Clinical Skills Final - Goniometry Skills

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Shoulder Flexion

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1

Shoulder Flexion

Axis: Greater tubercle

Proximal Arm: Bisecting the trunk/thorax

Moving Arm: Bisecting the humerus

ROM: ~180 degrees

End-Feel: Firm

<p>Axis: Greater tubercle</p><p>Proximal Arm: Bisecting the trunk/thorax</p><p>Moving Arm: Bisecting the humerus</p><p>ROM: ~180 degrees</p><p>End-Feel: Firm</p>
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2

Shoulder Extension

Axis: Greater tubercle

Proximal Arm: Bisect the trunk

Moving Arm: Bisecting the humerus

ROM: 65-80 degrees

End-Feel: Firm

<p>Axis: Greater tubercle</p><p>Proximal Arm: Bisect the trunk</p><p>Moving Arm: Bisecting the humerus</p><p>ROM: 65-80 degrees</p><p>End-Feel: Firm</p>
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3

Shoulder Abduction

Axis: Anterior aspect of the acromion

Proximal Arm: Parallel to midline of the sternum

Moving Arm: Bisecting the humerus

ROM: ~180 degrees

End-Feel: Firm

<p>Axis: Anterior aspect of the acromion</p><p>Proximal Arm: Parallel to midline of the sternum</p><p>Moving Arm: Bisecting the humerus</p><p>ROM: ~180 degrees</p><p>End-Feel: Firm</p>
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4

Shoulder Internal Rotation

Axis: Olecranon process

Proximal Arm: Vertical to ground

Moving Arm: Ulnar styloid

ROM: 30-50 degrees

End-Feel: Firm

<p>Axis: Olecranon process</p><p>Proximal Arm: Vertical to ground</p><p>Moving Arm: Ulnar styloid</p><p>ROM: 30-50 degrees</p><p>End-Feel: Firm</p>
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5

Shoulder External Rotation

Axis: Olecranon process

Proximal Arm: Completely vertical

Moving Arm: Ulnar styloid

ROM: ~ 90 degrees

End-Feel: Firm

<p>Axis: Olecranon process</p><p>Proximal Arm: Completely vertical</p><p>Moving Arm: Ulnar styloid</p><p>ROM: ~ 90 degrees</p><p>End-Feel: Firm</p>
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6

Elbow Flexion

Axis: Lateral epicondyle

Proximal Arm: Bisect humerus laterally

Distal Arm: Radial styloid

ROM: 130-145 degrees

End-Feel: Soft

Notes - make sure to use a towel to support humerus

<p>Axis: Lateral epicondyle</p><p>Proximal Arm: Bisect humerus laterally</p><p>Distal Arm: Radial styloid</p><p>ROM: 130-145 degrees</p><p>End-Feel: Soft</p><p>Notes - make sure to use a towel to support humerus</p>
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7

Elbow Extension

Axis: Lateral epicondyle

Proximal Arm: Bisect humerus laterally

Moving Arm: Radial styloid

ROM: 5 degrees hyperextension

End-Feel: Hard

<p>Axis: Lateral epicondyle</p><p>Proximal Arm: Bisect humerus laterally</p><p>Moving Arm: Radial styloid</p><p>ROM: 5 degrees hyperextension</p><p>End-Feel: Hard</p>
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8

Forearm Pronation

Axis: Lateral to ulnar styloid

Proximal Arm: Parallel to the shaft of the humerus

Distal Arm: Dorsal aspect of the forearm between the styloids

ROM: ~75 degrees

End-Feel: Firm

Notes - make sure elbow is at patients side

<p>Axis: Lateral to ulnar styloid</p><p>Proximal Arm: Parallel to the shaft of the humerus</p><p>Distal Arm: Dorsal aspect of the forearm between the styloids</p><p>ROM: ~75 degrees</p><p>End-Feel: Firm</p><p>Notes - make sure elbow is at patients side</p>
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9

Forearm Supination

Axis: Medial to ulnar styloid

Proximal Arm: Parallel to the shaft of the humerus

Distal Arm: Dorsal aspect of the forearm between the styloids

ROM: ~85 degrees

End-Feel: Firm

Notes - make sure elbow is at patients side

<p>Axis: Medial to ulnar styloid</p><p>Proximal Arm: Parallel to the shaft of the humerus</p><p>Distal Arm: Dorsal aspect of the forearm between the styloids</p><p>ROM: ~85 degrees</p><p>End-Feel: Firm</p><p>Notes - make sure elbow is at patients side</p>
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10

Wrist Flexion

Axis: Triquetrum/Ulnar styloid

Proximal Arm: Bisect forearm by aiming for the lateral epicondyle

Moving Arm: 5th metacarpal

ROM: 70-85 degrees

End-Feel: Firm

<p>Axis: Triquetrum/Ulnar styloid</p><p>Proximal Arm: Bisect forearm by aiming for the lateral epicondyle</p><p>Moving Arm: 5th metacarpal</p><p>ROM: 70-85 degrees</p><p>End-Feel: Firm</p>
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11

Wrist Extension

Axis: Triquetrum / Ulnar Styloid

Proximal Arm: Bisect forearm by the aiming for the lateral epicondyle

Moving Arm: 5th metacarpal

ROM: 60-75 degrees

End-Feel: Firm

<p>Axis: Triquetrum / Ulnar Styloid</p><p>Proximal Arm: Bisect forearm by the aiming for the lateral epicondyle</p><p>Moving Arm: 5th metacarpal</p><p>ROM: 60-75 degrees</p><p>End-Feel: Firm</p>
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12

Radial Deviation

Axis: Capitate

Proximal Arm: Bisect forearm

Moving Arm: 3rd metacarpal

ROM: 15-20 degrees

End-Feel: Firm

<p>Axis: Capitate</p><p>Proximal Arm: Bisect forearm</p><p>Moving Arm: 3rd metacarpal</p><p>ROM: 15-20 degrees</p><p>End-Feel: Firm</p>
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13

Ulnar Deviation

Axis: Capitate

Proximal Arm: Bisect forearm

Moving Arm: 3rd metacarpal

ROM: 35-40 degrees

End-Feel: Firm

<p>Axis: Capitate</p><p>Proximal Arm: Bisect forearm</p><p>Moving Arm: 3rd metacarpal</p><p>ROM: 35-40 degrees</p><p>End-Feel: Firm</p>
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14

MCP Flexion/Extension

Axis: Dorsal surface of joint

Proximal Arm: Dorsal metacarpal

Moving Arm: Dorsal proximal phalanx

ROM

  • Flexion: 90-115 degrees

  • Extension: 30-45 degrees

End-Feel: Firm

<p>Axis: Dorsal surface of joint</p><p>Proximal Arm: Dorsal metacarpal</p><p>Moving Arm: Dorsal proximal phalanx</p><p>ROM</p><ul><li><p>Flexion: 90-115 degrees</p></li><li><p>Extension: 30-45 degrees</p></li></ul><p>End-Feel: Firm</p>
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15

PIP Flexion/Extension

Axis: Dorsal surface of joint

Proximal Arm: Dorsal proximal phalanx

Distal Arm: Dorsal middle phalanx

ROM

  • Flexion: 100-120 degrees

  • Extension: 0 degrees (N/A)

End-Feel: Firm

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16

DIP Flexion/Extension

Axis: Dorsal surface of joint

Proximal Arm: Dorsal middle phalanx

Distal Arm: Dorsal distal phalanx

ROM:

  • Flexion: 70-90 degrees

  • Extension: ~30 degrees

End-Feel: Firm

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17

CMC Flexion

Axis: Trapezium

Proximal Arm: Bisecting radius

Moving Arm: 1st metacarpal

ROM: 15-20 degrees

End-feel: Firm

<p>Axis: Trapezium</p><p>Proximal Arm: Bisecting radius</p><p>Moving Arm: 1st metacarpal</p><p>ROM: 15-20 degrees</p><p>End-feel: Firm</p>
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18

CMC Extension

Axis: Trapezium

Proximal Arm: Bisect radius

Moving Arm: 1st metacarpal

ROM: 20-35 degrees

End-Feel: Firm

<p>Axis: Trapezium</p><p>Proximal Arm: Bisect radius</p><p>Moving Arm: 1st metacarpal</p><p>ROM: 20-35 degrees</p><p>End-Feel: Firm</p>
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19

CMC Abduction

Axis: Radial styloid

Proximal Arm: 2nd metacarpal

Moving Arm: 1st metacarpal

ROM: 40-50 degrees

End-Feel: Firm

<p>Axis: Radial styloid</p><p>Proximal Arm: 2nd metacarpal</p><p>Moving Arm: 1st metacarpal</p><p>ROM: 40-50 degrees</p><p>End-Feel: Firm</p>
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20

Opposition

  • Move tip of thumb towards 5th MCP

  • If they cannot touch, then use a ruler to measure distance from 5th MCP to tip of thumb

<ul><li><p>Move tip of thumb towards 5th MCP</p></li><li><p>If they cannot touch, then use a ruler to measure distance from 5th MCP to tip of thumb</p></li></ul>
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21

MCP Flexion (Thumb)

Axis: MCP joint of thumb

Proximal Arm: 1st metacarpal

Moving Arm: proximal phalanx of thumb

ROM: 50-60 degrees

End-Feel: Firm

<p>Axis: MCP joint of thumb</p><p>Proximal Arm: 1st metacarpal</p><p>Moving Arm: proximal phalanx of thumb</p><p>ROM: 50-60 degrees</p><p>End-Feel: Firm</p>
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22

MCP Extension (Thumb)

Axis: MCP joint of thumb

Proximal Arm: 1st metacarpal

Moving Arm: Proximal phalanx of thumb

ROM: 0-5 degrees

End-Feel: Firm

<p>Axis: MCP joint of thumb</p><p>Proximal Arm: 1st metacarpal</p><p>Moving Arm: Proximal phalanx of thumb</p><p>ROM: 0-5 degrees</p><p>End-Feel: Firm</p>
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23

IP Flexion (Thumb)

Axis: IP joint of thumb

Proximal Arm: Proximal phalanx of thumb

Moving Arm: Distal phalanx of thumb

ROM: 80-90 degrees

End-Feel: Firm

<p>Axis: IP joint of thumb</p><p>Proximal Arm: Proximal phalanx of thumb</p><p>Moving Arm: Distal phalanx of thumb</p><p>ROM: 80-90 degrees</p><p>End-Feel: Firm</p>
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24

IP Extension (Thumb)

Axis: IP joint of thumb

Proximal Arm: Proximal phalanx of thumb

Moving Arm: Distal phalanx of thumb

ROM: 20-30 degrees

End-Feel: Firm

<p>Axis: IP joint of thumb</p><p>Proximal Arm: Proximal phalanx of thumb</p><p>Moving Arm: Distal phalanx of thumb</p><p>ROM: 20-30 degrees</p><p>End-Feel: Firm</p>
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25

Capital Flexion

Retraction (no measurement)

<p>Retraction (no measurement)</p>
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26

Capital Extension

Protraction (no measurement)

<p>Protraction (no measurement)</p>
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27

Cervical Flexion

(make sure to tuck in chin) (no measurement)

<p>(make sure to tuck in chin) (no measurement)</p>
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Cervical Extension

(no measurement)

<p>(no measurement)</p>
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29

Cervical Sidebending

(no measurement)

<p>(no measurement)</p>
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30

Cervical Rotation

(no measurement)

<p>(no measurement)</p>
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31

Trunk Flexion

(no measurement)

<p>(no measurement)</p>
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32

Trunk Extension

(no measurement)

<p>(no measurement)</p>
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33

Trunk Side-Bending

(no measurement) (have them follow hands down their sides)

<p>(no measurement) (have them follow hands down their sides)</p>
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34

Trunk Rotation

(no measurement)

<p>(no measurement)</p>
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35

Hip Flexion

Axis: Greater trochanter of femur

Proximal Arm: Bisecting trunk (assuming trunk is flat)

Moving Arm: Bisecting thigh and aiming for lateral epicondyle of knee

ROM: ~120 degrees

End-Feel: Firm

<p>Axis: Greater trochanter of femur</p><p>Proximal Arm: Bisecting trunk (assuming trunk is flat)</p><p>Moving Arm: Bisecting thigh and aiming for lateral epicondyle of knee</p><p>ROM: ~120 degrees</p><p>End-Feel: Firm</p>
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36

Hip Extension

Axis: Greater trochanter of femur

Proximal Arm: Bisecting trunk (assuming trunk is flat)

Moving Arm: Bisecting thigh and aiming for lateral epicondyle of knee

ROM: ~20 degrees

End-Feel: Firm

<p>Axis: Greater trochanter of femur</p><p>Proximal Arm: Bisecting trunk (assuming trunk is flat)</p><p>Moving Arm: Bisecting thigh and aiming for lateral epicondyle of knee</p><p>ROM: ~20 degrees</p><p>End-Feel: Firm</p>
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37

Hip Abduction

Axis: ASIS of the leg you are measuring

Proximal Arm: Aligned with contralateral ASIS (horizontal across hip)

Moving Arm: Center of femur, aiming for center of patella

ROM: ~40 degrees

End-Feel: Firm

<p>Axis: ASIS of the leg you are measuring</p><p>Proximal Arm: Aligned with contralateral ASIS (horizontal across hip)</p><p>Moving Arm: Center of femur, aiming for center of patella</p><p>ROM: ~40 degrees</p><p>End-Feel: Firm</p>
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38

Hip Adduction

Axis: ASIS of leg you are measuring

Proximal Arm: Directly aligned with contralateral ASIS (horizontal across hip)

Moving Arm: Center of femur, aiming for center of patella

ROM: ~20 degrees

End-Feel: Firm

<p>Axis: ASIS of leg you are measuring</p><p>Proximal Arm: Directly aligned with contralateral ASIS (horizontal across hip)</p><p>Moving Arm: Center of femur, aiming for center of patella</p><p>ROM: ~20 degrees</p><p>End-Feel: Firm</p>
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39

Hip Internal Rotation

Axis: Center of patella

Proximal Arm: perpendicular to ground

Distal Arm: Center of lower leg, aiming for middle of the ankle (between malleoli)

ROM: ~35 degrees

End-Feel: Firm

<p>Axis: Center of patella</p><p>Proximal Arm: perpendicular to ground</p><p>Distal Arm: Center of lower leg, aiming for middle of the ankle (between malleoli)</p><p>ROM: ~35 degrees</p><p>End-Feel: Firm</p>
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40

Hip External Rotation

Axis: Center of patella

Proximal Arm: Perpendicular to ground

Moving Arm: Center of lower leg; aiming for middle of ankle (between malleoli)

ROM: ~ 40-45 degrees

End-Feel: Firm

<p>Axis: Center of patella</p><p>Proximal Arm: Perpendicular to ground</p><p>Moving Arm: Center of lower leg; aiming for middle of ankle (between malleoli)</p><p>ROM: ~ 40-45 degrees</p><p>End-Feel: Firm</p>
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41

Knee Flexion

  • Axis: Lateral femoral epicondyle

  • Proximal Arm: Greater trochanter

  • Moving Arm: Lateral malleolus

  • ROM: 130-150 degrees

  • End-Feel: Soft to Firm

<ul><li><p>Axis: Lateral femoral epicondyle</p></li><li><p>Proximal Arm: Greater trochanter</p></li><li><p>Moving Arm: Lateral malleolus</p></li><li><p>ROM: 130-150 degrees</p></li><li><p>End-Feel: Soft to Firm</p></li></ul>
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42

Knee Extension

Axis: Lateral femoral epicondyle

Proximal Arm: Greater trochanter

Moving Arm: Lateral malleolus

ROM: 0-5 hyperextension

Notes - patient is supine with towel under the “bulk” of gastroc; heel should be off table; apply pressure proximal and distal to patella

<p>Axis: Lateral femoral epicondyle</p><p>Proximal Arm: Greater trochanter</p><p>Moving Arm: Lateral malleolus</p><p>ROM: 0-5 hyperextension</p><p>Notes - patient is supine with towel under the “bulk” of gastroc; heel should be off table; apply pressure proximal and distal to patella</p>
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43

Ankle Dorsiflexion

  • Axis: Lateral malleolus

  • Proximal Arm: Head of fibula

  • Moving Arm: Parallel to 5th metatarsal

  • ROM: 15-25 degrees

  • End-Feel: Firm

  • Notes - legs are hanging off table (allowed to dangle); neutral position is 90 degrees

<ul><li><p>Axis: Lateral malleolus</p></li><li><p>Proximal Arm: Head of fibula</p></li><li><p>Moving Arm: Parallel to 5th metatarsal</p></li><li><p>ROM: 15-25 degrees</p></li><li><p>End-Feel: Firm</p></li><li><p>Notes - legs are hanging off table (allowed to dangle); neutral position is 90 degrees</p></li></ul>
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44

Ankle Plantarflexion

  • Axis: Lateral malleolus

  • Proximal Arm: Head of fibula

  • Moving Arm: Parallel to 5th metatarsal

  • ROM: 40-55 degrees

  • End-Feel: Firm

<ul><li><p>Axis: Lateral malleolus</p></li><li><p>Proximal Arm: Head of fibula</p></li><li><p>Moving Arm: Parallel to 5th metatarsal</p></li><li><p>ROM: 40-55 degrees</p></li><li><p>End-Feel: Firm</p></li></ul>
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45

Ankle Inversion

Axis: Talar dome between malleoli

Proximal Arm: Midline of the tibia

Moving Arm: 2nd metatarsal

ROM: 20-30 degrees

End-Feel: Firm

<p>Axis: Talar dome between malleoli</p><p>Proximal Arm: Midline of the tibia</p><p>Moving Arm: 2nd metatarsal</p><p>ROM: 20-30 degrees</p><p>End-Feel: Firm</p>
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46

Ankle Eversion

Axis: Talar dome between malleoli

Proximal Arm: Midline of the tibia

Moving Arm: 2nd metatarsal

ROM: 10-15 degrees

End-Feel: Firm

<p>Axis: Talar dome between malleoli</p><p>Proximal Arm: Midline of the tibia</p><p>Moving Arm: 2nd metatarsal</p><p>ROM: 10-15 degrees</p><p>End-Feel: Firm</p>
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47

Great Toe MTP Flexion/Extension

Axis: MTP Joint

Proximal Arm: 1st metatarsal

Moving Arm: Proximal phalanx

ROM:

  • Flexion: 30-40 degrees

  • Extension: 80-90 degrees

End-Feel: Firm

Note - ensure to apply any pressure at the proximal phalanx

<p>Axis: MTP Joint</p><p>Proximal Arm: 1st metatarsal</p><p>Moving Arm: Proximal phalanx</p><p>ROM:</p><ul><li><p>Flexion: 30-40 degrees</p></li><li><p>Extension: 80-90 degrees</p></li></ul><p>End-Feel: Firm</p><p>Note - ensure to apply any pressure at the proximal phalanx</p>
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