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INTRODUCTION

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This book is designed to serve as a guide to learning the technique of human joint measurement called goniometry. Background information on principles and procedures necessary for an understanding of goniometry is found in Part 1. Practice exercises are included at appropriate intervals to help the examiner apply this information and develop the psychomotor skills necessary for competency in goniometry. The validity and reliability of goniometric measurements are explored to encourage thoughtful and appropriate use of these techniques in clinical practice. Procedures for the goniometric examination of joint range of motion and muscle length testing of the upper extremity, lower extremity, and spine and temporomandibular joint are presented in Parts II, III, and IV, respectively.

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GONIOMETRY

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The term goniometry is derived from two Greek words, gonia, meaning angle, and metron, meaning measure. Therefore, goniometry refers to the measurement of angles, in particular the measurement of angles created at human joints by the bones of the body. The examiner obtains these measurements by placing the parts of the measuring instrument, called a goniometer, along the bones immediately proximal and distal to the joint being evaluated. Goniometry may be used to determine both a particular joint position and the total amount of motion available at a joint.

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Example:

The elbow joint is evaluated by placing the parts of the measuring instrument on the humerus (proximal segment) and the forearm (distal segment) and measuring either a specific joint position or the total arc of motion (Fig. 1.1).

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FIGURE 1.1

The left upper extremity of a subject in the supine position is shown. The parts of the measuring instrument have been placed along the proximal (humerus) and distal (radius) segments and centered over the axis of the elbow joint. When the distal segment has been moved toward the proximal segment (elbow flexion), a measurement of the arc of motion can be obtained.

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Goniometry is an important part of a comprehensive examination of joints and surrounding soft tissue. A comprehensive examination typically begins by interviewing the subject and reviewing records to obtain an accurate description of current symptoms; functional abilities; occupational, social, and recreational activities; and medical history. Observation of the body to assess bone and soft tissue contour, as well as skin and nail condition, usually follows the interview. Gentle palpation is used to determine skin temperature and the quality of soft tissue deformities and to locate pain symptoms in relation to anatomical structures. Anthropometric measurements such as leg length, circumference, and body volume may be indicated.

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The performance of active joint motions by the subject during the examination allows the examiner to screen for abnormal movements and gain information about the subject's willingness to move. If abnormal active motions are found, the examiner performs passive joint motions in an attempt ...

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