1. Range of motion

2. Contents Definition Type of ROM Components of range of motion
Goniometry
Measurement

3. Definition
 Range of motion (ROM) is the term that is used to describe the amount of movement you have at each joint

4. Type of ROM
Active Range of Motion
Passive Range of Motion

5. Active Range of Motion Dynamic flexibility Physiological movements
Joint motion that occurs because of muscle contraction

6. Passive Range of Motion
Static flexibility
Movement that is performed completely by the examiner
Endpoints in the range of motion

7. Components of range of motion
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

8. 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

9. 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

10. Goniometry

11. Goniometry procedure
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)

12. Type of Goniometer ① full-circle manual universal goniometer
most versatile &popular
② Gonoimeters for single
joint motion

13. Type of Goniometer ③ fluid inclinometer ④ pendulum inclinometer
⑤ electrogoniometer

14. Measurement
Upper Ext.
Lower Ext.
Spine

15. Upper Ext. Shoulder flexion(0~180°) Test Position Subject supine
Flatten lumbar spine (flex knees)
Shoulder no abduction, adduction or rotation
(note: to measure gleno-humeral motion, stabilize scapula)
Shoulder flexion(0~180°)
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)

16. 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)

17. Shoulder abduction(0~180°)
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)

18. 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

19. Shoulder external rotation(0~90°)
Test Position 
Subject supine 
Shoulder 90o abduction
Forearm neutral
Elbow flexed 90o
Stabilize arm
Goniometer Alignment 
Axis – olecranon process of ulna
Stationary arm – aligned vertically
Moving arm – aligned with ulna (styloid process)

20. Shoulder internal rotation(0~70°)
Test Position
Subject supine
Shoulder 90o abduction
Forearm neutral
Elbow flexed 90o
Stabilize arm
Goniometer Alignment
Axis – olecranon process of ulna
Stationary arm – aligned vertically
Moving arm – aligned with ulna (styloid process)

21. 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)

22. 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)

23. Forearm pronation(0~80°)
Test Position
Subject sitting
Shoulder neutral (arm at side)
Elbow flexed to 90o
Stabilize arm
Pronate forearm
Goniometer Alignment
Axis – lateral to ulnar styloid
Stationary arm – parallel to humerus
Moving arm – aligned with dorsum of radius

24. Forearm supination(0~80°)
Test Position
Subject sitting
Shoulder neutral (arm at side)
Elbow flexed to 90o
Stabilize arm
Supinate forearm
Goniometer Alignment
Axis – medial to ulnar styloid
Stationary arm – parallel to humerus
Moving arm – aligned with ventral aspect of radius

25. Wrist flexion(0~80°) Goniometer Alignment
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

26. Wrist extension(0~70°) Goniometer Alignment
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

27. 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

28. 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

29. Lower Ext. Hip flexion(0~120°) Test Position Subject supine
Allow knee to flex (to avoid limitation by tight hamstrings)
Stabilize pelvis to prevent rotation, Hip flex.
Hip flexion(0~120°)
Goniometer Alignment
Axis – greater trochanter
Stationary arm – aligned with midline of plevis
Moving arm – aligned with femur (lateral epicondyle)

30. 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)

31. 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)

32. 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)

33. 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)

34. Hip external rotation(0~45°)
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)

35. Knee flexion(0~135°) 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

36. Knee extension(135~0°) 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

37. Ankle plantar flexion(0~50°)
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

38. Ankle dorsiflexion(0~20°)
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

39. 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

40. 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

41. Spine CERVICAL SPINE FORWARD BENDING (flexion)
Test Position
Subject sitting with lumbar and thoracic spines supported
Stabilize lumbar and thoracic spines
Flex cervical spine
Goniometer Alignment
Axis – external auditory meatus
Stationary arm – vertical
Moving arm – aligned with nostrils

42. 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
Goniometer Alignment
Axis – external auditory meatus
Stationary arm – vertical
Moving arm – aligned with nostrils

43. 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

44. CERVICAL SPINE ROTATION
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

45. THORACO-LUMBAR SPINE FORWARD BENDING (flexion)
Test Position
Subject standing
Flex thoracic and lumbar spines
Tape Measure Alignment
Spinous processes of C7 and S1

46. THORACO-LUMBAR SPINE BACKWARD BENDING (extenion)
Test Position
Subject standing
Extend thoracic and lumbar spines
Tape Measure Alignment
Spinous processes of C7 and S1

47. THORACO-LUMBAR SPINE SIDEBENDING
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

48. THORACO-LUMBAR SPINE ROTATION
Test Position
Subject sitting
Stabilize pelvis
Do not allow sidebending, forward bending or backward bending
Rotate thoracic and lumbar spines
Goniometer Alignment
Axis - center of superior aspect of head
Stationary arm - aligned with anterior superior iliac spines
Moving arm - aligned with acromion processes