The term goniometer ir derived from greek
words Gonia meaning angle and metron
meaning measure.
Goniometer refers to the measurement of
angles created at human joints by the bones
of the body.
Goniometer is used to measure and document
the amount of active and passive joint motion
as well as abnormal fixed joint positions.
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Determining the presence or absence of
impairement
Establishing a diagnosis
Developing a prognosis ,treatment goals and
plan of care.
Evaluating progress or lack of progress toward
rehabilitative goals
Modifying treatment
Motivating the subject
Research the effectiveness of therapeutic
techniques or regimens
Fabricating orthoses and adaptive equipement.
Arthrokinematics
-is the term used to refer to the movement of
joint surfaces. These movements are described as
slides(glides),spins, and rolls.
Slide : is a translatory motion with sliding of one
surface over the other.(skidding of braked wheels)
Spin: is a rotary motion where all points on the
moving joint surface rotate around a fixed axis of
motion.( spinning of toy top)
Roll: is a rotary motion similar to the rolling of
bottom of rocking chair on the floor.
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The direction of the rolling and sliding
components of a roll-slide will vary depending
on the shape of the moving joint surface.
If a convex joint surface is moving, the convex
surface will roll in the same direction as the
angular motion of the shaft of the bone but will
slide in the opposite direction.
If a concave joint surface is moving ,the concave
surface will roll and slide in the same direction as
the angular motion of the shaft of the bone.
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Refers to the gross movement of the shafts of
bones rather than the movement of joint
surfaces.
The movement of the shafts of the bones are
usually described in terms of rotary or
angular motion produced as if the movement
occurs around a fixed axis of motion.
Goniometry measures the angles created by
the rotary motion of the shafts of the bones.
Osteokinematic motions take place in one of the
three cardinal planes of the body and three
corresponding axes.
Planes/Axis
- Sagittal plane/ medial-lateral axis
- Frontal plane / anterior-posterior axis
- Transverse plane / vertical axis
Movements at these planes and axes
Sagittal plane/M-L axis: Flexion Extension
Frontal plane/A-P axis: Abduction Adduction
Transverse plane/vert axis: Rotations
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Rom is the arc of motion that occurs at a joint
or a series of joints.
The starting position for measuring all ROM is
the anatomical position except for rotations
which is done in the transverse plane.
Three notation systems have been used to
define ROM.
- 0-180° system
- 180-0° system
- 360° system
1. 0 to 180 degree system
- The upper extremity and lower extremity joints are at
0 degrees for flexion-extension and abductionadduction when the body is in anatomical position.
- This system is also called as the neutral zero method
- Used widely throughout
2.180 to 0 degrees system
- Defines anatomical system as 180 degrees.
- Rom begins at 180 degrees and preceeds in an arc
towards 0 degrees.
3. 360 degrees system
- Also defines anatomical position as 180 degrees.
- The motions of flexion and abduction begin at 180
degrees and proceed in an arc toward 0 degrees.
- The motions of extension and adduction begin at 180
degrees and proceed in an arc towards 360 degrees.
- This system is more difficult to intepret
- Not used frequently
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It is the arc of motion attained by the subject during unassisted
voluntary joint motion.
Active ROM provides information about the subjects willingness to move,
coordination,muscle strength, and joint ROM
Is a good screening technique to help focus a physical examination
Passive ROM
- Is the arc of motion attained by an examiner without the assistance from
the subject.
- The subject remains relaxed and plays no active role in producing the
motion
- Normally rom is greater than active rom
- Additional rom is due to stretch of tissues surrounding the joint and the
reduced bulk of contracting muscles.
- Testing this rom provides examiner with information about the integrity
of the joint surfaces and the extensibility of the joint capsule and other
structures.
- Passive ROM rather than active ROM should be tested in goniometry
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The feeling experienced or felt by the examiner
as a barrier to further motion at the end of
passive ROM is called End-feel.
Normal end-feels
1. Soft : due to soft tissue approximation. Eg:
knee flexion
2. Firm: muscular stretch,capsular
stretch,ligamentous stretch.eg: hip flexion with
knee straight, extension of MCP jt,Forearm
supination.
3. Hard: bone contacting bone. Eg: elbow
extension
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Boggy : soft tissue edema,synovitis
Firm: occurs in a joint that normally has a soft
/hard end-feel. Due to increased muscular
tone,capsular/lig/muscular/facial shortening.
Hard: occurs in ajoint that normally has a soft
or firm end-feel. Bony block/grating is felt. Due
to OA, MO,fracture, Chondromalacia, loose
bodies in joint.
Empty: no real end-feel because pain prevents
movement. Due to acute jt inflammation,
bursitis, abscess, fracture, psychogenic
disorder.
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Refers to a decrease in passive ROM that is
substantially less than normal values for that
joint,given subjects age and gender.
May occur due to abnormalities of joint
surfaces, passive shortening of joint capsules,
ligaments, muscles, fascia, and skin
Conditions where hypomobility is seen are
OA,RA,spinal disorders, stroke,head
injury,CP,diabetes etc.
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Pathological conditions involving the entire joint
capsule cause a particular pattern of restriction
involving all or most of the passive motions of the
joint.this pattern of restriction is called a capsular
pattern.
Noncapsular patterns of restriction
- A limitation of passive motion that is not
proportioned similarly to a capsular pattern is called
a noncapsular pattern of restriction.
- Usually caused by a condition involving structures
other than joint capsule
- Due to internal joint derangement,adhesion ,lig
shortening, muscle strain,muscle contractures.
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Refers to an increase in passive RPOM that
exceeds normal values for that joint,given the
subjects age and gender.
Hypermobility is due to the laxity of soft
tissue structures such as ligs, capsules, and
muscles that normally prevent excessive
motion at a joint.
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Age
Gender: females more than males
Active/passive ROM
BMI
Occupational activities
Recreational activities
Testing position
Positioning
- Is an important part of goniometry because it is used to
place the joints in a zero starting position and helps to
stabilise the proximal joint segment.
- Affects the tension in soft tissue structures surrounding
the joint.
- Testing positions refer to the positions of the body that we
recommend for obtaining goniometric measurements.
- The testing positions are designed to do the following
- A. place the joint in a starting position of 0 degrees
- B. permit a complete ROM
- Provide stabilization for the proximal joint segment
- Testing positions involve position like supine,prone,sitting
and standing.