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Goniometry

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Submitted By royjenkins
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SHOULDER FLEXION

Test Position * Subject supine * Flatten lumbar spine (flex knees) * Shoulder no abduction, adduction or rotation * (note: to measure gleno-humeral motion, stabilize scapula) | Normal Range(for shoulder complex flexion) * 167o + or - 4.7o (American Academy of Orthopaedic Surgeons) * 150o (American Medical Association) * 166o (mean), 4.7o (standard deviation), (Boone and Azen) | 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) | Normal End Feel * Muscle Stretch |

SHOULDER EXTENSION

Test Position * Subject prone * Shoulder no abduction, adduction or rotation * (note: to measure gleno-humeral motion, stabilize scapula) | Normal Range(for shoulder complex flexion) * 62o + or - 9.5o (American Academy of Orthopaedic Surgeons) * 50o (American Medical Association) * 62.3o (mean), 9.5o (standard deviation), (Boone and Azen) | 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) | Normal End Feel * Capsular or ligamentous |
SHOULDER MEDIAL (INTERNAL) ROTATION

Test Position * Subject supine * Shoulder 90o abduction * Forearm neutral * Elbow flexed 90o * Stabilize arm | Normal Range * 69o + or - 4.6o (American Academy of Orthopaedic Surgeons) * 90o (American Medical Association) * 68.8o (mean), 4.6o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – olecranon process of ulna * Stationary arm – aligned vertically * Moving arm – aligned with ulna (styloid process) | Normal End Feel * Capsular |

SHOULDER LATERAL (EXTERNAL) ROTATION
SHOULDER LATERAL (EXTERNAL) ROTATION

Test Position * Subject supine * Shoulder 90o abduction * Forearm neutral * Elbow flexed 90o * Stabilize arm | Normal Range * 104o + or - 8.5o (American Academy of Orthopaedic Surgeons) * 90o (American Medical Association) * 103o (mean), 8.5o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – olecranon process of ulna * Stationary arm – aligned vertically * Moving arm – aligned with ulna (styloid process) | Normal End Feel * Capsular |

SHOULDER ABDUCTION

Test Position * Subject supine * Shoulder 0o flexion and extension * Shoulder laterally (externally) rotated * Shoulder abducted * Stabilize thorax (note: to measure gleno-humeral motion, stabilize scapula) | Normal Range(for shoulder complex abduction) * 184o + or - 7.0o (American Academy of Orthopaedic Surgeons) * 180o (American Medical Association) * 184o (mean), 7.0o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – center of humeral head near acromion process * Stationary arm – parallel to sternum * Moving arm – aligned with midline of humerus | Normal End Feel * Muscle Stretch |

ELBOW FLEXION

Test Position * Subject supine * Shoulder neutral (arm at side) * Forearm supinated * Elbow flexed * Stabilize arm | Normal Range * 141.0o + or - 4.9o (American Academy of Orthopaedic Surgeons) * 140.0o (American Medical Association) * 142.9o (mean), 5.6o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – lateral epicondyle of humerus * Stationary arm – aligned with humerus (center of acromion process) * Moving arm – aligned with radius (styloid process) | Normal End Feel * Soft tissue approximation (capsular for thin subjects) |

WRIST FLEXION

Test Position * Subject seated * Forearm stabilized on table * Flex wrist (fingers relaxed) | Normal Range * 75o + or - 6.6o (American Academy of Orthopaedic Surgeons) * 60o (American Medical Association) * 76.4o (mean), 6.3o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – lateral wrist (triquetrum) * Stationary arm – aligned with ulna * Moving arm – aligned with fifth metacarpal | Normal End Feel * Capsular |

WRIST EXTENSION

Test Position * Subject seated * Forearm stabilized on table * Extend wrist (fingers relaxed) | Normal Range * 74o + or - 6.6o (American Academy of Orthopaedic Surgeons) * 60o (American Medical Association) * 74.9o (mean), 6.4o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – lateral wrist (triquetrum) * Stationary arm – aligned with ulna * Moving arm – aligned with fifth metacarpal | Normal End Feel * Capsular |

HIP LATERAL (EXTERNAL) ROTATION

Test Position * Subject sitting on table * knee flexed * Stabilize distal thigh * hip laterally (externally) rotated | Normal Range * 44.0o + or - 4.8o (American Academy of Orthopaedic Surgeons) * 50.0o (American Medical Association) * 47.2o (mean), 6.3o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – center of patella * Stationary arm – aligned vertically * Moving arm – aligned with leg (crest of tibia) | Normal End Feel * Capsular |
HIP MEDIAL (INTERNAL) ROTATION
HIP MEDIAL (INTERNAL) ROTATION

Test Position * Subject sitting on table * knee flexed * Stabilize distal thigh * medially (internally) rotate hip | Normal Range * 44.0o + or - 4.3o (American Academy of Orthopaedic Surgeons) * 40.0o (American Medical Association) * 47.3o (mean), 6.0o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – center of patella * Stationary arm – aligned vertically * Moving arm – aligned with leg (crest of tibia) | Normal End Feel * Capsular |

HIP FLEXION Test Position * Subject supine * Allow knee to flex (to avoid limitation by tight hamstrings) * Stabilize pelvis to prevent rotation * Flex hip | Normal Range * 121.0o + or - 6.4o (American Academy of Orthopaedic Surgeons) * 100.0o (American Medical Association) * 122.3o (mean), 6.1o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – greater trochanter * Stationary arm – aligned with midline of plevis * Moving arm – aligned with femur (lateral epicondyle) | Normal End Feel * Capsular |
HIP FLEXION

HIP EXTENSION

Test Position * Subject prone * Stabilize pelvis to prevent rotation * Extend hip | Normal Range * 12.0o + or - 5.4o (American Academy of Orthopaedic Surgeons) * 30.0o (American Medical Association) * 9.8o (mean), 6.8o (standard deviation), (Boone and Azen) | Goniometer Alignment * Axis – greater trochanter * Stationary arm – aligned with midline of plevis * Moving arm – aligned with femur (lateral epicondyle) | Normal End Feel * Capsular or ligamentous |

KNEE FLEXION

Test Position * Subject supine * Allow hip to flex * Flex knee | Normal Range * 141o + or - 5.3o (American Academy of Orthopaedic Surgeons) * 150o (American Medical Association) * 142.5o (mean), 5.4o, (standard deviation) (Boone and Azen) | Goniometer Alignment * Axis – lateral epicondyle of femur * Stationary arm – aligned with greater trochanter * Moving arm – aligned with lateral malleolus | Normal End Feel * Soft tissue approximation |

ANKLE DORSIFLEXION

Test Position * Subject prone * Flex knee * Stabilize sub-talar in neutral * Dorsiflex ankle by pushing through 5th metatarsal head | Normal Range * 13o + or - 4.4o (American Academy of Orthopaedic Surgeons) * 20o (American Medical Association) * 12.6o (mean), 4.4o, (standard deviation) (Boone and Azen) | Goniometer Alignment * Axis – lateral malleolus * Stationary arm – aligned with fibular head * Moving arm – aligned with fifth metatarsal | Normal End Feel * Capsular |
ANKLE PLANTARFLEXION

Test Position * Subject supine * Extend knee * Stabilize leg * Plantarflex ankle | Normal Range * 56o + or - 6.1o (American Academy of Orthopaedic Surgeons) * 40o (American Medical Association) * 56.2o (mean), 6.1o, (standard deviation) (Boone and Azen) | Goniometer Alignment * Axis – lateral malleolus * Stationary arm – aligned with fibular head * Moving arm – aligned with fifth metatarsal | Normal End Feel * Capsular |

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