USING GONIOMETERS FOR JOINT RANGE OF MOTION TESTING

BY MARK MCKEAN

Flexibility is the capacity of a joint to move through its full range of motion. There is no
single test that gives you a score for overall flexibility as each test is specific to a
particular movement or joints. In fact, in many tests used by trainers a series of joints are
involved and it is often difficult to determine the actual flexibility of a joint when tested in
combination with others.

The classic example is the sit and reach test. In order for a client to reach towards their
toes when seated, they must have good calf flexibility so the toes can be pulled back
toward the hands, hamstring flexibility to allow the pelvis to rotate forwards towards the
feet when seated, and lower and upper back flexibility to allow the trunk to flex forwards
toward the feet. As you can see there are multiple joints involved and a client can touch
their feet and record a positive result for this test and still have poor flexibility at any one
joint in this total movement. It is not uncommon for a client to have poor hamstring
flexibility but increased upper back flexibility and still touch their toes in the sit and reach
test.

There are direct and indirect methods of measuring flexibility. The indirect method usually
involves the linear measurement of distances between segments or from an external object.
Direct methods measure angular displacements between adjacent segments or from an
external reference.

A goniometer is used in the medical field to measure a joint's range of motion. It can be
helpful in determining if a patient is lacking in
mobility due to an injury, and how well they
may be recovering from an injury. The term
"goniometer" comes from two Greek words
that mean "angle" and "measure." This is
essentially what you are doing when you
measure range of motion, measuring an angle.
You are measuring the angles created between
the bones of the body.

Using a goniometer to measure flexibility

allows you to isolate and measure the range of
motion (ROM) at a single joint and compare them to the ideal standards as shown in the
tables below. The tables show the ideal range of movement in both directions from the
joint start position. When you add up the two angles, you get the total range achieved
through that plane of movement.

As an example if you consider the hip joint range of motion in external and internal
rotation. The table tells us that the range should be 450 each way with a total range of 900.
When testing a client you may find that the external rotation range is only 300, and the
internal 450. This tell us that the total range is 750, and the tightness is in the direction of
external rotation as the ideal range is 450 and the client only achieved a 300 range.
 Ext 45 Hip Ext 10
Flexion 180 Flexion 125
Range 225 Range 135
Abduction 180 Abduction 45
Shoulder Adduction 0 Adduction 10
Range 180 Range 55
Lat rot 90 Lat rot 45
Med rot 70 Med rot 45
Range 160 Range 90
Ext 0 Ext 0
Elbow Flex 145 Knee Flex 140
Range 145 Range 140
Supination 90 Plant flex 45
Forearm Pronation 90 Ankle Dorsi flex 20
Range 180 Range 65
Ext 70 Inversion 40
Wrist Flex 80 Foot Eversion 20
Range 150 Range 60

How to use a Goniometer

Step1
Have your client in the appropriate position and ask them to move the joint to the
fullest range of motion possible in the direction you wish to measure. Remember to
stablise the structure so that compensations do not occur and you get a false reading

Step2
Place the goniometer over the fulcrum or centre of the joint. This will vary
depending on which joint you are
measuring. Place the stationary arm of the
goniometer along the stationary line of the
body (again, this will vary depending on
which joint you are measuring), and the
movable arm on the moving part of the
body. Ideally you are trying to align the axis
of the goniometer with the joint centres of
joint fulcrums so that the line in the centre
of each arm of the goniometer ‘connects’
these joint centres. This isolates the joint
movement for a more accurate
measurement and ensure a consistent method that can repeated with accuracy.

Step3
Look at the reading on the goniometer before removing it from the patient's body.
Ensure that you take an accurate reading of the degree of motion on the goniometer,
 and that you consistently use the same stationary and movable landmarks on the
body when measuring. Record the range of motion for the joint in a table like the
one above for future reference.

Got to this site and download my record chart to use with your testing.
http://www.markmckean.com/PT.aspx?FunctionName=Trainers&Cat=Forms_and_Manuals