Occupational therapists use goniometric measurements to quantify range of motion limitations, guide treatment interventions, and document effectiveness. The universal goniometer is the most widely used tool, measuring joint angles by aligning stationary and movable arms along bony landmarks with a protractor-style scale. Proper patient, joint, goniometer, and therapist positioning is crucial for reliability and validity. Stabilization of adjacent joints isolates the motion being measured.
Range of motion (ROM) measurements are performed to evaluate joint impairment, develop treatment goals, assess progress, and modify treatment. ROM is described in 3 planes and axes and measured using a goniometer. Active ROM is voluntary motion while passive ROM uses external assistance. Several factors determine ROM including joint integrity, scarring, age, gender, joint shape, and health of surrounding tissues. Common causes of limited ROM include contractures, arthritis, and pain. Precise positioning and stabilization are needed to reliably measure ROM of various joints like the shoulder, spine, and knee. Standardized testing procedures and documentation of measurements are important.
Dr. Robin McKenzie developed the McKenzie Method for treating back pain mechanically without surgery or medication. The method involves assessing a patient's pain response to various spinal movements to determine the underlying problem. Treatment focuses on specific exercises that centralize the pain by improving spinal mechanics. Exercises may involve extension, flexion, or lateral movements. The goal is to reduce pain and improve range of motion over several weeks with a home exercise program. Precautions are taken for certain conditions like spinal stenosis or recent trauma. The McKenzie Method provides an alternative to medication for many back pain issues.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
This document provides information on measuring range of motion for various joints using a goniometer. It describes testing positions, stabilization techniques, and placement of the goniometer arms for measuring flexion, extension, abduction, adduction, and rotation at the hip, knee, ankle, and toes. Standard ranges of motion are provided for each movement as well as common substitutions and normal end feels. The document explains that a goniometer is an instrument used to measure joint angles and derives its name from the Greek words for angle and measure.
This document provides an analysis of posture including definitions, types of posture, and the key body structures and forces involved in maintaining posture. It discusses static and dynamic posture and defines the concepts of center of gravity, base of support, and line of gravity. It describes the various systems that contribute to postural control and different postural responses to perturbations. Finally, it analyzes posture in the sagittal plane and the forces acting on the ankle, knee, hip, and lumbosacral joint regions.
It is a technique developed by Janet H Carr and Roberta B Shepherd which provides physiotherapists and occupational therapists with an approach to stroke rehabilitation that is clear, relevant, and effective, building on the research-based model created by the authors
The document discusses goniometry techniques for measuring range of motion of the wrist and fingers. It provides details on positioning, goniometer alignment, and normal range of motion values for various wrist, hand, and finger motions according to sources like the American Academy of Orthopedic Surgeons. A variety of goniometry tools are presented, from universal goniometers to electrogoniometers, digital tools, and 3D motion analysis systems.
Range of motion (ROM) measurements are performed to evaluate joint impairment, develop treatment goals, assess progress, and modify treatment. ROM is described in 3 planes and axes and measured using a goniometer. Active ROM is voluntary motion while passive ROM uses external assistance. Several factors determine ROM including joint integrity, scarring, age, gender, joint shape, and health of surrounding tissues. Common causes of limited ROM include contractures, arthritis, and pain. Precise positioning and stabilization are needed to reliably measure ROM of various joints like the shoulder, spine, and knee. Standardized testing procedures and documentation of measurements are important.
Dr. Robin McKenzie developed the McKenzie Method for treating back pain mechanically without surgery or medication. The method involves assessing a patient's pain response to various spinal movements to determine the underlying problem. Treatment focuses on specific exercises that centralize the pain by improving spinal mechanics. Exercises may involve extension, flexion, or lateral movements. The goal is to reduce pain and improve range of motion over several weeks with a home exercise program. Precautions are taken for certain conditions like spinal stenosis or recent trauma. The McKenzie Method provides an alternative to medication for many back pain issues.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
This document provides information on measuring range of motion for various joints using a goniometer. It describes testing positions, stabilization techniques, and placement of the goniometer arms for measuring flexion, extension, abduction, adduction, and rotation at the hip, knee, ankle, and toes. Standard ranges of motion are provided for each movement as well as common substitutions and normal end feels. The document explains that a goniometer is an instrument used to measure joint angles and derives its name from the Greek words for angle and measure.
This document provides an analysis of posture including definitions, types of posture, and the key body structures and forces involved in maintaining posture. It discusses static and dynamic posture and defines the concepts of center of gravity, base of support, and line of gravity. It describes the various systems that contribute to postural control and different postural responses to perturbations. Finally, it analyzes posture in the sagittal plane and the forces acting on the ankle, knee, hip, and lumbosacral joint regions.
It is a technique developed by Janet H Carr and Roberta B Shepherd which provides physiotherapists and occupational therapists with an approach to stroke rehabilitation that is clear, relevant, and effective, building on the research-based model created by the authors
The document discusses goniometry techniques for measuring range of motion of the wrist and fingers. It provides details on positioning, goniometer alignment, and normal range of motion values for various wrist, hand, and finger motions according to sources like the American Academy of Orthopedic Surgeons. A variety of goniometry tools are presented, from universal goniometers to electrogoniometers, digital tools, and 3D motion analysis systems.
This document defines goniometry as a technique used to measure range of motion in joints. It discusses the definition, uses, parts of a goniometer, degrees of freedom in joints, and procedures for goniometric measurement. Key points covered include that a goniometer consists of stationary, moving, and body arms to measure angles in degrees, and it is used to identify contractures or decreased range of motion from injury or disuse, help develop treatment goals, and evaluate rehabilitation progress. Normal ranges of motion are provided for the shoulder and elbow.
The document discusses postural control and balance, defining it as the ability to control body position in space. It describes static and dynamic postural control, and notes an intervention program should be based on an accurate evaluation. The summary provides exercises to improve postural alignment, control of movement, adaptation to tasks/environments, and fall prevention. A balance training program incorporates steady state, anticipatory and reactive exercises focusing on static and dynamic postural control.
This document provides instructions for performing goniometry to measure range of motion at various joints in the body, including the shoulder, elbow, wrist, hip, knee, and ankle. Goniometry involves using a goniometer, which has a fulcrum, stationary arm, and moving arm, to measure joint angles. The document describes patient positioning and goniometer placement for range of motion tests for motions like shoulder flexion, elbow extension, wrist pronation, hip abduction, knee flexion, and ankle dorsiflexion. It also provides normal range of motion values for reference.
Re-education means educating something, which is already known by an individual.
Here the patient knows the activities or movements or functions that has, to be performed but due to his ailment or diseased pathology he could not perform it properly.
The document describes the starting position, range of motion, precautions, and factors limiting range of motion for various neck and trunk motions including flexion, extension, rotation, lateral flexion, and hyperextension. The neck motions include flexion from 0-45 degrees, extension from 45-0 degrees, rotation from 0-60 degrees to each side, and lateral flexion from 0-45-60 degrees to each side. Trunk motions include flexion of approximately 4 inches, hyperextension of 2 inches, and lateral flexion and rotation measuring differences in distances between starting and ending positions using landmarks like spinous processes.
Biomechanics and pathomechanics of scoliosisRashmitadash3
This document discusses the biomechanics and pathomechanics of scoliosis. Some key points:
- Scoliosis is a lateral curvature of the spine that deviates from the normal vertical line. It can occur in the sagittal, coronal, or axial planes.
- In structural scoliosis, asymmetrical pressure on immature vertebrae causes uneven growth, resulting in wedging and rotation. Soft tissues also shorten on the concave side.
- Several theories try to explain scoliosis progression, like the Hueter-Volkmann law about bone growth and Stoke's vicious cycle theory.
- Types of scoliosis include idiopathic, congenital, neu
This document provides an overview of orthosis, including definitions of splints and braces, classifications of orthosis, principles of splint design, materials used, prefabricated splints, and biomechanical principles. It also describes various upper and lower limb orthosis, such as figure of eight axilla wraps, gunslinger splints, airplane splints, hemi arm slings, elbow flexion harnesses, cockup splints, and more. The objectives, indications, and designs of different orthosis are discussed in detail.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
This document provides an overview of posture biomechanics, including:
1. Definitions of static and dynamic posture, and descriptions of optimal sagittal and frontal plane alignment.
2. Explanations of how posture is controlled through sensory inputs, muscle activity, and strategies like fixed support and changing support.
3. Analyses of deviations from optimal posture, including positions of the foot, knee, spine, and effects of sitting and lying postures. Factors like age, gender, and occupation are also discussed.
Kinetics and Kinematics of Gait summarizes gait terminology, phases, joint motion, determinants, and the kinetics and kinematics of the trunk and upper extremities during gait. It describes the six determinants of gait including pelvic rotation and tilting, knee flexion in stance, and foot and knee mechanisms which function to minimize center of gravity displacement. The document also outlines the muscle activity, internal joint moments, and energy requirements including potential and kinetic energy exchange during the gait cycle.
Goniometry refers to the precise measurement of joint angles using instruments such as a universal goniometer. Goniometric data is used to determine impairment, establish diagnoses, develop treatment plans, and evaluate progress. Joint motion includes arthrokinematics (gliding and spinning of joint surfaces) and osteokinematics (bone movements). Range of motion is measured in three planes (sagittal, frontal, transverse) using instruments properly aligned with bony landmarks. Both active and passive range of motion are measured to evaluate joint integrity and flexibility. Restricted or increased range of motion can indicate conditions like capsular patterns of hypomobility or generalized hypermobility.
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
Manual therapy techniques like joint mobilizations and manipulations can be used to safely restore normal joint mechanics and reduce trauma. Effective use requires knowledge of anatomy, arthrokinematics, and pathologies. Several concepts for manual therapy techniques were introduced, including Cyriax, Mulligan, Maitland, and McKenzie. Contraindications include inflammation, effusion, and hypermobility while indications include reversible hypomobility and functional limitations responding to mechanical treatment. Grading systems determine appropriate mobilization force and different joints require specific examination and treatment techniques.
This document discusses strategies to reduce force on the hip joint for individuals with hip osteoarthritis or weak hip abductor muscles. It analyzes using a lateral lean, cane on the same side, or cane on the opposite side. A lateral lean reduces gravitational torque but increases energy expenditure. A cane on the same side provides some relief but a cane on the opposite side may offset gravity's torque, reducing the need for abductor muscle force and joint compression to just body weight. However, the full distance between hand and hip may overestimate the cane's effectiveness.
Electrical stimulation motor points and applicationSreeraj S R
The document discusses the motor points of various nerves including the axillary, musculocutaneous, radial, median, ulnar, femoral, sciatic, tibial, superior peroneal, deep peroneal and facial nerves. It also discusses principles of electrical stimulation application such as patient positioning, skin preparation, testing the equipment, determining treatment parameters and monitoring the patient during treatment. Precautions, contraindications and procedures for initiating, conducting and terminating the treatment are provided.
This document discusses the physical examination of the shoulder, including assessment of range of motion and specific tests to evaluate for common shoulder pathologies. It begins by reviewing the anatomy of the shoulder joint and surrounding structures. Range of motion is assessed in all planes, including active and passive motion. Specific tests are described to evaluate the rotator cuff muscles, biceps tendon, and impingement. Conditions like tendonitis, bursitis, tears, and impingement can be identified by pain or weakness during particular range of motion activities against resistance. The physical examination provides insight into shoulder function and the source of any pain or limitations.
The document discusses various aspects of shoulder biomechanics during pulling movements. It considers whether pulling is better characterized as a translational or rotational movement, and what factors influence this. Some key points discussed include:
- Pulling involves elements of both translation and rotation, and the contribution of each depends on variables like grip width and bar height.
- The scapula and trunk play an important role in distributing forces. Proper scapular stability is important for injury prevention.
- Slow, heavy pulls with the elbow passing the trunk line can overload small rotator cuff muscles if other joints don't move together. Lighter loads or explosive movements may reduce this.
- Push-pull strength ratios
The document summarizes key aspects of human walking (gait) including:
- The gait cycle is divided into stance and swing periods, with distinct functional tasks in each.
- Gait parameters like velocity, cadence, stride length are described.
- Determinants of gait like pelvic rotation, knee flexion, and foot/ankle mechanics help minimize vertical displacement of the center of gravity and increase efficiency.
- Gait analysis methods including observational, quantitative techniques like kinetics, electromyography, motion capture are outlined.
Different pathological gaits like amputee, ataxic, and spastic gaits are also briefly discussed.
The document provides an overview of the Kaltenborn joint mobilization method. It describes how traditional manipulations have changed over time to reduce risk of injury. Kaltenborn introduced using linear translatoric movements instead of rotational forces to further reduce joint compression. The method evaluates joints for hypomobility and uses grades I-III mobilizations within or at the end of the joint's range of motion to restore normal movement and reduce pain. Precise positioning and understanding concave/convex bone movement aids effective and safe treatment.
Goniometry involves measuring the range of motion of joints using a goniometer. Key steps in the goniometry procedure include positioning the joint at zero position, moving it to the end of its range of motion, palpating bony landmarks, aligning the goniometer, and recording the measurement. Valid and reliable goniometric measurements require proper stabilization of proximal joint components and identification of the end feel, or resistance felt at the end of range. The document then provides details on positioning, procedures, and normal ranges for measuring several upper extremity joints including the shoulder, elbow, forearm, wrist, and finger joints.
Goniometry refers to the measurement of joint angles using a goniometer. There are various types of goniometers that have a body and two arms to align along bones proximal and distal to the joint. Goniometry is used to measure both active and passive range of motion of joints to assess limitations. The document provides details on goniometry procedures, principles, factors affecting range of motion, indications, contraindications and examples of normal range of motion measurements for various upper and lower limb joints.
This document defines goniometry as a technique used to measure range of motion in joints. It discusses the definition, uses, parts of a goniometer, degrees of freedom in joints, and procedures for goniometric measurement. Key points covered include that a goniometer consists of stationary, moving, and body arms to measure angles in degrees, and it is used to identify contractures or decreased range of motion from injury or disuse, help develop treatment goals, and evaluate rehabilitation progress. Normal ranges of motion are provided for the shoulder and elbow.
The document discusses postural control and balance, defining it as the ability to control body position in space. It describes static and dynamic postural control, and notes an intervention program should be based on an accurate evaluation. The summary provides exercises to improve postural alignment, control of movement, adaptation to tasks/environments, and fall prevention. A balance training program incorporates steady state, anticipatory and reactive exercises focusing on static and dynamic postural control.
This document provides instructions for performing goniometry to measure range of motion at various joints in the body, including the shoulder, elbow, wrist, hip, knee, and ankle. Goniometry involves using a goniometer, which has a fulcrum, stationary arm, and moving arm, to measure joint angles. The document describes patient positioning and goniometer placement for range of motion tests for motions like shoulder flexion, elbow extension, wrist pronation, hip abduction, knee flexion, and ankle dorsiflexion. It also provides normal range of motion values for reference.
Re-education means educating something, which is already known by an individual.
Here the patient knows the activities or movements or functions that has, to be performed but due to his ailment or diseased pathology he could not perform it properly.
The document describes the starting position, range of motion, precautions, and factors limiting range of motion for various neck and trunk motions including flexion, extension, rotation, lateral flexion, and hyperextension. The neck motions include flexion from 0-45 degrees, extension from 45-0 degrees, rotation from 0-60 degrees to each side, and lateral flexion from 0-45-60 degrees to each side. Trunk motions include flexion of approximately 4 inches, hyperextension of 2 inches, and lateral flexion and rotation measuring differences in distances between starting and ending positions using landmarks like spinous processes.
Biomechanics and pathomechanics of scoliosisRashmitadash3
This document discusses the biomechanics and pathomechanics of scoliosis. Some key points:
- Scoliosis is a lateral curvature of the spine that deviates from the normal vertical line. It can occur in the sagittal, coronal, or axial planes.
- In structural scoliosis, asymmetrical pressure on immature vertebrae causes uneven growth, resulting in wedging and rotation. Soft tissues also shorten on the concave side.
- Several theories try to explain scoliosis progression, like the Hueter-Volkmann law about bone growth and Stoke's vicious cycle theory.
- Types of scoliosis include idiopathic, congenital, neu
This document provides an overview of orthosis, including definitions of splints and braces, classifications of orthosis, principles of splint design, materials used, prefabricated splints, and biomechanical principles. It also describes various upper and lower limb orthosis, such as figure of eight axilla wraps, gunslinger splints, airplane splints, hemi arm slings, elbow flexion harnesses, cockup splints, and more. The objectives, indications, and designs of different orthosis are discussed in detail.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
This document provides an overview of posture biomechanics, including:
1. Definitions of static and dynamic posture, and descriptions of optimal sagittal and frontal plane alignment.
2. Explanations of how posture is controlled through sensory inputs, muscle activity, and strategies like fixed support and changing support.
3. Analyses of deviations from optimal posture, including positions of the foot, knee, spine, and effects of sitting and lying postures. Factors like age, gender, and occupation are also discussed.
Kinetics and Kinematics of Gait summarizes gait terminology, phases, joint motion, determinants, and the kinetics and kinematics of the trunk and upper extremities during gait. It describes the six determinants of gait including pelvic rotation and tilting, knee flexion in stance, and foot and knee mechanisms which function to minimize center of gravity displacement. The document also outlines the muscle activity, internal joint moments, and energy requirements including potential and kinetic energy exchange during the gait cycle.
Goniometry refers to the precise measurement of joint angles using instruments such as a universal goniometer. Goniometric data is used to determine impairment, establish diagnoses, develop treatment plans, and evaluate progress. Joint motion includes arthrokinematics (gliding and spinning of joint surfaces) and osteokinematics (bone movements). Range of motion is measured in three planes (sagittal, frontal, transverse) using instruments properly aligned with bony landmarks. Both active and passive range of motion are measured to evaluate joint integrity and flexibility. Restricted or increased range of motion can indicate conditions like capsular patterns of hypomobility or generalized hypermobility.
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
Manual therapy techniques like joint mobilizations and manipulations can be used to safely restore normal joint mechanics and reduce trauma. Effective use requires knowledge of anatomy, arthrokinematics, and pathologies. Several concepts for manual therapy techniques were introduced, including Cyriax, Mulligan, Maitland, and McKenzie. Contraindications include inflammation, effusion, and hypermobility while indications include reversible hypomobility and functional limitations responding to mechanical treatment. Grading systems determine appropriate mobilization force and different joints require specific examination and treatment techniques.
This document discusses strategies to reduce force on the hip joint for individuals with hip osteoarthritis or weak hip abductor muscles. It analyzes using a lateral lean, cane on the same side, or cane on the opposite side. A lateral lean reduces gravitational torque but increases energy expenditure. A cane on the same side provides some relief but a cane on the opposite side may offset gravity's torque, reducing the need for abductor muscle force and joint compression to just body weight. However, the full distance between hand and hip may overestimate the cane's effectiveness.
Electrical stimulation motor points and applicationSreeraj S R
The document discusses the motor points of various nerves including the axillary, musculocutaneous, radial, median, ulnar, femoral, sciatic, tibial, superior peroneal, deep peroneal and facial nerves. It also discusses principles of electrical stimulation application such as patient positioning, skin preparation, testing the equipment, determining treatment parameters and monitoring the patient during treatment. Precautions, contraindications and procedures for initiating, conducting and terminating the treatment are provided.
This document discusses the physical examination of the shoulder, including assessment of range of motion and specific tests to evaluate for common shoulder pathologies. It begins by reviewing the anatomy of the shoulder joint and surrounding structures. Range of motion is assessed in all planes, including active and passive motion. Specific tests are described to evaluate the rotator cuff muscles, biceps tendon, and impingement. Conditions like tendonitis, bursitis, tears, and impingement can be identified by pain or weakness during particular range of motion activities against resistance. The physical examination provides insight into shoulder function and the source of any pain or limitations.
The document discusses various aspects of shoulder biomechanics during pulling movements. It considers whether pulling is better characterized as a translational or rotational movement, and what factors influence this. Some key points discussed include:
- Pulling involves elements of both translation and rotation, and the contribution of each depends on variables like grip width and bar height.
- The scapula and trunk play an important role in distributing forces. Proper scapular stability is important for injury prevention.
- Slow, heavy pulls with the elbow passing the trunk line can overload small rotator cuff muscles if other joints don't move together. Lighter loads or explosive movements may reduce this.
- Push-pull strength ratios
The document summarizes key aspects of human walking (gait) including:
- The gait cycle is divided into stance and swing periods, with distinct functional tasks in each.
- Gait parameters like velocity, cadence, stride length are described.
- Determinants of gait like pelvic rotation, knee flexion, and foot/ankle mechanics help minimize vertical displacement of the center of gravity and increase efficiency.
- Gait analysis methods including observational, quantitative techniques like kinetics, electromyography, motion capture are outlined.
Different pathological gaits like amputee, ataxic, and spastic gaits are also briefly discussed.
The document provides an overview of the Kaltenborn joint mobilization method. It describes how traditional manipulations have changed over time to reduce risk of injury. Kaltenborn introduced using linear translatoric movements instead of rotational forces to further reduce joint compression. The method evaluates joints for hypomobility and uses grades I-III mobilizations within or at the end of the joint's range of motion to restore normal movement and reduce pain. Precise positioning and understanding concave/convex bone movement aids effective and safe treatment.
Goniometry involves measuring the range of motion of joints using a goniometer. Key steps in the goniometry procedure include positioning the joint at zero position, moving it to the end of its range of motion, palpating bony landmarks, aligning the goniometer, and recording the measurement. Valid and reliable goniometric measurements require proper stabilization of proximal joint components and identification of the end feel, or resistance felt at the end of range. The document then provides details on positioning, procedures, and normal ranges for measuring several upper extremity joints including the shoulder, elbow, forearm, wrist, and finger joints.
Goniometry refers to the measurement of joint angles using a goniometer. There are various types of goniometers that have a body and two arms to align along bones proximal and distal to the joint. Goniometry is used to measure both active and passive range of motion of joints to assess limitations. The document provides details on goniometry procedures, principles, factors affecting range of motion, indications, contraindications and examples of normal range of motion measurements for various upper and lower limb joints.
The document discusses goniometry, which is the measurement of joint angles using a goniometer. It outlines what goniometry is, the importance and types of goniometers, how to measure range of motion for various joints including the shoulder, wrist, hip and hand, and considerations for validity and reliability when performing goniometric measurements. Proper procedures and positioning for accurate goniometric assessment of different joints are described.
The document discusses goniometry, which is the measurement of joint angles using a goniometer. It outlines what goniometry is, the importance and types of goniometers, how to measure range of motion for various joints including the shoulder, wrist, hip and hand, and issues around validity and reliability. Standard procedures for goniometric measurement are provided along with important notes for accurate assessment.
GONIOMETRY FOR UPPER LIMB DISCUSSES IN CONCISE THE DIFFERENT TYPES OF GONIOMETERS AVAILABLE FOR MEASURING VARIOUS JOINT ROM, PRINCIPLES OF GONIOMETRY AND PLACEMENT OF GONIOMETER FOR MEASURING RANGE OF MOTION IN UPPER LIMB (SHOULDER, ELBOW, FOREARM AND WRIST JOINT).
This document provides information about evaluating range of motion of the shoulder joint using a goniometer. It describes starting and ending positions for measuring flexion, extension, abduction, internal rotation, and external rotation of the shoulder. Normal range of motion values are listed for each motion. Instructions are provided for positioning and moving the patient's arm through each motion to obtain accurate goniometric measurements of shoulder range of motion.
Goniometry is used to measure joint range of motion. There are different types of goniometers including universal, finger, and electro goniometers. To take an accurate measurement, the therapist positions the goniometer arms parallel to the longitudinal axis of the proximal and distal body parts, with the axis over the joint. Range of motion can then be measured actively or passively. Goniometry is used to assess limitations, track progress, and guide treatment for conditions affecting joint mobility.
This document provides instructions for assessing range of motion and muscle strength of the hip joint. It describes patient positioning and examiner techniques for range of motion testing of hip flexion, extension, abduction, adduction, and internal and external rotation. It also explains how to grade hip muscle strength on the Oxford Scale from grades 0 to 5 during motions like extension, flexion, abduction, and adduction. References for more information on goniometry and pelvic floor physical therapy are provided at the end.
Goniometry involves using a goniometer to measure the range of motion of joints. A goniometer has two arms hinged at an origin point, with one arm fixed and the other movable. It is placed over the joint being measured to determine the angle of movement. There are two common reference systems - one uses 0 degrees as the starting position and measures movement toward 180 degrees, while the other uses 180 degrees as the starting position and measures movement toward 0 degrees. The document provides detailed instructions on properly positioning and using a goniometer to measure range of motion for various joints like the shoulder, elbow, wrist, and others.
The document discusses the alignment of a trans-tibial prosthesis (TTP). It defines alignment as the spatial relationship between prosthetic components and the amputee's body. Proper alignment is important for comfort and a natural gait. There are three types of alignment discussed: bench, static, and dynamic. Bench alignment sets the initial positioning before fitting. Static alignment evaluates alignment while standing or sitting. Dynamic alignment observes the user walking to further refine the alignment based on gait analysis and user feedback. The goal is smooth, natural walking with even weight distribution and less energy expenditure.
Balance and postural equilibrium involve maintaining the center of gravity within the base of support. This document outlines several key concepts:
- Balance is affected by factors like the size of the base of support and center of gravity position.
- Strategies like ankle, hip, and stepping strategies automatically maintain or restore balance when instability is detected.
- Balance is assessed through tests of static, anticipatory, and dynamic balance. Common tests include single leg stance, functional reach, and Berg Balance Scale.
- A systems model shows that balance results from interactions between musculoskeletal, sensory, motor, environmental, and other factors.
Anthropometry involves measuring the human body to assess things like body composition, edema, and limb symmetry. Key anthropometric measurements include length, circumference, width, and skinfold thickness using tools like a tape measure, calipers, and stadiometer. Examples provided include leg length discrepancy tests, Schober's test, and taking girth measurements of various body parts like waist, calf, and ankle. Anthropometric measurements can help clinicians evaluate impairments and monitor rehabilitation progress.
A goniometer is a device used to measure angles, typically in the field of physiotherapy, occupational therapy, and biomechanics. It consists of a flat, circular, or semi-circular protractor-like instrument with an adjustable arm or arms. The primary purpose of a goniometer is to measure the range of motion at a joint in the body.
Here's a basic overview of how a goniometer is used and some key points about its features
This document provides information about the structure, movements, and biomechanics of the knee joint. It also discusses manual muscle testing of the hamstrings and quadriceps as well as the design, fabrication, and use of a floor reaction orthosis. A floor reaction orthosis is designed to harness the ground reaction force during stance phase to provide sagittal plane stability and extension moment at the knee, assisting with conditions like quadriceps weakness. The document provides details on patient positioning, grading scales, and techniques for casting, modifying, and fabricating such an orthosis.
This document provides information about goniometry and range of motion measurements of various joints, including the shoulder complex. It defines goniometry as the measurement of joint angles using a goniometer. The document describes how to position and stabilize the individual and properly align the goniometer to measure flexion and extension of the shoulder joint. Flexion and extension occur in the sagittal plane around the medial-lateral axis. Normal range of motion for shoulder flexion is 165-180 degrees and for glenohumeral flexion is 100-115 degrees.
Goniometry and Manual Muscle Testing of the UEbenjatchison
This document provides guidance on performing range of motion assessments of the upper extremity. Key points include obtaining consent from the patient, understanding joint biomechanics, performing functional assessments before isolated joint motions, measuring both active and passive range of motion, using proper goniometer alignment, and recording all findings systematically. Proper patient positioning, clear communication, and awareness of each patient's situation are emphasized.
This document discusses the concept of mobilization with movement (MWM), as developed by Brian Mulligan. MWM involves applying a sustained accessory mobilization by the therapist while the patient performs an active movement. It is based on the idea that minor positional faults in joints can cause pain and limited range of motion, and that correcting these faults through MWM can provide fast pain relief and improved function. Specific MWM techniques discussed for the spine include natural apophyseal glides, reverse natural apophyseal glides, and sustained natural apophyseal glides, while movement with mobilizations is described as the extremity technique. The principles, indications, contraindications and applications of MWM are outlined.
Similar to Occupational Therapy Goniometry Measurement Range of Motion (20)
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities. Therapists design customized activity plans tailored to each patient's abilities and interests to maintain skills and encourage independence. Occupations are used as therapy to improve quality of life and support individuals as dementia progresses.
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities to support independence. Therapists evaluate each patient's abilities and design customized programs, choosing interventions that are enjoyable, purposeful and match the person's interests and skills. The goal is to use familiar tasks and routines to enhance quality of life and function through the stages of dementia.
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities to support independence. Therapists evaluate each patient's abilities and design customized programs, choosing interventions that are enjoyable, purposeful and match the person's interests and skills. The goal is to use familiar tasks and routines to enhance quality of life and function through the stages of dementia.
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities to support independence. Therapists evaluate each patient's abilities and design customized programs focused on remaining skills rather than deficits. The goal is improving quality of life and functioning through non-pharmacological interventions that reduce behavioral issues and maximize comfort.
Parkinson's disease is a progressive neurological disorder that causes motor symptoms like tremors and rigidity. Occupational therapy can help people with Parkinson's maintain independence through customized treatment plans. Therapists focus on improving mobility, balance, coordination, dexterity and other motor skills compromised by the disease to make daily activities and tasks easier.
Pain is a complex experience influenced by sensory, emotional, cognitive, and social factors. Physical therapists address pain by focusing on movement and function rather than just symptoms. Treatment may include manual therapy, therapeutic exercise, education, and strategies to help patients cope with and self-manage their pain.
The document discusses pain management in aged care facilities. It focuses on the importance of properly assessing and treating pain in elderly patients, as untreated pain can decrease quality of life. It also stresses the need for facilities to have strong pain management policies and train staff on identifying and responding to pain effectively in residents.
Occupational therapy can help people with dementia by engaging them in meaningful activities to improve their quality of life and functioning. Therapists evaluate clients' abilities and tailor interventions and adaptations to maximize independence in daily living skills. The goal is to enhance well-being and compensate for cognitive and functional impairments through customized non-pharmacological approaches.
Neurocognitive domains refer to specific cognitive abilities like memory, language, and executive function. Dementia is linked to decline across multiple domains, with memory typically the first and most severe. Early detection of declines in neurocognitive domains can help diagnose dementia and allow for earlier treatment and support planning.
Falls are a serious risk for older adults, resulting in injuries, loss of independence, and even death. Proper lighting, removal of tripping hazards, and exercise can help seniors stay mobile and prevent falls. Regular vision exams, medication reviews, and home safety checks are also recommended to address common risk factors and keep seniors safe in their homes.
Falls are a serious risk for older adults, resulting in injuries, loss of independence, and even death. Common risk factors for falls include poor vision or balance, use of medications, and home hazards. Implementing prevention strategies like exercise programs, home safety checks, and medical reviews of medications can help reduce risks and keep seniors safe in their homes.
Motor skills naturally decline with age as the body slows down and becomes less coordinated over time. Older adults also take longer to learn and remember new motor skills due to typical age-related declines in cognitive processing speed and working memory. However, regular physical activity and exercise can help offset some of these effects of aging on motor performance and learning by maintaining muscle strength, flexibility, balance, and cognitive abilities into older adulthood.
Functional movement is essential for healthy aging. As we age, our mobility and flexibility naturally decline if not maintained through regular movement and exercise. Exercises that improve balance, coordination, and range of motion can help offset age-related declines and maintain independence later in life.
The document discusses the role of a community care worker. As a community care worker, typical responsibilities include assisting clients with daily living activities like bathing, dressing, and meal preparation. Community care workers also provide companionship, monitor clients' well-being, and help coordinate care with other medical professionals.
Community Care Workers provide in-home care and assistance to elderly, disabled, or otherwise vulnerable individuals in order to help them live independently in their own homes and communities. Their responsibilities include helping with activities of daily living like bathing, dressing, and meal preparation as well as providing companionship, transportation to appointments, and light housekeeping. The goal of their work is to support individuals' health, safety, and well-being so they can maintain maximum independence.
The document discusses the physiological changes that occur with aging and their impact. As people age, they experience changes in various body systems like sensory, cardiovascular, musculoskeletal, and neurological systems. These changes can affect functional abilities and independence with daily activities unless addressed through occupational therapy interventions.
Occupational therapy can help the elderly population with daily living activities. Therapists assist seniors with tasks like cooking, cleaning, and personal care. The goal is to improve independence and quality of life for older adults through customized interventions and exercises.
Occupational therapy can help elderly patients maintain independence and quality of life. Therapists assist seniors with daily activities like bathing, cooking, cleaning, and more through customized treatment plans. The goal is to adapt tasks and environments to an individual's physical and cognitive abilities so they can live as autonomously as possible for longer.
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International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
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Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
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Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
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2. - Goniometric measurements are used by occupational therapists to
quantify baseline limitations of motion, decide on appropriate
therapeutic interventions, and document the effective-ness of
these intervention.
- The universal goniometer (i.e, full-circle manual goniometer)
remains the most versatile and widely used instrument in clinical
practice.
- Clinical Measurement of Range of Motion Review of Goniometry
Emphasizing Reliability and Validity.
- Reliability in goniometry simply means the consistency or the
repeatability of the ROM measurements, that is, whether the
application of the instrument and the procedures produce the same
measurements consistently under the same conditions.
3.
4.
5.
6. Goniometry
- Goniometry is the measurement of joint angles. And uses a
goniometer to measure joints
- The same goniometry structure is : two arms (one stationary and
one moveable) and an axis (fulcrum) that is surrounded by the body
of the goniometer, which contains a measuring scale.
- The scale is usually similar to a protractor and calibrated in degrees.
The scale can be either a 360° full-circle or a 180° half-circle
- Goniometer arms range in length from 1 in. to 14 in. Use the long-
armed goniometers to measure long bone joints such as the knee,
and the short-arm goniometers to measure smaller joints such as the
toe and finger interphalangeal joints
7. Positioning
- Position involves four factors: the patient, the joint, the goniometer,
and yourself.
- Incorrectly positioning any of these items can result in an
inaccurate measurement of joint motion.
- You should position the patient so the joint to be measured can move
through its ROM freely, without obstruction, and so you can easily
observe the joint.
- The patient should be comfortable. If you need to measure several
motions, you should plan the sequence of measurements so you will
minimally change the patient’s position
8. Positioning
- You must also carefully consider the position of the segment to be
measured, particularly when measuring active motion.
- A segment that must lift against gravity may give a false active
motion measurement if its muscles are not sufficiently strong
enough to lift through the range of motion.
-
- When measuring passive ROM, performing too many activities at
the same time such as stabilizing the part, holding the extremity
against gravity, and aligning the goniometer may lead to a gross
error of measurement.
- You should document the segment’s position during ROM testing
when recording the measurement.
9. Positioning
- Positioning the goniometer correctly is crucial; if the arms of the
goniometer are not aligned properly, the measure will be inaccurate.
Likewise, moving the axis of the goniometer off the joint line will
yield an incorrect measurement.
- Your position is just as important as the other factors in ROM
measurements.
- Once you have placed the goniometer and ensured proper
alignment, you must read the goniometer at eye level for an accurate
reading.
- If you measure hip flexion and read the goniometer in an erect
standing position, the results could differ by several degrees from
the reading you would obtain if you knelt down to read the
goniometer at eye level.
10. Stabilization
- Stabilization is isolating the motion of the joint while eliminating
unwanted motion from adjacent structures.
- You must stabilize the patient before measuring ROM or examining
end feel to assure reliable results.
- Most often, you will stabilize the proximal joint segment and move
the distal segment.
- You must isolate a joint motion to examine it accurately.
- If you allow both joint segments to move, true joint end feel may be
inaccurate.
11. Stabilization
- If you do not stabilize the proximal segment, motion of other joints
may contribute additional motion gains, exaggerating the joint’s
true motion and resulting in substitution.
- If you measure shoulder flexion without appropriately stabilizing
the shoulder, the patient can hyperextend the spine and falsely
appear to have greater shoulder motion.
- Your knowledge of possible substitutions and an awareness of the
patient’s movement will assist in recognizing substitution patterns.
- Stabilization during ROM examination ensures a truer execution of
the test and a more accurate result.
12. Measurement
- Goniometric measurement requires proper alignment of the
stationary and moveable arms and the goniometer’s axis.
- Use bony landmarks to properly place these elements.
- Place the stationary arm along the longitudinal axis of the stabilized
joint segment and the moveable arm parallel to the longitudinal axis
of the moving joint segment.
- When using a 180°-scale goniometer, you may need to reverse the
stationary and moving arms before the moveable arm will register
on the scale.
- Align the goniometer’s axis with the joint’s axis of motion. If the
goniometer arms are accurately placed, the fulcrum will be
positioned correctly.
13. Measurement
- The axis is placed at the joint, the stationary arm is along the
longitudinal aspect of the stabilized segment, and the moveable arm
is placed in alignment with the moving segment.
- To correctly align the goniometer arms, position yourself so your
line of vision is at the same level as the goniometer.
- Checking both arms more than once before reading the scale also
assures correct alignment.
- Often, you will align the stationary arm and then unwittingly move it
again when adjusting the moveable arm; even highly experienced
clinicians make a habit of checking and rechecking the goniometric
arm and axis positions before reading the measurement.
14. Measurement
- Before measuring range of motion, you should explain to the patient
what you will do.
- Take measurements at the start and end positions of the joint
motion.
- If you are only interested in the end of the ROM, it is assumed that
the start position is 0° and has been verified by visual determination.
- ROM examination is usually performed on the uninvolved extremity
before the injured extremity.
- Performing the examination in this sequence provides you with an
idea of what to expect when you examine ROM of the injured
segment
15. Measurement
- You should record the date, the patient’s position (seated, prone), the
type of motion (active or passive), and the side of the body and joint
measured.
- Note any pain or other abnormal reactions that occur during the
examination.
- If the patient lacks full motion, record the degrees as a range.
- If a patient lacks 20° of knee extension and has full knee flexion
motion, record ROM as 20-145°.
- If the patient has excessive motion, or hypermobility, use a minus to
indicate excessive mobility.
16. Measurement
- If the patient has 15° of hyperextension of the knee and normal
flexion motion, record -15-145°.
- Avoid using a visual estimate to determine range of motion.
- The visual estimate may be off and can easily vary among clinicians,
and it is not an objective measure.
- Especially avoid estimating if you use the measurement to identify a
deficiency, record progress, or determine a patient’s readiness to
return to normal activity levels.
17. Shoulder Flexion
Test Position Normal Range
Subject Supine
Flatten lumbar spine (flex knees)
Shoulder no abduction, adduction or rotation
(note: to measure gleno-humeral motion, stabilize scapula)
(for shoulder complex flexion)
167° ± 4.7° (American Academy of Orthopaedic Surgeons)
150° (American Medical Association)
166° (mean), 4.7° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – center of humeral head near acromion process
Stationary arm – parallel mid-axillary line
Moving arm – aligned with midline of humerus (lateral epicondyle)
Muscle Stretch
18. Shoulder Extension
Test Position Normal Range
Subject Supine
Shoulder no abduction, adduction or rotation
(note: to measure gleno-humeral motion, stabilize
scapula)
(for shoulder complex flexion)
62° ± 9.5° (American Academy of Orthopaedic Surgeons)
50° (American Medical Association)
62.3° (mean), 9.5° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – center of humeral head near acromion process
Stationary arm – parallel mid-axillary line
Moving arm – aligned with midline of humerus (lateral
epicondyle)
Capsular or ligamentous
19. Shoulder Abduction
Test Position Normal Range
Subject Supine
Shoulder 0° flexion and extension
Shoulder laterally (externally) rotated
Shoulder abducted
Stabilize thorax (note: to measure gleno-humeral motion, stabilize
scapula)
(for shoulder complex abduction)
184° ± 7.0° (American Academy of Orthopaedic Surgeons)
180° (American Medical Association)
184° (mean), 7.0° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – center of humeral head near acromion process
Stationary arm – parallel to sternum
Moving arm – aligned with midline of humerus
Muscle Stretch
20. Shoulder Medial (Internal) Rotation
Test Position Normal Range
Subject Supine
Shoulder 90° abduction
Forearm neutral
Elbow fixed 90°
Stabilize arm
69° ± 4.6° (American Academy of Orthopaedic Surgeons)
90° (American Medical Association)
68.8° (mean), 4.6° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – olecranon process of ulna
Stationary arm – aligned vertically
Moving arm – aligned with ulna (styloid process)
Capsular
21. Shoulder Lateral (External) Rotation
Test Position Normal Range
Subject Supine
Shoulder 90° abduction
Forearm neutral
Elbow fixed 90°
Stabilize arm
104° ± 8.5° (American Academy of Orthopaedic Surgeons)
90° (American Medical Association)
103° (mean), 8.5° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – olecranon process of ulna
Stationary arm – aligned vertically
Moving arm – aligned with ulna (styloid process)
Capsular
22. Elbow Flexion
Test Position Normal Range
Subject Supine
Shoulder neutral (arm at side)
Forearm supinated
Elbow fixed
Stabilize arm
141° ± 4.9° (American Academy of Orthopaedic Surgeons)
140° (American Medical Association)
142.9° (mean) 5.6° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – lateral epicondyle of humerus
Stationary arm – aligned humerus (center of acromion process)
Moving arm – aligned with radius (styloid process)
Soft tissue approximation (capsular for thin subjects)
23. Elbow Extension
Test Position Normal Range
Subject Supine
Shoulder neutral (arm at side)
Forearm supinated
Elbow fixed
Stabilize arm
0.3° ± 2.0° (American Academy of Orthopaedic Surgeons)
0.0° (American Medical Association)
0.6° (mean) 3.1° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – lateral epicondyle of humerus
Stationary arm – aligned humerus (center of acromion process)
Moving arm – aligned with radius (styloid process)
Bone on bone
24. Forearm Supination
Test Position Normal Range
Subject sitting
Shoulder neutral (arm at side)
Elbow fixed at 90°
Stabilize arm
Supinate forearm
81° ± 4.0° (American Academy of Orthopaedic Surgeons)
80° (American Medical Association)
82.1° (mean) 3.8° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – medial to ulnar styloid
Stationary arm – parallel to humerus
Moving arm – aligned with ventral aspect of radius
Capsular
25. Forearm Pronation
Test Position Normal Range
Subject sitting
Shoulder neutral (arm at side)
Elbow fixed at 90°
Stabilize arm
Supinate forearm
75° ± 5.3° (American Academy of Orthopaedic Surgeons)
80° (American Medical Association)
75.8° (mean) 5.1° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – lateral to ulnar styloid
Stationary arm – parallel to humerus
Moving arm – aligned with dorsum of radius
Capsular
26. Wrist Flexion
Test Position Normal Range
Subject sitting
Forearm stabilized on table
Flex wrist (fingers relaxed)
75° ± 6.6° (American Academy of Orthopaedic Surgeons)
60° (American Medical Association)
76.4° (mean) 6.3° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – lateral wrist
Stationary arm – aligned with ulna
Moving arm – aligned with fifth metacarpal
Capsular
27. Wrist Extension
Test Position Normal Range
Subject sitting
Forearm stabilized on table
Extended wrist (fingers relaxed)
74° ± 6.6° (American Academy of Orthopaedic Surgeons)
60° (American Medical Association)
74.9° (mean) 6.4° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – lateral wrist (triquetrum)
Stationary arm – aligned with ulna
Moving arm – aligned with fifth metacarpal
Capsular
28. Wrist Radial Deviation
Test Position Normal Range
Subject sitting with forearm resting on table
Stabilize forearm to prevent pronation or supination
21° ± 4.0° (American Academy of Orthopaedic Surgeons)
20° (American Medical Association)
21.5° (mean) 4.0° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – capitate
Stationary arm – aligned with forearm (lateral epicondyle)
Moving arm – aligned with metacarpal of middle finger
Ligamentous (ulnar collateral ligament)
29. Wrist Ulnar Deviation
Test Position Normal Range
Subject sitting with forearm resting on table
Stabilize forearm to prevent pronation or supination
35° ± 3.8° (American Academy of Orthopaedic Surgeons)
30° (American Medical Association)
36.0° (mean) 3.8° (standard deviation), (Boone and Azen)
Goniometer Alignment Normal End Feel
Axis – capitate
Stationary arm – aligned with forearm (lateral epicondyle)
Moving arm – aligned with metacarpal of middle finger
Ligamentous (radial collateral ligament
30. Metacarpophalangeal Joint Flexion
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist and interphalangeal joints relaxed
Forearm neutral
Stabilize metacarpal to prevent motion
86° (index), 91° (ring), 105° (little) (American Academy of Orthopedic
Surgeons - active motion)
90° (American Medical Association)
Goniometer Alignment Normal End Feel
Dorsal metacarpophalangeal joint
Stationary arm - aligned with metacarpal
Moving arm – aligned with proximal phalange
capsular
31. Metacarpophalangeal Joint Extension
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist and interphalangeal joints relaxed
Forearm neutral
Stabilize metacarpal to prevent motion
22° (index), 18° (long), 23° (ring), 19° (little) (American Academy of
Orthopedic Surgeons - active motion)
20° (American Medical Association)
Goniometer Alignment Normal End Feel
Dorsal metacarpophalangeal joint
Stationary arm - aligned with metacarpal
Moving arm – aligned with proximal phalange
capsular
32. Metacarpophalangeal Joint Abduction
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist neutral
Forearm neutral
Stabilize metacarpal to prevent motion
???
Goniometer Alignment Normal End Feel
Dorsal metacarpophalangeal joint
Stationary arm - aligned with metacarpal
Moving arm – aligned with proximal phalange
capsular
33. Metacarpophalangeal Joint Adduction
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist neutral
Forearm neutral
Stabilize metacarpal to prevent motion
???
Goniometer Alignment Normal End Feel
Dorsal metacarpophalangeal joint
Stationary arm - aligned with metacarpal
Moving arm – aligned with proximal phalange
capsular
34. Interphalangeal Joint Flexion
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist, metacarpal, and non-tested interphalangeal joints relaxed
Forearm neutral
Stabilize proximal bone to prevent motion
American Academy of Orthopedic Surgeons
PIP fingers - 102° (index), 105° (long), 108° (ring), 106° (little) (active
motion)
DIP fingers - 72° (index), 71° (long), 63° (ring), 65° (little) (active
motion)
IP thumb - 73°
American Medical Association
100° (PIP finger), 70° (DIP fingers), 80° (IP thumb)
Goniometer Alignment Normal End Feel
Dorsal proximal interphalangeal joint
Stationary arm - aligned with proximal phalange
Moving arm – aligned with middle phalange
Proximal Interphalangeal Finger Joints
bone on bone (if tissues overlying palmar aspect of bones is thin)
soft tissue approximation (if tissues overlying palmar aspect of bones is
thick)
Distal Interphalangeal Finger Joints and Thumb Interphalangeal Joint
capsular
35. Interphalangeal Joint Extension
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist, metacarpal, and non-tested interphalangeal joints relaxed
Forearm neutral
Stabilize proximal bone to prevent motion
American Academy of Orthopedic Surgeons
PIP fingers - 7° (index), 7° (long), 6° (ring), 9° (little) (active motion)
DIP fingers - 8° (all finger DIPs)
IP thumb - 5°
0° (American Medical Association)
Goniometer Alignment Normal End Feel
Dorsal proximal interphalangeal joint
Stationary arm - aligned with proximal phalange
Moving arm – aligned with middle phalange
capsular
36. Thumb Carpometacarpal Joint Flexion
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist neutral
Stabilize carpals to prevent wrist motion
???
Goniometer Alignment Normal End Feel
Axis - carpometacarpal joint
Stationary arm - aligned with radius
Moving arm – aligned with metacarpal of thumb
capsular
37. Thumb Carpometacarpal Joint Extension
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist neutral
Stabilize carpals to prevent wrist motion
???
Goniometer Alignment Normal End Feel
Axis - carpometacarpal joint
Stationary arm - aligned with radius
Moving arm – aligned with metacarpal of thumb
capsular
38. Thumb Carpometacarpal Joint Abduction
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist neutral
Forearm neutral
Stabilize carpals to prevent wrist motion
70° (American Academy of Orthopedic Surgeons)
Goniometer Alignment Normal End Feel
Axis - radial styloid
Stationary arm - aligned with metacarpal of index finger
Moving arm – aligned with metacarpal of thumb
Muscle stretch (adductor pollicus, skin, fascia)
39. Thumb Carpometacarpal Joint Adduction
Test Position Normal Range
Subject sitting with forearm resting on table
Wrist neutral
Forearm neutral
Stabilize carpals to prevent wrist motion
0° ???
Goniometer Alignment Normal End Feel
Axis - radial styloid
Stationary arm - aligned with metacarpal of index finger
Moving arm – aligned with metacarpal of thumb
Soft tissue approximation
40. Thumb Carpometacarpal Joint Opposition
Test Position Normal Range
Subject sitting with forearm supinated and resting on table
Wrist neutral
Stabilize fifth metacarpal
Able to touch tip of thumb to base of fifth finger (American Academy
of Orthopedic Surgeons)
Goniometer Alignment Normal End Feel
Goniometer cannot be used
Use a ruler to measure distance between tip of thumb and base of
fifth finger
Capsular or Soft tissue approximation