UE ROM Joint Motions

What are the steps we need to take when we are performing for our practicum?

1. Introduce yourself (Hi___! My name is Kelly and I will be your OT for today. I will be measuring your range of motion using this goniometer")

2. Explain the purpose and procedure of goniometry assessment to the client.

3. Position the patient appropriately.

4. Communicated the desired motion verbally and by demonstration.

5. Ask the client to demonstrate the desired motion.

6. Align the goniometer with static arm, axis and movable arm.

7. Instruct client to complete the desired motion to their end range without pain

8. Maintain alignment of the goniometer , monitoring for compensatory motions 

9. Note the angle of the goniometer once client has completed AROM of joint

10. Document the movement by noting the measurement in degrees e.g. Elbow Flexion: 0 -135

What is the plane and axis for shoulder flexion?

Sagittal Plane 

Med-lat axis

What is the prime movers for shoulder flexion?

Deltoid (anterior fibers) 

Pectoralis major (clavicular upper fibers) 

Biceps brachii

Coracobrachialis

What is the normal range and joint end feel for shoulder flexion?

0-180, Firm

Goniometer axis for shoulder flexion

1 inch ⬇ acromion, lateral aspect glenohumeral joint

Goniometer stationary arm for shoulder flexion

Parallel to the lateral midline of the trunk

Goniometer moveable arm for shoulder flexion

Parallel to longitudinal axis of humerus on lateral aspect

Positioning for shoulder flexion

What is the plane and axis for shoulder extension?

Sagittal Plane 

Med-lat axis

What are the prime movers for shoulder extension?

Deltoid (posterior fibers) 

Latissimus dorsi

Teres Major

What is the normal range and joint end feel for shoulder extension?

0-60, Firm

Goniometer axis for shoulder extension

1 inch ⬇acromion 

Lateral aspect glenohumeral joint

Goniometer stationary arm for shoulder extension

Parallel to lateral midline of trunk

Goniometer moveable arm for shoulder extension

Parallel to longitudinal axis of humerus on lateral aspect

Positioning for shoulder extension

What is the plane and axis for shoulder abduction?

Frontal Plane 

Ant-post axis

What are the prime movers for shoulder abduction?

Deltoid (middle fibers)

Supraspinatus

What is the normal range and joint end feel for shoulder abduction

0-180, Firm

Goniometer axis for shoulder abduction

1 inch ⬇acromion

Post or Ant aspect of glenohumeral joint

Goniometer stationary arm for shoulder abduction

Parallel to spine, along the trunk

Goniometer moveable arm for shoulder abduction

Parallel to longitudinal axis of humerus

Positioning for shoulder abduction

What is the plane and axis for horizontal abduction?

Transverse plane

Vertical axis

What are the prime movers for horizontal abduction?

Deltoid (posterior fibers)

Teres minor

Infrapinatus

What is the normal range and joint end feel for shoulder abduction?

0-180, Firm

Goniometer axis for horizontal abduction

On top of acromion

Goniometer stationary arm for shoulder abduction

Parallel to spine, along the trunk

Goniometer moveable arm for shoulder abduction

Parallel to longitudinal axis of humerus of superior aspect

Positioning for horizontal abduction

What is the plane and axis for horizontal adduction?

Transverse plane

Vertical axis

What are the primer movers for horizontal adduction?

Deltoid (anterior fibers)

Pectoralis major (upper fibers)

What is the normal range and joint end feel for horizontal adduction?

0-140

Firm

Goniometer axis for horizontal adduction

On top of the acromion process

Goniometer stationary arm for horizontal adduction

Parallel to shaft of superior humerus & remains perpendicular to body as humerus moves anterior

Goniometer moveable arm for horizontal adduction

Parallel to longitudinal axis of humerus of superior aspect

Positioning for horizontal adduction

What is the plane and axis for internal rotation?

Transverse plane

Vertical axis

What are the prime movers for internal rotation?

Subscapularis

Teres major

Deltoid (anterior fibers)

Pectoralis Major

Latissimus Dorsi

What is the normal range and joint end feel for internal rotation

0-70

Firm

Goniometer axis for internal rotation

Olecranon process of ulna

Goniometer stationary arm for internal rotation

Perpendicular to floor

Goniometer moveable arm for internal rotation

Parallel to longitudinal axis of ulna

Positioning for internal rotation

What is the plane and axis for external rotation?

Transverse plane

Vertical axis

What are the primer movers for external rotation?

Deltoid (posterior fibers)

Infraspinatus

Teres minor

What is the normal range and joint end feel for external rotation?

0-90, Firm

Goniometer axis for external rotation

Olecranon process of ulna

Goniometer stationary arm for external rotation

Perpendicular to floor

Goniometer moveable arm for external rotation

Parallel to longitudinal axis of ulna

Positioning for external rotation

What is the plane and axis for elbow flexion and extension?

Sagittal Plane 

Med-lat axis

What are the prime movers for elbow flexion and extension?

Flexion

Brachialis

Biceps Brachii

Brachioradialis

Extension 

triceps brachii (all heads)

anconeus

What is the normal range and joint end feel for elbow flexion/extension?

0-150

Flexion

Soft

Extension

Hard

Goniometer axis for elbow flexion and extension

Lateral epicondyle of the humerus

Goniometer stationary arm for elbow flexion and extension

Parallel to the longitudinal axis of the humerus on the lateral aspect

Goniometer moveable arm for elbow flexion and extension

Parallel to the longitudinal axis of the radius

Positioning for elbow flexion and extension

What is the plane and axis for pronation?

Transverse plane

Vertical axis

What are the prime movers for pronation?

pronator teres

pronator quadratus

What is the normal range and joint end feel for pronation?

0-80

Hard

Goniometer axis for pronation

Longitudinal axis of the forearm displace towards the ulnar side

Goniometer stationary arm for pronation

Perpendicular to the floor, parallel with humerus

Goniometer moveable arm for pronation

Across the distal radius and ulna on the dorsal surface

Positioning for pronation

What is the plane and axis for supination?

Transverse plane

Vertical axis

What are the prime movers for supination?

Biceps brachii

Supinator

What is the normal range and joint end feel for supination?

0-80

Firm

Goniometer axis for supination

Longitudinal axis of the forearm displaced towards the ulnar side

Goniometer stationary arm for supination

Perpendicular to the floor, which should also be parallel to the humerus.

Goniometer moveable arm for supination

Across the distal radius and ulna on the volar surface

Positioning for supination

What is the plane and axis for wrist flexion?

Sagittal Plane 

Med-lat axis

What are the prime movers for wrist flexion?

Flexor carpi radialis 

Flexor carpi ulnaris

Palmaris Longus

What is the normal range and joint end feel for wrist flexion?

0-80

Firm

Goniometer axis for wrist flexion

Wrist joint line with the 3rd metacarpal in capitate region

Goniometer stationary arm for wrist flexion

Along the midline if the dorsal surface of the forearm

Goniometer moveable arm for wrist flexion

Parallel to the longitudinal axis of the 3rd metacarpal

Positioning for wrist flexion

What is the plane for wrist extension?

Sagittal Plane 

Med-lat axis

What are the prime movers for wrist extension?

Extensor carpi radialis longus
Extensor carpi radialis brevis

Extensor carpi ulnaris

What is the normal range and joint end feel for wrist extension?

0-70

Firm

Goniometer axis for wrist extension

Volar wrist in line with palmaris longus in line with third metacarpal over carpals

Goniometer stationary arm for wrist extension

Along the midline of the volar surface of forearm

Goniometer moveable arm for wrist extension

Parallel to the longitudinal axis of the 3rd metacarpal. rest between 3rd and 4th digits if digits allow correct alignment

Positioning for wrist extension

What is the plane and axis for ulnar deviation?

Frontal Plane 

Ant-post axis

What are the prime movers for ulnar deviation?

Extensor carpi ulnaris

Flexor carpi ulnaris

What is the normal range and joint end feel for ulnar deviation?

0-30

Firm

Goniometer axis for ulnar deviation

Dorsal aspect of the wrist joint in line of the 3rd metacarpal over the capitate bone

Goniometer stationary arm for ulnar deviation

Midline of the forearm on the dorsal side

Goniometer moveable arm for ulnar deviation

Midline of the 3rd metacarpal

Positioning for ulnar deviation

What is the plane and axis for radial deviation?

Frontal Plane 

Ant-post axis

What are the primer movers for radial deviation?

Extensor carpi radialis longus

Extensor carpi radialis brevis

Flexor carpi radialis

What is the normal range and joint end feel for radial deviation

0-20

Firm

Goniometer axis for radial deviation

Dorsal side. wrist joint align based on the 3rd metacarpal over the capitate

Goniometer stationary arm for radial deviation

Midline of the forearm on the dorsal side.

Goniometer moveable arm for radial deviation

3rd metacarpal on midline

Positioning for radial deviation