Hands & LE ROM Joint Motion

What is the plane and axis for thumb cmc (radial abduction)?

Frontal Plane 

Ant-post axis

What are the prime movers for thumb cmc (radial abduction)?

Abductor pollicis longus

Extensor pollicis brevis

Abductor pollicis brevis

Extensor pollicis longus

What is the normal range and joint end feel for thumb CMC radial abduction?

0-50

Firm

Goniometer axis for thumb cmc (radial abduction)

On the dorsal side of the wrist at the junction of the base of the first

metacarpal and the trapezium.

Goniometer stationary arm for thumb cmc (radial abduction)

Parallel to the second metacarpal.

Goniometer moveable arm for thumb cmc (radial abduction)

Parallel to the first metacarpal

Positioning for thumb cmc (radial abduction)

What is the plane and axis for thumb cmc (palmar abduction)

Sagittal Plane 

Med-lat axis

What are the prime movers for thumb cmc (palmar abduction)

Abductor pollicis longus

Abductor pollicis brevis

What is the normal range and joint end feel for thumb cmc (palmar abduction)

0-50

Firm

Goniometer axis for thumb cmc (palmar abduction)

On the radial side of the wrist at the junction of the base of the first

metacarpal and the trapezium.

Goniometer stationary arm for thumb cmc (palmar abduction)

On the radial surface parallel to the second metacarpal.

Goniometer moveable arm for thumb cmc (palmar abduction)

Parallel to the first metacarpal.

Positioning for thumb cmc (palmar abduction)

What is the plane and axis for thumb mcp flexion?

Frontal Plane 

Ant-post axis

What are the prime movers for thumb mcp flexion?

Flexor pollicis longus 

Flexor pollicis brevis

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

0-50

Springy/soft

Goniometer axis for thumb mcp flexion

On the dorsal aspect of the metacarpophalangeal (MCP) joint.

Goniometer stationary arm for thumb mcp flexion

On the dorsal surface along the midline of the first metacarpal

Goniometer moveable arm for thumb mcp flexion

On the dorsal surface along the midline of the proximal phalanx of the thumb.

Positioning for thumb mcp flexion

What is the plane and axis for thumb mcp extension?

Frontal Plane 

Ant-post axis

What are the prime movers for thumb mcp extension?

Extensor pollicis brevis

Extensor pollicis longus

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

0-50

Firm

Goniometer axis for thumb mcp extension

On the dorsal aspect of the metacarpophalangeal (MCP) joint

Goniometer stationary arm for thumb mcp extension

On the dorsal surface along the midline of the first metacarpal.

Goniometer moveable arm for thumb mcp extension

On the dorsal surface along the midline of the proximal phalanx of the thumb.

Positioning for thumb mcp extension

What is the plane and axis for thumb IP flexion/extension?

Frontal Plane 

Ant-post axis

What is the prime movers for thumb IP flexion?

Flexor pollicis longus

What is the prime movers for thumb IP extension?

Extensor pollicis longus

What is the normal range and joint end feel for thumb IP flexion and extension?

0-80

Flexion

Spingy/soft

Extension

Firm

Goniometer axis for thumb IP flexion and extension

On the dorsal aspect of the interphalangeal (IP) joint.

Goniometer stationary arm for thumb IP flexion and extension

On the dorsal surface along the proximal phalanx.

Goniometer moveable arm for thumb IP flexion and extension

On the dorsal surface along the distal phalanx.

Positioning for thumb IP flexion/extension

What is the plane for opposition?

All 3 planes (Frontal, sagittal, and transverse)

Positioning for opposition

What is the plane and axis for finger mcp flexion/extension

Sagittal Plane 

Med-lat axis

What are the prime movers for finger mcp flexion?

FDS

FDP

Dorsal & palmar Interossei

Lumbricals

Flexor digiti minimi

What are the prime movers for finger mcp extension?

Extensor digitorum

Extensor indicis

Extensor digiti minimi

What is the normal range (index finger) for finger mcp flexion and joint end feel?

0-86

Firm

Goniometer axis for finger MCP flexion/extension

On the dorsal aspect of the MP joint of the finger being measured.

Goniometer stationary arm for finger MCP flexion/extension

On the dorsal surface along the midline of the metacarpal of the finger being measured.

Goniometer moveable arm for finger MCP flexion/extension

On the dorsal surface along the midline of the proximal phalanx of the finger being measured.

Positioning for finger MCP flexion/extension

What is the plane and axis for finger PIP flexion/extension?

Sagittal Plane 

Med-lat axis

What are the prime movers for finger PIP flexion?

FDS

FDP

What are the prime movers for finger PIP extension?

Interossei 

Lumbricals 

Extensor digitorum (central tendon)

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

0-100

Springy/soft

Goniometer axis for finger PIP flexion/extension

Dorsal PIP joint of finger being measured

Goniometer stationary arm for finger PIP flexion/extension

Dorsal surface along midline of proximal phalanx of finger being measured

Goniometer moveable arm for finger PIP flexion/extension

Dorsal along midline of medial phalanx of finger being measured.

Positioning for finger PIP flexion/extension

What is the plane and axis for finger DIP flexion/extension?

Sagittal Plane 

Med-lat axis

What are the prime movers for finger DIP flexion?

Flexor digitorum profundus (FDP)

What are the prime movers for finger DIP extension?

Interossei 

Lumbricals

Extensor digitorum (terminal tendon)

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

0-90 (DIP flexion)

Soft/Springy (Flexion)

Firm (Extension)

Goniometer axis for finger DIP flexion/extension

On the dorsal aspect of the DIP joint of the finger being measured.

Goniometer stationary arm for finger DIP flexion/extension

On the dorsal surface along the midline of the middle phalanx of the finger being measured.

Goniometer moveable arm for finger DIP flexion/extension

On the dorsal surface along the midline of the distal phalanx of the finger being measured

Positioning for finger DIP flexion/extension

Explain how composite finger flexion is measured

Measuring combined flexion of the PIP and DIP joints or combined flexion of the MP, PIP, and DIP joints using a ruler. 

PIP and DIP combined flexion measurement placed at the distal palmar crease 

MP, PIP, and DIP combined flexion placed at the proximal palmar crease.

Measure in cm AND from distal palmar crease to finger pa

Positioning for composite finger flexion

Explain how finger abduction/adduction is measured

Demonstrate: spread fingers apart as much as you can 

Measure from tip of index finger to the tip of the pinky. 

Measure in inches

Positioning for finger abduction/adduction

What is the plane and axis for ankle plantar flexion?

Sagittal Plane 

Med-lat axis

What are the prime movers for ankle plantar flexion?

Gastrocnemius

Soleus

Tibialis posterior

What is the normal range and joint end feel?

0-50

Springy

Goniometer axis for ankle plantar flexion

Lateral malleolus

Goniometer stationary arm for ankle plantar flexion

Midline of lateral fibula

Goniometer movable arm for ankle plantar flexion

Parallel to bottom of hindfoot (calcaneus)

Positioning for ankle plantar flexion

Start at 90 then subtract the value you measure to get the results

What is the plane and axis for cervical rotation?

Transverse plane

Vertical axis

What are the prime movers for cervical rotation?

Sternocleidomastoid

Upper trapezius

Levator Scapulae

Splenius group (splenius capitis and splenius cervicis)

What is the normal range and joint end feel?

0 - 45

Firm

Goniometer axis for cervical rotation

Middle top of the head

Goniometer stationary arm for cervical rotation

Parallel to the imaginary line between the acromial processes

Goniometer moveable arm for cervical rotation

Top of head in line with the tip of the nose/parallel to nose

What is the plane and axis for cervical flexion?

Sagittal Plane 

Med-lat axis

What are the prime movers for cervical flexion?

Sternocleidomastoid

Anterior Scalenes

Longus colli

Longus capitis

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

0 - 45

Firm

Goniometer axis for cervical flexion

Over the external auditory meatus (passage leading into the ear) (which is the ear)

Goniometer stationary arm for cervical flexion

Perpendicular or parallel to the floor

Goniometer moveable arm for cervical flexion

Along the base of the nose

Positioning for cervical flexion

Start at 90, then subtract the number you got to get the results

read the red numbers

What is the plane and axis for cervical lateral flexion?

Frontal plane

Ant-post axis

What are the primer movers for cervical lateral flexion?

Sternocleidomastoid

All scalenes (w/ribs fixed)

Trapezius (upper fibers)

Levator scapulae

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

0-60

Firm

Goniometer axis for cervical lateral flexion

C7 spinous process

Goniometer stationary arm for cervical lateral flexion

Over the spinous processes of the thoracic vertebrae with arm perpendicular to floor

Goniometer moveable arm for cervical lateral flexion

Dorsal midline of head

Positioning for cervical lateral flexion

What is the plane and axis for trunk flexion?

Sagittal Plane 

Med-lat axis

What are the prime movers for trunk flexion?

Iliopsoas group 

Rectus Abdominis

What is the normal range and joint end feel?

0-80

Tape measure axis for trunk flexion

Position the tape measurer on the spinous processes of C7 and S1

Tape measure stationary arm

First, measure with the client in upright position

Tape measure moveable arm

Then, measure with the client in maximum trunk flexion (the difference between the 2 measurements is the amount of flexion present)

Positioning for tape measure