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Goniometry Exam
OTA assessments
Question | Answer |
---|---|
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. |