things to watch for measuring Shoulder Flexion
Sitting or standing Shoulder Extension patient position
Side of patient Shoulder Extension Therapist Position
Located center on the head of the humerus (just distal to acromion process) Shoulder Extension Axis Location
Forearm and wrist in neutral. Shoulder Extension Starting Position
Client’s arm is to be brought in back of the body in a sagittal plane of movement Shoulder Extension Ending position
Also parallel to trunk Shoulder Extension Stationary arm
Also parallel to humerus Shoulder Extension Mobile Arm
excessive scapular motion, spinal flexion Things to watch for measuring Shoulder Extension
Sitting or Standing Shoulder Abduction patient position
Behind patient Shoulder Abduction Therapist Position
on acromion process on posterior surface of shoulder Shoulder Abduction Axis Location
Palm up with shoulder in adduction with external rotation to prevent impingement Shoulder Abduction Starting Position
Client’s arm is raised to side of body in a frontal plane of movement Shoulder Abduction Ending position
parallel to trunk Shoulder Abduction Stationary arm
parallel to humerus Shoulder Abduction Mobile Arm
watch for lateral trunk bending Things to watch for measuring Shoulder Abduction
Sitting Horizontal Shoulder Abduction Patient Position
Standing behind patient Horizontal Shoulder Abduction Therapist Position
over acromion process Horizontal Shoulder Abduction Axis Location
shoulder in 90 degrees of abduction, palm down moving the shoulder into abduction. Horizontal Shoulder Abduction Starting Position
Move arm toward back of body patient's arm is raised to side of body in frontal plane of movement. Horizontal Shoulder Abduction Ending position
parallel over shoulder toward the neck Horizontal Shoulder Abduction Stationary arm
Parallel to the humerus on the superior aspect Horizontal Shoulder Abduction Mobile Arm
trunk bending Things to watch for measuring Horizontal Shoulder Abduction
Sitting Horizontal Shoulder Adduction Patient Position
Standing behind patient Horizontal Shoulder Adduction Therapist Position
Also on acromion process Horizontal Shoulder Adduction Axis Location
Shoulder in 90 degrees of abduction, palm down moving the shoulder into adduction Horizontal Shoulder Adduction Starting Position
Arm reaching in front and across body to opposite side patient's arm is moved in front of the body in horizontal plane of movement Horizontal Shoulder Adduction Ending position
Also parallel over shoulder toward the neck Horizontal Shoulder Adduction Stationary arm
Also Parallel to the humerus on the superior aspect Horizontal Shoulder Adduction Mobile Arm
trunk bending Things to watch for measuring Horizontal Shoulder Adduction
sitting or standing Shoulder Internal Rotation Patient Position
Beside patient Shoulder Internal Rotation Therapist Position
on olecranon process of elbow (point of elbow) Shoulder Internal Rotation Axis Location
Shoulder in 90 degrees of abduction, elbow in 90 degrees of flexion. Move into External rotation (like resting on an arm rest that is at shoulder height) Shoulder Internal Rotation Starting Position
Client’s forearm is swung down gently, keeping humerus parallel to floor Shoulder Internal Rotation Ending position
parallel to where forearm started Shoulder Internal Rotation Stationary arm
parallel to where forearm is at Shoulder Internal Rotation Mobile Arm
trunk bending, arm is straight Things to watch for measuring Shoulder Internal Rotation
sitting or standing Shoulder External Rotation Patient Position
Beside patient Shoulder external Rotation Therapist Position
Also on olecranon process of elbow (point of elbow) Shoulder external Rotation Axis Location
Also Shoulder in 90 degrees of abduction, elbow in 90 degrees of flexion. Move into External rotation (like resting on an arm rest that is at shoulder height) Shoulder external Rotation Starting Position
Client’s forearm is lifted gently, keeping humerus parallel to floor Shoulder external Rotation Ending position
Also parallel to where forearm started Shoulder external Rotation Stationary arm
Also parallel to where forearm is at Shoulder external Rotation Mobile Arm
trunk bending arm is sraight Things to watch for measuring Shoulder external Rotation
sitting or standing Elbow Extension to Flexion Patient Position
On side of patient Elbow Extension to Flexion Therapist Position
placed over lateral epicondyle of humerus at end of elbow crease Elbow Extension to Flexion Axis Location
Forearm supination with palm up (straighten as much as possible) Elbow Extension to Flexion Starting Position
Client bring palm towards shoulder Client’s forearm begins in extended position and is raised in a sagittal plane of movement. Elbow Extension to Flexion Ending position
parallel to midline of humerus Elbow Extension to Flexion Stationary arm
parallel to radius Elbow Extension to Flexion Mobile Arm
Watch for shoulder flexion Things to watch for measuring Elbow Extension to Flexion
Sitting Forearm supination Patient Position
Sitting in front of patient Forearm supination Therapist Position
at volar aspect of wrist just proximal to ulnar styloid Forearm supination Axis Location
Shoulder Adducted, Elbow at 90 degrees flexion. start with forearm in mid position/neutral. Forearm supination Starting Position
move palm toward the ceiling Client’s forearm is rotated laterally around ulna. Forearm supination Ending position
pointing downward perpendicular to floor Forearm supination Stationary arm
resting against volar aspect of wrist Forearm supination Mobile Arm
Elbow in ribs, watch for shoulder abduction Things to watch for measuring Forearm supination
Sitting Forearm pronation Patient Position
Also Sitting in front of patient Forearm pronation Therapist Position
At the dorsal aspect of wrist, just proximal to ulnar styloid Forearm pronation Axis Location
Also Shoulder Adducted, Elbow at 90 degrees flexion . start with forearm in mid position/neutral. Forearm pronation Starting Position
Patient moves palm to face the ground Client’s forearm is rotated medially around ulna. Forearm pronation Ending position
Pointing downward perpendicular to floor Forearm pronation Stationary arm
resting against volar aspect of wrist Forearm pronation Mobile Arm
Elbow in ribs, watch for shoulder internal rotation Things to watch for measuring Forearm pronation
Sitting (table) Wrist flexion patient position
Sitting across patient Wrist flexion therapist position
Center of Dorsal aspect of wrist (RC joint) Wrist flexion Axis location
Seated with elbow on table fingers toward ceiling. Wrist flexion Starting position
Palm down toward the table Wrist flexion Ending position
Lies down the center of the arm between the radius and ulna Wrist flexion stationary arm
along the center of the 3rd metacarpal (there will be space at the wrist bend) Wrist flexion Mobile arm
Watch for pronation/supination Things to watch for measuring Wrist flexion
Sitting (table) Wrist extension patient position
Also Sitting across patient Wrist extension therapist position
center of the volar/palmar surface of the wrist (RC joint) Wrist extension Axis location
also Seated with elbow on table fingers toward ceiling Wrist extension Starting position
Palm toward ceiling Wrist extension Ending position
also lies down the center of the forearm between the radius and ulna Wrist extension stationary arm
also along the center of the 3rd metacarpal (there will be space at the wrist bend) Wrist extension Mobile arm
watch for pronation/supination Things to watch for measuring Wrist extension
Sitting (table) Ulnar Deviation Patient position
Sitting in front of table Ulnar Deviation Therapist position
the base of the 3rd metacarpal (capitate - RC joint) Ulnar Deviation Axis location
Seated with forearm pronated and palm flat on table Ulnar Deviation Starting position
Pinky moved towards patients wrist Client’s hand is laterally extended in a horizontal plane of movement Ulnar Deviation Ending position
Lies down the center of the forearm Ulnar Deviation stationary arm
along the 3rd metacarpal (stay in line of metacarpal and not fingers) Ulnar Deviation Mobile arm
Watch for pronation/supination Things to watch for measuring Ulnar Deviation
Sitting (table) Radial Deviation Patient position
Also Sitting in front of table Radial Deviation Therapist position
the base of the 3rd metacarpal (capitate - RC joint) Radial Deviation Axis location
Seated with forearm pronated and palm flat on table Radial Deviation Starting position
patients thumb toward wrist Client’s hand is medially extended in a horizontal plane of movement. Radial Deviation Ending position
Also Lies down the center of the forearm Radial Deviation stationary arm
also along 3rd metacarpal Radial Deviation Mobile arm
Watch for pronation/supination Things to watch for measuring Radial Deviation
Sitting (Table) Digit MP Flexion Patient position
in front of table Digit MP Flexion Therapist position
over lateral aspect of MP joint of index finger Digit MP Flexion Axis location
Elbow on table with hand elevated in front of patient. Digit MP Flexion Starting position
patient making a fist Digit MP Flexion Ending position
on the digit you are measuring Digit MP Flexion stationary arm
Dorsum of the hand Digit MP Flexion Mobile arm
Thumb not in palm Things to watch for measuring Digit MP Flexion
Sitting (table) Digit PIP Flexion Patient position
In front of table Digit PIP Flexion Therapist position
centered on dorsal surface of PIP joint being measured. Digit PIP Flexion Axis location
Elbow on table with hand elevated in front of patient Digit PIP Flexion Starting position
making a fist Digit PIP Flexion Ending position
over proximal phalanx Digit PIP Flexion stationary arm
over distal phalanx Digit PIP Flexion Mobile arm
Thumb not in palm Things to watch for measuring Digit PIP Flexion
Sitting (Table) Digit DIP Flexion Patient position
In front of table Digit DIP Flexion Therapist position
dorsal surface of DIP joint Digit DIP Flexion Axis location
Elbow on table with hand elevated in front of patient Digit DIP Flexion Starting position
making a fist . Extend MP joint enough to fit moveable arm without hitting the palm Digit DIP Flexion Ending position
over middle phalanx Digit DIP Flexion Stationary Arm
over middle phalanx Digit DIP Flexion Mobile arm
Thumb not in palm Things to watch for measuring Digit DIP Flexion
Sitting (table) Thumb MP Flexion Patient position
in front of table Thumb MP Flexion Therapist position
dorsal surface of MP joint Thumb MP Flexion Axis location
Neutral wrist on the ulnar border (45 degrees forearm supination) Thumb MP Flexion Starting position
(Reach thumb to bottom of palm) Client’s thumb distal of MP joint is flexed down Thumb MP Flexion Ending position
over thumb metacarpal Thumb MP Flexion Stationary Arm
over thumb metacarpal Thumb MP Flexion Mobile arm
On metacarpal not tendon Things to watch for measuring Thumb MP Flexion
Sitting Thumb IP Flexion Patient position
in front of table Thumb IP Flexion Therapist position
dorsal surface of IP joint Thumb IP Flexion Axis location
Neutral wrist on the ulnar border. Measure when the MP is also flexed. Thumb IP Flexion Starting position
(Reach thumb to bottom of palm) Client’s thumb distal of IP joint is flexed down Thumb IP Flexion Ending position
over proximal phalanx Thumb IP Flexion Stationary Arm
over distal phalanx Thumb IP Flexion Mobile arm
May need to slightly elevate hand to not hit table, keeping forearm stabilized on table Things to watch for measuring Thumb IP Flexion
Sitting Thumb CMC Radial Abduction Patient position
Sitting across table Thumb CMC Radial Abduction Therapist position
over CMC joint at base of thumb Thumb CMC Radial Abduction Axis location
Palm flat on table Thumb CMC Radial Abduction Starting position
Move thumb away from side of fingers Client’s thumb is abducted in a horizontal plane of movement. Thumb CMC Radial Abduction Ending position
In line with 2nd metacarpal Thumb CMC Radial Abduction Stationary Arm
parallel to thumb metacarpal Thumb CMC Radial Abduction Mobile arm
on metacarpal not tendon Things to watch for measuring Thumb CMC Radial Abduction
Sitting Thumb CMC Palmar Abduction Patient position
Sitting across table Thumb CMC Palmar Abduction Therapist position
1st CMC joint (anatomical snuff box) Thumb CMC Palmar Abduction Axis location
Hand and wrist on ulnar border Thumb CMC Palmar Abduction Starting position
Thumb move away from index finger (in a plane perpendicular to palm) Thumb CMC Palmar Abduction Ending position
in line with 2nd metacarpal Thumb CMC Palmar Abduction Stationary Arm
in line with 1st metacarpal Thumb CMC Palmar Abduction Mobile arm
on metacarpal not tendon Things to watch for measuring Thumb CMC Palmar Abduction
measure with ruler part of goniometer between center of pulp of thumb and small finger Thumb opposition.
Created by: OTAbaddies
 

 



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