Applied Anatomy Goniometry Quiz

What can goniometry measurement provide for a patient?

-Willingness to move a body part

-Level of consciousness

-Ability to follow instructions

-Attention span

-Coordination

-Joint ROM

-Movements that cause or increase pain

-Muscle strength

-Ability to perform functional activities

What are some reasons ROM may be decreased?

-Unwillingness to Move

-Inability to follow instructions

-Restricted joint mobility

-Muscle weakness

-Pain

You are about to do passive ROM on a patient with right shoulder surgery. They're taking hydrocodone (pain medication) are you able to perform passive ROM?

yes, because it's a precaution (you just have to be aware of the injury)

-increased pain

-inflammatory process in a joint

-medication: pain/muscle relaxant

-osteoporosis/bone fragility

-hypermobile joint

-hemophilia

-hemotoma

-bony ankylosis

-disruption of soft tissue after injury

-recently healed fracture

-prolonged immobilization

Precautions for ROM testing

In a patient taking medication for pain or a muscle relaxant, why should precautions be taken?

because the patient may not be able to respond appropriately, and movement may be performed too vigorously

In the presence of marked osteoporosis in a condition where bone fragility is a factor, how should precautions be taken in testing for ROM?

perform PROM with extreme care or not at all

Where should a precaution for ROM testing be assessed, especially for a person with a hematoma?

Elbow, hip, knee

precautions for ROM testing

After an injury where there has been a disruption of soft tissue (tendon, muscle, ligament). What is this an example of?

contraindicaiton

You can NOT perform ROM

percaution

You CAN perform ROM, just be aware/cautious of injury

How do you perform a functional scan of active motion?

-perform symmetrical movements

-motion is equal to the uninvolved side: "normal" or functional

-Appearance of normal motion: does not need to be measured with goniometry

-Measure the range of motion that is less than the normal range or restricted/excessive

What does it mean if the motion is equal to the uninvolved side?

normal or functional

Do you need to measure with goniometry if a motion appears normal? When do you need to measure?

no; measure range of motion that's less than normal range, restricted, excessive

-little study of criterion-related validity

-more reliable than visual estimation of joint ROM

universal goniometer

varies depending on the joint and motion assessed

Reliability of goniometric measurement

better than intertester (interrater) reliability; same therapist should perform all measure when possible

intratester (intrarater) reliability

Does the size of the goniometer used to assess ROM at a joint affect measurement reliability?

no

Unviersal goniometer is a 180/360 degree protractor with one ___________ that joins 2 arms. One arm is _______, and the other arm is moveable around the axis or fulcrum of the protractor.

Axis; stationary

Where is the axis of the goniometer placed?

over the axis of movement

What can be used to represent the axis of motion, even though this may not represent the exact location of the axis of movement throughout the entire ROM?

specific bony prominence/anatomical landmark

normally lies parallel to the longitudinal axis of the fixed proximal joint segment, and or points toward a distant bony prominence on the proximal segment

stationary arm of the goniometer

normally lies parallel to the longitudinal axis of the moving distal joint segment and/or points toward a distant bony prominence on the distal segment

moveable arm

How do you prepare a patient for goniometry testing?

1. Expose the area

2. Briefly explain ROM assessment and measurement procedures

3. Explain and demonstrate the movement and/or passively move the patient's uninvolved limb through ROM

4. Position the joint assessed in anatomical position

5. seated, standing, or supine

How should you position the patient to prepare them for goniometry testing?

-anatomical position

-The proximal joint segment stabilized for only the desired motion

-full ROM movement, unrestricted

-goniometer properly placed to measure ROM

For preparing a patient for goniometry testing, the __________ joint segment should be stabalized to allow only the desired motion.

proximal

The most common method used to assess and measure joint ROM. All joint motions are measured from a defined zero position, either the anatomical position or a position specified as zero.

neutral zero method

How is the goniometer first aligned to measure ROM? What should you do if it is not possible to attain this position?

at the defined zero position; the joint is positioned as close as possible to the zero position

The patient moves the part to be tested while the therapist aligns the stationary and movable arms

measuring joint ROM

When will the therapist note the measurement in degrees of the motion?

at the peak of the patient's motion

A measurement can be repeated, but what should you be aware of?

fatigue

What are the parts of measuring joint range of motion?

1. Neutral Zero Method

2. defined zero position/position as close as possible to it

3. Patient moves while the therapist aligns the stationary and movable arms

4. At the peak of motion: note the measurement in degrees of motion

5. range of motion recorded

6. Repeat if needed, but be aware of fatigue

What is the joint range of motion always recorded in? What should always be noted?

degrees; the side being measured

What should you always note in documenting the joint range of motion?

If the motion measured is active or passive range of motion

Motion exceeds the 0-degree position

recorded using a "+" before the measurement

How would the measurement be recorded for an elbow hyperextended 10 degrees?

+10 degrees of elbow extension

If a joint motion is less than the amount to reach the 0-degree position

recorded using "-" before the measurement

What does it mean if a measurement is recorded as -15 degrees of wrist extension?

The patient is unable to actively extend their wrist to a neutral 0-degree position

goniometer placement

1. axis

2. stationary arm

3. movable arm

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