Gioniometry

Question 1

Full ROM across a joint is dependent on 2 components:

Answer 1

1) joint ROM

2) Muscle length

Question 2

Joint ROM is the…

Answer 2

motion available at any single joint

Question 3

Full or complete joint ROM is influenced by:

Answer 3

• associated bony structure of the joint

- physiologic characteristics of the CT surrounding the joint (ligaments/capsule)

Question 4

Joint kinematics refers to

Answer 4

motion of the body without regard to forces or torques that may produce motion

(aka human movement without regard to cause)

Question 5

2 subcategories of joint motion/kinematics are:

Answer 5

1) osteokinematics (physiologic motion)

2) arthrokinematics (accessory motion)

Question 6

Osteokinematics is

Answer 6

movement of a bone segment as it moves away from the trunk or pelvis about the joint axis

Question 7

Arthrokinematics is

Answer 7

movements of articular or joint surfaces in relation to one another during osteokinematic motion
(glide/slide, roll and spin)

Question 8

Arthrokinematic/acessory movement is evaluated by assessing what?

Answer 8

joint play

Question 9

Osteokinematic movement is assessed using:

Answer 9

goniometry

Question 10

what is the reference point for most goniometric measurements of joint ROM?

Answer 10

anatomical position

Question 11

Goniometry is used by the PT to assess

Answer 11

osteokinematic OR joint range of motion

Question 12

Joint ROM is a function of

Answer 12

• joint morphology
• joint capsule and ligaments
• muscles and tendons (contractile tissues) that cross joint being assessed

Question 13

Purpose of Gonio

Answer 13

• asess existing ROM for comparison
• determine joint function for both active and passive ROM
• assess hypo vs. hyper-mobility

Question 14

the stationary arm of the goniometer is the _________ segment and is aligned on the fixed segment

Answer 14

proximal

Question 15

the moving arm of the goniometer is the ____________ segment

Answer 15

distal

Question 16

when using the 0-180 system the 0 degree starting position refers to when the patient is in…

Answer 16

anatomical position

Question 17

Procedures for assessing joint ROM

Answer 17

• stabilization of proximal segment
• determine if passive or active ROM will be assessed
• repeat AROM 1-2x
• explain purpose to patient
• position patient in preferred position
• use passive ROM if patient cannot complete AROM for typical ROM of joint
• determine end-feel

Question 18

generally speaking, should you perform AROM or passive ROM first?

Answer 18

• USUALLY assess AROM first to allow patient to move through their available range without risk of causing pain

Question 19

why repeat AROM 1-2x?

Answer 19

-permits assessment of consistency of available AROM

Question 20

moving a patient through their available passive ROM permits:

Answer 20

• assessment and documentation of any limitations to full ROM
• pain, muscle guarding, tightness

Question 21

typical bony end-feel

Answer 21

hard

example- elbow extension

Question 22

typical capsular end-feel

Answer 22

firm

example- elbow supination

Question 23

Typical muscular end-feel

Answer 23

firm

ankle dorsiflexion with knee extension

Question 24

typical soft-tissue end-feel

Answer 24

soft

elbow flexion

Question 25

Abnormal end-feels

Answer 25

empty, springy (rebound at extreme of possible ROM), muscle spasm

Question 26

in general, with goniometric measurements, is inter or intra-rater reliability higher?

Answer 26

intra-rater - if same therapist measures same joint ROM twice, should be within +/- 5 degrees

Question 27

Hip flexion

Answer 27

0-120 degrees SA= midline of the pelvis/trunk Fulcrum is greater trochanter MA= lateral femoral condyle

Question 28

Hip abduction

Answer 28

``` 0-45 degrees SA= contralateral ASIS Fulcrum= ipsilateral ASIS MA= midline of the patella *do not allow hip external rotation ```

Question 29

Hip extension

Answer 29

0-15 degrees SA= midline of the pelvis/trunk Fulcrum= greater trochanter MA= lateral femoral epicondyle

Question 30

hip external rotation

Answer 30

``` SITTING typical range is 0-45 degrees SA= perpendicular to the floor Fulcrum= midpoint of the patella MA= anterior midline of the tibia along the tibial crest ```

Question 31

Hip internal rotation

Answer 31

``` SITTING 0-45 degrees SA= perpendicular to the floor Fulcrum = midpoint of the patella MA= anterior midline of the tibia, along the crest of the tibia ```

Question 32

Hip external rotation (prone)

Answer 32

measurements are the same- preferred position (internal rotation can also be done prone)

Question 33

Knee flexion

Answer 33

0-135 degrees SA= greater trochanter Fulcrum= lateral epicondyle of the femur MA= lateral malleolus *assess baseline ROM is patient CANNOT attain 0 degrees or full extension

Question 34

dorsiflexion

Answer 34

``` supine- knee flexed 0-20 degrees SA= fibular head, midline of the fibula fulcrum= depends on the person MA= midline of the 5th metatarsal ```

Question 35

Plantarflexion

Answer 35

0-50 degrees SA= fibular head, midline of the fibula MA= midline of the 5th met

Question 36

Prone values for dorsiflexion knee extended

Answer 36

0-10 degrees

Question 37

Prone values for dorsiflexion knee flexed

Answer 37

15-20 degrees

Question 38

Inversion (seated)

Answer 38

0-35 degrees SA= anterior midline of tib fulcrum= anterior aspect of talocrural joint midway between medial and lateral malleoli MA= midline of the second metatarsal

Question 39

total foot eversion

Answer 39

0-15 degrees

Question 40

first MTP

Answer 40

0-90 degrees extension - must have at least 50 degrees for walking flexion- 0-35 degrees

Question 41

shoulder flexion

Answer 41

0-180 GH 0-100

Question 42

Shoulder extension

Answer 42

0-60 GH 0-20

Question 43

shoulder abduction

Answer 43

0-180 GH 0-110

Question 44

shoulder internal rotation

Answer 44

0-70 degrees

Question 45

shoulder external rotation

Answer 45

0-90

Question 46

Elbow flexion

Answer 46

0-150

Question 47

forearm pronation

Answer 47

0-80

Question 48

forearm supination

Answer 48

0-80

Question 49

wrist flexion

Answer 49

0-80

Question 50

wrist hyperextension

Answer 50

0-70

Question 51

radial deviation

Answer 51

0-20

Question 52

ulnar deviation

Answer 52

0-30

Question 53

MCP, PIP, and DIP flexion

Answer 53

0-90 0-100 0-90

Question 54

C-spine rotation

Answer 54

0-60