Goniometry

the measurment of angles in human joints

• gonia-greek meaning angle
• metron-greek meaning measure

particular joint position and total amount of motion available at a joint

arthrokinematics

• slide
• spin
• roll

usually occur in combination with each other and result in movement of the shafts of bones

slide

*a braked wheel skidding

spin

*a toy top spinning

roll

• *bottom of rocking chair on the floor
• *tire rolling on the road

osteokinematics

*this is what we really measure (angle created by the rotary motion of the shafts of the bones)

arc of motion that occurs at a joint or series of joints

anatomical position......ZERO degrees

active ROM (AROM)

• willingness to move
• coordination
• muscle strength
• joint ROM

passive ROM (PROM)

passive is slightly greater than active bc each joint has a small amount of available motion that is not under voluntary control

• joint capsules
• tendons
• ligaments
• skin
• fasia

to protect joint structures...it allows the joint to absorb extrinsic forces

• -amount of motion permitted by joint structure(PROM) -vs- subjects ability to produce motion at a joint (AROM)
• -integrity of articular surfaces
• -extensibility of joint capsule
• -extensibility of associated ligaments, muscles, fascia, and skin

patients efforts are joined by the PTA to determine the AAROM

allows pt to assist to whatever level they can during testing

hypomobility

pathological condition involving the entire joint capsule that causes a particular pattern of restriction involving all or most of the passive motions of the joint

limitation of PROM that isnt proportioned similarly to a capsular pattern

• *usually involves structures other than the entire joint capsule
• -internal joint derangement
• -adhesion of a part of a joint capsule
• -ligament shortening
• -muscle strains
• -muscle contractures

its used to place the joint in a zero starting position to help stabilize the proximal joint segment

isolating motion to one joint..helps to ensure that a true motion is obtained, rather than a measurement of combined motions that occue at a series of joints

end-feel

soft tissue approximation

knee flexion (contact between soft tissue of the posterior leg and posterior thigh)

• muscular stretch - hip flexion with knee straight (passive elastic tension of hamstring muscle)
• capsular stretch - extenstion of MCP joints of the fingers (tension in the anterior capsule)
• ligamentous stretch - forearm supination (tension in the palmar radioulnar ligament of the inferior radioulnar joint, interosseous membrane, oblique cord)

occurs sooner or later in ROM than is usual, or in a joint that normally has a firm or hard end feel. feels boggy

occurs sooner or later in ROM than is usual, or in a joint that normally has a soft or hard end feel

• occurs sooner or later in the ROM than is usual, or in a joint that normally has a soft or firm end feel.
• a bony grating or block is felt

no real end feel bc pain prevents reaching end of ROM. no resistance is felt except for patients protective muscle splinting or muscle spasm

• soft tissue edema
• synovitis

• increased muscular tonus
• capsular, muscular, ligamentous, and fasical shortening

• chondromalacia
• osteoarthritis
• loose bodies in joint
• myositis ossificans
• fracture

• acute inflammation
• bursitis
• abscess
• fracture
• psychogenic disorder

hypermobility

loosey-goosey

laxity (looseness) of soft tissue structures such as ligaments, capsules, and muscles that normally prevent excessive motion at joint

how well the measurement represents the true value of the variable of interest

amount of consistency between successive measurements of the same variable, on the same subject, under the same conditions

• presence of jt ROM limitations
• pt progress toward rehabilitative goals
• assess the effectiveness of ther interventions

• mvmt of the joint axis (neck)
• variations in manual force applied by the examiner during PROM
• variations in a subjects effort during AROM

same tester

2 different testers

4-5degrees

*must have >6degrees for improvement

5-6degrees

*must have >7degrees for improvement

alignment of the arms of the goniometer with the proximal and distal segments of the jt being evaluated

muscle length

-maximal distance between the proximal and distal attachments of a muscle to bone

to assess for hypermobility or hypomobility and the structures involved

measured indirectly by determining the end of ROM of the joints crossed by the muscles

by the number of joints they cross from their proximal to their distal attachments

1

at the end of the joint they cross

PROM in the direction opposite to the muscles action is decreased and the end feel is firm owing to a muscular stretch

2

multipal

full PROM to occur simultaneously at all joints crosses by these muscles

*This is known as passive insufficiency

indirectly by measuring PROM in the direction opposite to the muscles action at the 2nd joint (for two-joint) or the last joint to be moved (for multi-joint)