1. Ms. Treto, Physical Therapy Academy
Goniometry
Ms. Treto,
Physical Therapy Academy

2. Goniometry From 2 Greek words “gonia,” meaning angle and
“metron,” meaning measure.
Measurement of angles created at human joints
by the bones of the body.

3. Goniometry
Measurements obtained with the use of an instrument called, goniometer.
May be used to determine, both a particular joint position and the
total amount of motion available at a joint.

4. active and passive joint motion and abnormal fixed joint positions.
goniometry
Used to measure and document the amount of
active and passive joint motion and abnormal
fixed joint positions.

5. Goniometric data can provide a basis for:
Determining the presence and absence of impairment.
2. Establishing a diagnosis.
3. Developing a prognosis, treatment goals, and plan of care.
4. Evaluating progress or lack of progress.

6. Goniometric data can provide a basis for:
5. Modify treatment.
6. Motivating the patient.
7. Researching the effectiveness of therapeutic techniques.
8. Fabricating orthoses and adaptive equipment.

7. Active Joint Motion PASSIVE JOINT MOTION
To assess abnormal movements and patient’s willingness to move.
PASSIVE JOINT MOTION
To determine reasons for joint limitation.
Assess tissue that is limiting the motion.
Detect pain.

8. Osteokinematics Movement of shafts of bones.
Described in terms of rotary motion produced, as if the movement
occurs around a fixed axis of motion.
Osteokinematic motions are described as taking place in one of the three
cardinal planes of the body around three corresponding axes.
Three axes lie at right angles to one another and to the corresponding plane.

9. The three planes: Sagittal Plane
Divides the body to right and left halves.
A median sagittal plane divides the body into equal right and
left halves.
Flexion and extension occur at the sagittal plane and at the
axis perpendicular to the sagittal plane, which is the
medial – lateral axis.

11. The three planes: 2. Frontal Plane:
Divides the body into front and back halves.
Abduction and adduction occur at the frontal plane, on the anterior – posterior axis.

13. The three planes: 3. Transverse Plane:
Divides the body into upper and lower halves.
Rotations occur on a transverse plane around a vertical axis.

15. Motions occurring at a single plane are measured by goniometry.
A joint that allows motion in only one plane is described
as having one degree of freedom of motion.
Example:
Interphalangeal joints: 1° of freedom
Glenohumeral joints: 3° of freedom

16. Active range of Motion:
Arc of motion attained by a subject during unassisted voluntary joint
motion.
Gives examiner information about: patient’s willingness to move,
coordination, muscle strength and joint ROM.
If pain occurs:
It may be due to contracting or stretching of contractive tissues
or stretching or pinching on non-contractile tissues.

17. Passive range of motion:
Arc of motion attained by the examiner with assistance
from the patient.
Patient remains relaxed and plays no active role in
producing the motion.
Normally, passive ROM is slightly greater than active
ROM.

18. Passive range of motion:
Testing passive ROM provides the examiner information
about: the integrity of the articular surfaces and the
extensibility of the joint capsule, associated ligaments,
muscle, fascia and skin.
Pain during PROM is caused by stretching or pinching of
non-contractile tissues, pain at end range of PROM is
due to stretching of contractile tissues.

19. End-feel There are normal limitations to joint motion, such as:
Joint capsules
Ligaments
Passive tension of muscles, fascia and skin
Soft tissue approximation
Contact of joint surfaces.

20. End-feel The feeling experienced by an examiner as a barrier to
further motion, at the end of PROM.
The ability to distinguish among the various end-feels
helps the examiner identify the type of limiting structures.

21. Normal end-feels: End - feel Structure Example SOFT
-soft tissue approximation
-elbow flexion
FIRM
-muscular stretch
-capsular stretch
-ligamentous
-hip flexion with knee straight
-extension of MCP joint
-forearm supination
HARD
-bone contacting bone
-elbow extension

22. abNormal end-feels: End - feel Structure Example SOFT
-occurs sooner or later in ROM than is usual or in a joint that normally has firm or hard end-feel
-soft tissue edema
- synovitis
FIRM
-occurs sooner or later in ROM than is usual or in a joint that normally has a soft or hard end-feel
-increased muscular tone
-capsular, muscular ligaments and fascial shortening

23. abNormal end-feels: End - feel Structure Example HARD
-occurs sooner or later in ROM than is usual or in a joint that normally has soft or firm end-feel. A bony grating or bony block is felt
-chondromalacia
-osteoarthritis
-Loose bodies in a joint
- fracture
EMPTY
-no real end-feel because pain prevents reaching end od ROM. No resistance us felt except for patient’s protective muscle splinting as muscle spasm
-acute joint inflammation
-bursitis
-abcess
-fracture

24. Hypomobility: HYPERMOBILITY:
Refers to a decrease in PROM that is substantially less than
normal values for that joint.
HYPERMOBILITY:
Refers to an increase in PROM that exceeds normal
values for that joint.

25. Factors affecting ROM:
AGE
GENDER
Other subject characteristics
Factors related to the testing process

26. Knowledge of the following are prerequisites for testing each joint and motion:
Testing positions
Stabilization required
Joint structure and function
Normal end-feels
Anatomical bony landmark
Instrument alignment

27. skills of the following are prerequisites for testing each joint and motion:
Position and stabilize correctly
Move a body part through appropriate ROM
Determine the end of the ROM
Palpate appropriate bony landmark
Align the measuring instrument with landmarks
Read measuring instrument
Record measurements correctly

28. Positioning:
Used to place joints in a zero starting position and to help
stabilize the proximal segment.
Affects the amount of tension on tissues surrounding a
joint.

29. Testing Positions:
Refers to positions of the body recommended for obtaining
goniometric measurements.
Testing positions are designed to:
Place the joint in a zero starting position
Permit complete ROM
Provide stabilization for the proximal joint segment
For testing positions, avoid moving the patient
unnecessarily.

30. Stabilization:
Stabilizing the patient’s body and proximal joint segment
so that a motion can be isolated to the joint being
examined.
Helps to ensure that a true measurement of the motion
has been obtained.

31. Equipment: Universal Goniometer -
Instrument most commonly used in the clinical setting.
Made of plastic or metal.
Parts:
Body – resembles a protractor. May form a half circle
or a full circle.
Stationary arm – a structural part of the body and can’t
be moved independently from the body,
Moving arm – is attached to the center of the body
by a rivet or screw like device.

32. Equipment: Gravity-dependent Goniometer
Inclinometer, pendulum goniometer, fluid (bubble)
goniometer.
Electrogoniometer
Used more often in research than in clinical settings.

33. Alignment: Goniometer alignment:
Refers to the alignment of the arms of the goniometer
with the proximal and distal segments of the joint being
evaluated.
Uses BONY anatomical landmarks
Usually:
Stationary arm – proximal segments of the joint
Moving arm – distal segment of the joint
Fulcrum – axis of motion of the joint
During alignment and reading the goniometer, EXAMINER MUST BE
EYE LEVEL WITH THE GONIOMETER

34. RECORDING: Numerical tables, pictorial charts or within the written
text of an evaluation.
Items recommended to be recorded:
Patient’s name, age, gender
Examiner’s name
Date and time of measurement
Type of goniometer used
Joint and motion measured

35. RECORDING: Items recommended to be recorded continued:
ROM, degrees at beginning of motion and degrees at
end of motion
Type of motion: passive or active
Discomfort or pain reported by the patient during testing
Any related objective findings; protective muscle spasm,
crepitus, restrictions
Any deviation from recommended testing positions.

36. RECORDING: If patient has normal, pain free ROM: simply record WNL.
Example:
AROM of ® elbow flexion:
0 - 50°
0 - 70°
20° - 70°
20° °

37. Validity and reliability:
Validity – “degree to which an instrument measures what
is supposed to measure; the extent to which it fulfills its
purpose.”
Reliability – amount of consistency between successive
measurements of the same variable on the same patient
under the same conditions.

38. Normal joint range of motions
ACTION
DEGREES OF MOTION
SHOULDER
FLEXION
EXTENSION
ABDUCTION
0 – 180
0 – 40
ELBOW
FOREARM
PRONATION
SUPINATION
0 – 80
0 - 80
WRIST
RADIAL DEVIATION
ULNAR DEVIATION
0 – 60
0 – 20
0 - 30

39. Normal joint range of motions
ACTION
DEGREES OF MOTION
HIP
FLEXION
EXTENSION
ABDUCTION
ADDUCTION
0 – 100
0 – 40
0 - 40
KNEE
ANKLE
PLANTARFLEXION
DORSIFLEXION
0 – 20
FOOT
INVERSION
EVERSION
0 – 30