Range of motion
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Definition
Type of ROM
Components of range of motion
Goniometry
Measurement
Definition
• Range of motion (ROM) is the term
that is used to describe the amount of
movement you have at each joint.
Type of ROM
• Active Range of Motion
• Passive Range of Motion
Active Range of Motion
• Dynamic flexibility
• Physiological movements
• Joint motion that occurs because of
muscle contraction
Passive Range of Motion
• Static flexibility
• Movement that is performed
completely by the examiner
• Endpoints in the range of motion
Components of range of motion
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Sex
Age
Race
Shape of the bone and cartilage
Muscle power and tone
Muscle bulk
Ligaments and joint capsule laxity
Extensibility of the skin and subcutaneous
tissue
Goniometry
• measuring the available range of
motion or the position of a joint
• typically this is a measure of PASSIVE
motion
• If you are documenting active range of
motion, document that this is so
Goniometry
• Stationary arm : placed parallel with
the longitudinal axis of the fixed part
• Movable arm : along the longitudinal
axis of the movable segment
• Axis of rotation(pin) : at the
intersection of the stationary &
movable arms
Goniometry
Goniometry procedure
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position joint in zero position and stabilize proximal
joint component
move joint to end of range of motion (to assess
quality of movement)
determine end-feel at point where measurement
will be taken ( at end of available range of motion)
identify and palpate bony landmarks
align goniometer with bony landmarks while
holding joint at end of range
read the goniometer
record measurement (e.g. elbow flexion = 130o)
Type of Goniometer
① full-circle manual
universal goniometer
most versatile &popular
② Gonoimeters for single
joint motion
Type of Goniometer
③ fluid inclinometer
④ pendulum inclinometer
⑤ electrogoniometer
Measurement
•Upper Ext.
•Lower Ext.
•Spine
Upper Ext.
Test Position
Shoulder flexion
(0~180°)
• Subject supine
• Flatten lumbar spine
(flex knees)
• Shoulder no abduction,
adduction or rotation
• (note: to measure
gleno-humeral motion,
stabilize scapula)
Goniometer Alignment
• Axis – center of humeral
head near acromion
process
• Stationary arm – parallel
mid-axillary line
• Moving arm – aligned
with midline of humerus
(lateral epicondyle)
Shoulder extension (0~60°)
Test Position
• Subject prone
• Shoulder no abduction,
adduction or rotation
• (note: to measure
gleno-humeral motion,
stabilize scapula)
Goniometer Alignment
• Axis – center of humeral head near acromion
process
• Stationary arm – parallel mid-axillary line
• Moving arm – aligned with midline of humerus
(lateral epicondyle)
Shoulder abduction (0~180°)
Test Position
• Subject supine
• Shoulder 0° flexion and
extension
• Shoulder laterally
(externally) rotated
• Shoulder abducted
• Stabilize thorax (note:
to measure glenohumeral motion,
stabilize scapula)
Shoulder abduction (0~180°)
Goniometer Alignment
• Axis – center of humeral head near
acromion process
• Stationary arm – parallel to sternum
• Moving arm – aligned with midline of
humerus
Shoulder external rotation (0~90°)
Test Position
• Subject supine
• Shoulder 90° abduction
• Forearm neutral
• Elbow flexed 90°
• Stabilize arm
Goniometer Alignment
• Axis – olecranon process of ulna
• Stationary arm – aligned vertically
• Moving arm – aligned with ulna (styloid process)
Shoulder internal rotation (0~70°)
Test Position
• Subject supine
• Shoulder 90° abduction
• Forearm neutral
• Elbow flexed 90°
• Stabilize arm
Goniometer Alignment
• Axis – olecranon process of ulna
• Stationary arm – aligned vertically
• Moving arm – aligned with ulna (styloid process)
Elbow flexion (0~150°)
Test Position
• Subject supine
• Shoulder neutral (arm
at side)
• Forearm supinated
• Elbow flexed
• Stabilize arm
Goniometer Alignment
• Axis – lateral epicondyle of humerus
• Stationary arm – aligned with humerus (center of
acromion process)
• Moving arm – aligned with radius (styloid process)
Elbow extension (150~0°)
Test Position
• Subject supine
• Shoulder neutral (arm
at side)
• Forearm supinated
• Elbow extended
• Stabilize arm
Goniometer Alignment
• Axis – lateral epicondyle of humerus
• Stationary arm – aligned with humerus (center of
acromion process)
• Moving arm – aligned with radius (styloid process)
Forearm pronation (0~80°)
Test Position
• Subject sitting
• Shoulder neutral (arm
at side)
• Elbow flexed to 90°
• Stabilize arm
• Pronate forearm
Goniometer Alignment
• Axis – lateral to ulnar styloid
• Stationary arm – parallel to humerus
• Moving arm – aligned with dorsum of radius
Forearm supination (0~80°)
Test Position
• Subject sitting
• Shoulder neutral (arm
at side)
• Elbow flexed to 90°
• Stabilize arm
• Supinate forearm
Goniometer Alignment
• Axis – medial to ulnar styloid
• Stationary arm – parallel to humerus
• Moving arm – aligned with ventral aspect of radius
Wrist flexion (0~80°)
Test Position
• Subject seated
• Forearm stabilized on
table
• Flex wrist
(fingers relaxed)
Goniometer Alignment
• Axis – lateral wrist (triquetrum)
• Stationary arm – aligned with ulna
• Moving arm – aligned with fifth metacarpal
Wrist extension (0~70°)
Test Position
• Subject seated
• Forearm stabilized on
table
• Extend wrist
(fingers relaxed)
Goniometer Alignment
• Axis – lateral wrist (triquetrum)
• Stationary arm – aligned with ulna
• Moving arm – aligned with fifth metacarpal
Radial deviation (0~20°)
Test Position
• Subject sitting with
forearm resting on
table
• Stabilize forearm to
prevent pronation or
supination
Goniometer Alignment
• Axis – capitate
• Stationary arm – aligned with forearm (lateral
epicondyle)
• Moving arm – aligned with metacarpal of middle
finger
Ulnar deviation (0~30°)
Test Position
• Subject sitting with
forearm resting on
table
• Stabilize forearm to
prevent pronation or
supination
Goniometer Alignment
• Axis – capitate
• Stationary arm – aligned with forearm (lateral
epicondyle)
• Moving arm – aligned with metacarpal of middle
finger
Lower Ext.
Hip flexion (0~120°)
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Test Position
• Subject supine
• Allow knee to flex (to
avoid limitation by tight
hamstrings)
• Stabilize pelvis to
prevent rotation, Hip
flex.
Goniometer Alignment
Axis – greater trochanter
Stationary arm – aligned with midline of plevis
Moving arm – aligned with femur (lateral epicondyle)
Hip extension (0~30°)
Test Position
• Subject prone
• Stabilize pelvis to
prevent rotation
• Extend hip
Goniometer Alignment
• Axis – greater trochanter
• Stationary arm – aligned with midline of plevis
• Moving arm – aligned with femur (lateral epicondyle)
Hip abduction (0~45°)
Test Position
• Subject supine
• Stabilize pelvis to
prevent pelvic list
• Abduct hip
Goniometer Alignment
• Axis – anterior superior iliac spine (ASIS)
• Stationary arm – aligned with opposite ASIS
• Moving arm – aligned with femur (center of patella)
Hip adduction (0~30°)
Test Position
• Subject supine
• Stabilize pelvis to
prevent pelvic list
• Abduct opposite hip (to
allow room for tested
limb to adduct)
• Adduct hip
Goniometer Alignment
• Axis – anterior superior iliac spine (ASIS)
• Stationary arm – aligned with opposite ASIS
• Moving arm – aligned with femur (center of patella)
Hip internal rotation (0~45°)
Test Position
• Subject sitting on table
• knee flexed
• Stabilize distal thigh
• medially (internally)
rotate hip
Goniometer Alignment
• Axis – center of patella
• Stationary arm – aligned vertically
• Moving arm – aligned with leg (crest of tibia)
Hip external rotation (0~45°)
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Test Position
Subject sitting on table
knee flexed
Stabilize distal thigh
hip laterally (externally)
rotated
Goniometer Alignment
Axis – center of patella
Stationary arm – aligned vertically
Moving arm – aligned with leg (crest of tibia)
Knee flexion (0~135°)
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Test Position
Subject supine
Allow hip to flex
Flex knee
Goniometer Alignment
Axis – lateral epicondyle of femur
Stationary arm – aligned with greater trochanter
Moving arm – aligned with lateral malleolus
Knee extension (135~0°)
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Test Position
Subject prone
Stabilize femur
Extend Knee
Goniometer Alignment
Axis – lateral epicondyle of femur
Stationary arm – aligned with greater trochanter
Moving arm – aligned with lateral malleolus
Ankle plantar flexion (0~50°)
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Test Position
Subject supine
Extend knee
Stabilize leg
Plantarflex ankle
Goniometer Alignment
Axis – lateral malleolus
Stationary arm – aligned with fibular head
Moving arm – aligned with fifth metatarsal
Ankle dorsiflexion (0~20°)
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Test Position
Subject prone
Flex knee
Stabilize sub-talar in
neutral
• Dorsiflex ankle by
pushing through 5th
metatarsal head
Goniometer Alignment
Axis – lateral malleolus
Stationary arm – aligned with fibular head
Moving arm – aligned with fifth metatarsal
Ankle inversion (0~35°)
• Test Position
• Subject prone
• Stabilize tibia in sagittal
plane (rotate hip or
pelvis to align tibia)
• Invert calcaneus
• Goniometer Alignment
• Axis – automatically positioned by alignment of
goniometer arms
• Stationary arm – aligned with midline of leg
• Moving arm – aligned with midline of calcaneus
Ankle eversion (0~15°)
• Test Position
• Subject supine
• Stabilize calcaneus and
talus
• Evert forefoot
• Goniometer Alignment
• Axis – automatically positioned by alignment of
goniometer arms
• Stationary arm – aligned with midline of leg
• Moving arm – aligned with plantar aspect of
metatarsal heads
Spine
CERVICAL SPINE FORWARD BENDING (flexion)
Test Position
• Subject sitting with
lumbar and thoracic
spines supported
• Stabilize lumbar and
thoracic spines
• Flex cervical spine
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Goniometer Alignment
Axis – external auditory meatus
Stationary arm – vertical
Moving arm – aligned with nostrils
CERVICAL SPINE BACKWARD
BENDING (extension)
• Test Position
• Subject sitting with lumbar
and thoracic spines
supported
• Stabilize lumbar and
thoracic spines
• Mouth relaxed and slightly
open
• Extend cervical spine
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Goniometer Alignment
Axis – external auditory meatus
Stationary arm – vertical
Moving arm – aligned with nostrils
CERVICAL SPINE
SIDEBENDING
• Test Position
• Subject sitting with
lumbar and thoracic
spines supported
• Stabilize lumbar and
thoracic spines
• Sidebend cervical spine
• Goniometer Alignment
• Axis – spinous process of C7
• Stationary arm – spinous processes of thoracic
spine
• Moving arm – posterior midline of head at occipital
protuberance
CERVICAL SPINE ROTATION
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• Test Position
• Subject sitting with
lumbar and thoracic
spines supported
• Stabilize lumbar and
thoracic spines
• Rotate cervical spine
Goniometer Alignment
Axis – center of superior aspect of head
Stationary arm – aligned with acromion processes
Moving arm – aligned with tip of nose
THORACO-LUMBAR SPINE
FORWARD BENDING (flexion)
• Test Position
• Subject standing
• Flex thoracic and
lumbar spines
• Tape Measure
Alignment
• Spinous processes of
C7 and S1
THORACO-LUMBAR SPINE
BACKWARD BENDING
(extenion)
• Test Position
• Subject standing
• Extend thoracic and
lumbar spines
• Tape Measure
Alignment
• Spinous processes of
C7 and S1
THORACO-LUMBAR SPINE
SIDEBENDING
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Test Position
Subject standing
Stabilize pelvis
Sidebend thoracic and
lumbar spines
Goniometer Alignment
Axis - S1 spinous process
Stationary arm - vertical
Moving arm - C7 spinous process
THORACO-LUMBAR SPINE
ROTATION
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Test Position
Subject sitting
Stabilize pelvis
Do not allow sidebending,
forward bending or
backward bending
• Rotate thoracic and lumbar
spines
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Goniometer Alignment
Axis - center of superior aspect of head
Stationary arm - aligned with anterior superior iliac spines
Moving arm - aligned with acromion processes