Preface

The measurement of joint motion is an important component of a thorough physical examination of the extremities and spine, one which helps health professionals identify impairments and assess rehabilitative status. The need for a comprehensive text with sufficient written detail and photographs to allow for the standardization of goniometric measurement methods—both for the purposes of teaching and clinical practice led to the development of the first edition of the Measurement of Joint Motion: A Guide to Goniometry in 1985. Our approach included a discussion and illustration of testing position, stabilization, end-feel, and goniometer alignment for each measurable joint in the body. The resulting text was extremely well received by a variety of health professional educational programs and was used as a reference in many clinical settings.

In the years following initial publication, a considerable amount of research on the measurement of joint motion appeared in the literature. Consequently, a second edition, published in 1995, included a chapter on the reliability and validity of joint measurement as well as joint-specific research sections in each existing chapter. We also expanded the text by adding structure, osteokinematics, arthrokinematics, capsular and noncapsular patterns of limitation, and functional ranges of motion for each joint.

The third edition included extensive new research findings related to joint motion. New to the third edition was the inclusion of muscle length testing at joints where muscle length is often a factor affecting range of motion. This addition integrated the measurement procedures used in this book with the American Physical Therapy Association's Guide to Physical Therapy Practice. Inclinometer techniques for measuring range of motion of the spine were added to coincide with current practice in some clinical settings. Illustrations were included to accompany anatomical descriptions so that the reader had a visual reminder of the joint structures involved in range of motion. New illustrations of bony anatomical landmarks and photographs of surface anatomy were added to help the reader align the goniometer accurately.

In the fourth edition we reorganized the content in Chapters 4,5,6,7,8,9,10,11,12,13 to create a more logical progression from anatomical descriptions of joint structures and landmarks used in goniometer alignment directly to the measurement procedures. Information summarizing research findings now follows, rather than precedes, the measurement procedures. This restructuring makes it easier for readers that are focused on learning measurement technique, as well as readers that are focused on reviewing the research literature for evidencebased practice, to find what they are seeking. Similar to earlier editions we have incorporated new information on normative range of motion values for various age and gender groups, as well as the range of motion needed to perform common functional tasks. We added current information on the effects of subject characteristics, such as body mass, occupational and recreational activities, and the effects of the testing process, such as the testing position and type of measuring instrument, on range of motion. In the fourth edition we added and restructured more measurement techniques to the spine chapters and added several commonly used methods to assess finger and thumb range of motion. The TMJ chapter was enhanced with clear photographs and illustrations of measurement techniques. In addition, over 90 new photographs and illustrations replaced many of the older, dated art work.

This book continues to present goniometry logically and clearly. Chapter 1 discusses basic concepts regarding the use of goniometry to assess range of motion and muscle length in patient evaluation. Arthrokinematic and osteokinematic movements, elements of active and passive range of motion, hypomobility, hypermobility, and factors affecting joint motion are included. The inclusion of end-feels and capsular and noncapsular patterns of joint limitation introduces readers to current concepts in orthopedic manual therapy and encourages them to consider joint structure while measuring joint motion.

Chapter 2 takes the reader through a step-by-step process to master the techniques of goniometric evaluation, including: positioning, stabilization, instruments used for measurement, goniometer alignment, and the recording of results. Exercises that help develop necessary psychomotor skills and demonstrate direct application of theoretical concepts facilitate learning.

Chapter 3 discusses the validity and reliability of measurement. The results of validity and reliability studies on the measurement of joint motion are summarized to help the reader focus on ways of improving and interpreting goniometric measurements. Mathematical methods of evaluating reliability are shown along with examples and exercises so that the readers can assess their reliability in taking measurements.

Chapters 4,5,6,7,8,9,10,11,12,13 present detailed information on goniometric testing procedures for the upper and lower extremities, spine, and temporomandibular joint. When appropriate, muscle length testing procedures are also included. The text presents the anatomical landmarks, testing position, stabilization, testing motion, normal end-feel, and goniometer alignment for each joint and motion, in a format that reinforces a consistent approach to evaluation. The extensive use of photographs and captions eliminates the need for repeated demonstrations by an instructor and provides the reader with a permanent reference for visualizing the procedures. Also included is information on joint structure, osteokinematic and arthrokinematic motion, and capsular patterns of restrictions. A review of current literature regarding normal range of motion values; the effects of age, gender, and other factors on range of motion; functional range of motion; and reliability and validity of measurement procedures are also presented for each body region to assist the reader to comply with evidence-based practice.

We hope this book makes the teaching and learning of goniometry easier and improves the standardization and thus the reliability and validity of this examination tool. We believe that the fourth edition provides a comprehensive coverage of the clinical measurement of joint motion and muscle length. We hope that the additions will motivate health professionals to conduct research and to use research results in evaluation. We encourage our readers to provide us with feedback on our current efforts to bring you a high-quality, user-friendly text.