Goniometry

• Measure a joint's range of motion.

• It can be helpful in determining, if a patient is
lacking in mobility due to an injury, or how
well he/she is recovering after sustaining an
injury.
In 1912, the physicist, Max von Laue
• Greek words, ‘gonia’, meaning angle
• ‘metron’, meaning measure.
Goniometry refers to the measurement of
angles. Specifically it can say that the
measurement of angles created at human joints
by the bones of the body.
Goniometry may be used to determine both a
particular joint position & the total amount of
motion available at a joint. Goniometry is an
important part of a comprehensive evaluation
of joints & surrounding soft tissue. (Norkin,
C.C & White, D.J, 1998, p 3)
 Importance of Goniometry:
• Determine the presence or absence of dysfunction
• Establishing a diagnosis
• Develop treatment goal
• Evaluating progress or lack of progress towards
rehabilitative goal
• Modify treatment
• Researching the effectiveness of specific
therapeutic techniques or regimens
• Fabricating orthosis & adaptive equipment
 Competency in Goniometry:

• Recommended the testing position

• Alternative position
• Stabilization required
• Joint structure & function
• Normal end-feel
• Anatomical bony landmark
• Instrument alignment
 Importance of End-feel in
Goniometry:
• The felling which is experienced by an examiner as a barrier to further
motion at the end of a passive ROM is called the end-feel.
• The amount of passive ROM is determined by the orientation of particular
joint. Some joint are structured so that the joint capsule limit the end of the
ROM in a particular direction. In other joint ligaments limit the ROM.
Other normal limitations to motion include passive muscle tension, soft
tissue approximation & contact of joint surface.
• So in every joint in the body have a normal characteristic end-feel which is
specific for that joint. Due to abnormality in the joint we will find another
end-feel which is called abnormal end-feel. Abnormal end-feel indicates the
limitation of ROM of that particular joint.
• So during measurement of joint ROM it is necessary to understand & feel
the end-feel of a joint to detect accurate Joint range.
 Importance of positioning in
Goniometry:
• Positioning is one of the most important components
of goniometry. Joint ROM vary according to the
different position of the body. In resting position the
ROM of one joint can be vary in loading position.

• Fore example: The ROM of hip flexion with knee

straight is limited than the ROM of hip flexion with
knee flex position.

• That’s why, during the measurement of joint ROM,

every joint has a particular ‘Recommended testing’
positions, from which ROM are measured.
 HOW TO USE A GONIOMETER

• Step 1:
• Place the Goniometer over the fulcrum of the joint. This will vary depending on which joint you are measuring.
Place the stationary arm of the Goniometer along the stationary line of the body (again, this will vary depending
on which joint you are measuring), and the movable arm on the moving part of the body.

• Step 2:
• Ask your patient to move the joint in the desired direction. Have the patient move to her fullest extent of motion,
following the movement with the movable arm of the Goniometer. Make sure the stationary arm stays straight.

• Step 3:
• Stabilize the stationary portion of the body. This is the part of the body that is proximal (closer to the midline of
the body) to the joint you are testing. It is important that the patient does not move his body while moving the
joint; this step isolates the joint movement for a more accurate measurement.

• Step 4:
• Look at the reading on the Goniometer before removing it from the patient's body. Ensure that you take an
accurate reading of the degree of motion on the Goniometer, and that you consistently use the same stationary
and movable landmarks on the body when measuring, to ensure consistency. Be sure to record the range of
motion for the joint.
 TECHNIQUE OF MEASUREMENT

• The procedure & its purpose should be clearly

explained to the patient.
• The relevant part of the body should be undress
• At the beginning of the examination the position of the
part should be stable & the standard position of zero.
• If pain is present, the starting position may have to be
modified & the test given in the most comfortable
position possible & with gentle handling
• When possible, the motion should be compared with
the opposite limb or side
• The movement can be active or passive. If possible
both are used. Any difference between these
movements should be recorded
• The movement should be carried out slowly. Both limbs may
be used to aid movement, improve stability or to prevent trick
movement
• Place the Goniometer in correct position
• Patient should complete the range before measuring
commences
• The Goniometer should be place along the lateral side of the
limb in the appropriate position & should not press on the limb
in any way
• Several reading needs to be taken. The average of these
reading should be recorded
• Joint range & the range of pain should be clearly recorded.
The result should be signed, dated & filed
• Re-test should be done at regular intervals so that progress can
be detected
 Different types of goniometry

• Plastic Goniometers:
• 12 ½" Goniometer: Scale reads 0° to 180° and 0°
to 360° in 1° increments
• 8" Goniometer: Scale reads 0° to 180° in opposite
directions in 1° increments
• 6" Goniometer: Scale reads 0° to 180° in opposite
directions in 1° increments
• 6 ¾ " Goniometer: Scale reads 0° to 180° in 5°
increments. I deal for small joints
 Parts of a Goniometer
• Body (Fulcrum) - The body of a goniometer is the
centerpiece, usually circular or semicircular, with a
protractor printed on its face and the fulcrum of the
movement arm at its center.
– Generally, the fulcrum of the goniometer is placed over the
center of a joint during measurement.
• Stationary Arm (Stabilization Arm) - The arm that is
affixed to the body of the goniometer in such away that it's
relative position does not change.
– Generally, the stationary arm is aligned with a reference line that
does not move during measurement.
• Moving Arm (Movement Arm) - The arm that is affixed to
the face of the goniometer at it's fulcrum; and
Shoulder joint:
 Shoulder
• Flexion 180
• Extension 50
• Abduction 180
• Adduction 50
• Lateral Rotation/ External Rotation 90
• Medial Rotation/ Internal Rotation 90
• Circumduction 360
 FLEXION:
Recommended testing position: Supine lying
position. Both arm straight & placed side of
the trunk
 Goniometer alignment:

• The fulcrum of the Goniometer is placed over

the acromion process.
• The stationary and moving arms are aligned
with the midline of the humerus and lateral
epicondyle.
 Placement of Goniometer:
• The fulcrum is placed over the acromion
process.
• The stationary and moving arms are aligned
with the lateral midline of the humerus and the
lateral epicondyle.
 Alignment of Goniometer:

• The fulcrum is placed at the acromion process.

• The stationary and moving arms are aligned
with the anterior midline of the humerus.
 Alignment of Goniometer:
• The fulcrum should be centered over the
olecranon process.
• The moving arm is aligned with the ulnar
styloid and the stationary arm should be
perpendicular to the floor.
 LATERAL ROTATION:
• Alignment of Goniometer:
• Fulcrum should be on the olecranon process.
• The moving arm should be aligned with the
ulnar styloid and the stationary arm should be
perpendicular to the floor.
There are three types of ROM exercises:
Passive
Active
Active assists
 Elbow
• Flexion 140
• Extension 0
• Supination 80
• Pronation 80
 ELBOW FLEXION
The fulcrum should be aligned with the lateral
epicondyle of the humerus.
The stationary arm is positioned along the
midline of the humerus, the moving arm is
aligned with the radial styloid process.
 Wrist
• Flexion 80
• Extension 70
• Radial Deviation 20
• Ulnar Deviation 30
 Flexion
The proximal Goniometer arm is aligned along
the ulna in line with the olecranon process and
the ulnar styloid process. The distal arm is
aligned along the fifth metacarpal.
Extension
 Finger
• MCP Flexion 90 Extension 0-5
• PIP Flexion 110 Extension 0
• DIP Flexion 85 Extension 5
MCP FLEXION

MCP Extension
MCP Abduction