Understanding Planes and Axes: Sagittal Plane with medial-lateral axis
Produces flexion and extension movements.
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| Term | Definition |
|---|---|
Understanding Planes and Axes: Sagittal Plane with medial-lateral axis | Produces flexion and extension movements. |
Understanding Planes and Axes: Frontal (coronal) plane with anterior-posterior axis | Produces abduction and adduction movements. |
Understanding Planes and Axes: Transverse (horizontal) plane with vertical axis | Produces rotation movements. |
What is goniometry? | Measuring the available range of motion (passive motion). |
What does goniometry mean literally? | Gonia means angle and metron means measure. |
What are the parts of a goniometer? | Stationary arm, moving arm, and axis. |
What are the purposes of goniometry? | Determine impairments, develop treatment goals, evaluate rehab progress, motivate the client, and research treatment effectiveness. |
What are the 6 steps of goniometry procedure? | 1) Positioning and stabilization 2) Quality check 3) End feel 4) Landmark 5) Alignment 6) Read and record measurement |
What is step 1 of goniometry? | Positioning and stabilization. |
What should be done first in positioning and stabilization? | Position the joint in 0 position as the reference point. |
What should be done if 0 position is unachievable? | It must be recorded. |
What limiting factors should be noted during positioning and stabilization? | Pain, muscle tightness, and contracture. |
What is the most frequent cause of invalid goniometry measurements? | Poor stabilization. |
How should the patient be during goniometry? | Relaxed with no voluntary muscle contraction. |
What is step 2 of goniometry? | Quality check. |
What is done during the quality check? | Move the joint to the end of ROM to assess quality of movement. |
What is step 3 of goniometry? | End feel. |
What is end feel? | Resistance to further movement at the end of passive ROM. |
What is step 4 of goniometry? | Landmark. |
What is done during the landmark step? | Identify and palpate bony landmarks. |
What is step 5 of goniometry? | Alignment. |
What is done during the alignment step? | Align the goniometer with bony landmarks while holding the joint at end range. |
What is step 6 of goniometry? | Read and record measurement. |
How should ROM measurements be recorded? | One direction at a time. |
How can reliability of goniometry be improved? | Use the same goniometer, positioning, procedure, and examiner. |
Which is typically more reliable in goniometry: upper or lower extremity? | Upper extremity measurements are typically more reliable than lower extremity measurements. |
What does AAOS stand for? | American Academy of Orthopedic Surgeons. |
What does AMA stand for? | American Medical Association. |
What upper extremity landmarks are important in goniometry? | Humerus, humeral head, acromion process, medial epicondyle, lateral epicondyle, olecranon, styloid processes of ulna and radius, capitate, triquetrum, metacarpals, MCP joints, and mid-axillary line. |
What is the test position for MCP flexion? | Sitting with forearm resting on table, wrist and interphalangeal joints relaxed, forearm neutral, and stabilize metacarpal. |
What is the normal ROM for MCP flexion? | 86° index, 91° ring, 105° little according to AAOS; 90° according to AMA. |
What is the axis for MCP flexion? | Dorsal metacarpophalangeal joint. |
What is the stationary arm for MCP flexion? | Aligned with metacarpal. |
What is the moving arm for MCP flexion? | Aligned with proximal phalanx. |
What is the test position for MCP extension? | Sitting with forearm resting on table, wrist and interphalangeal joints relaxed, forearm neutral, and stabilize metacarpal. |
What is the normal ROM for MCP extension? | 22° index, 18° long, 23° ring, 19° little according to AAOS; 20° according to AMA. |
What is the axis for MCP extension? | Dorsal metacarpophalangeal joint. |
What is the stationary arm for MCP extension? | Aligned with metacarpal. |
What is the moving arm for MCP extension? | Aligned with proximal phalanx. |
What is the normal end feel for MCP extension? | Capsular. |
What is the test position for wrist flexion? | Sitting with forearm stabilized on table and flex wrist with fingers relaxed. |
What is the normal ROM for wrist flexion? | 75° ± 6.6° according to AAOS; 60° according to AMA. |
What is the axis for wrist flexion? | Lateral wrist at the triquetrum. |
What is the stationary arm for wrist flexion? | Aligned with ulna. |
What is the moving arm for wrist flexion? | Aligned with fifth metacarpal. |
What is the normal end feel for wrist flexion? | Capsular. |
What is the test position for wrist extension? | Sitting with forearm stabilized on table and extend wrist with fingers relaxed. |
What is the normal ROM for wrist extension? | 74° ± 6.6° according to AAOS; 60° according to AMA. |
What is the axis for wrist extension? | Lateral wrist at the triquetrum. |
What is the stationary arm for wrist extension? | Aligned with ulna. |
What is the moving arm for wrist extension? | Aligned with fifth metacarpal. |
What is the normal end feel for wrist extension? | Capsular. |
What is the test position for wrist radial deviation? | Sitting with forearm resting on table and stabilize forearm to prevent pronation or supination. |
What is the normal ROM for wrist radial deviation? | 21° ± 4.0° according to AAOS; 20° according to AMA. |
What is the axis for wrist radial deviation? | Capitate. |
What is the stationary arm for wrist radial deviation? | Aligned with forearm toward the lateral epicondyle. |
What is the moving arm for wrist radial deviation? | Aligned with metacarpal or middle metacarpal. |
What is the normal end feel for wrist radial deviation? | Ligamentous. |
What is the test position for wrist ulnar deviation? | Sitting with forearm resting on table and stabilize forearm to prevent pronation or supination. |
What is the normal ROM for wrist ulnar deviation? | 35° ± 3.8° according to AAOS; 30° according to AMA. |
What is the axis for wrist ulnar deviation? | Capitate. |
What is the stationary arm for wrist ulnar deviation? | Aligned with forearm toward the lateral epicondyle. |
What is the moving arm for wrist ulnar deviation? | Aligned with metacarpal or middle metacarpal. |
What is the normal end feel for wrist ulnar deviation? | Ligamentous. |
What is the test position for forearm supination? | Sitting, shoulder neutral at side, elbow flexed to 90°, stabilize arm, and supinate forearm. |
What is the normal ROM for forearm supination? | 81° ± 4.0° according to AAOS; 80° according to AMA. |
What is the axis for forearm supination? | Medial to ulnar styloid. |
What is the stationary arm for forearm supination? | Parallel to humerus. |
What is the moving arm for forearm supination? | Aligned with ventral aspect of radius. |
What is the normal end feel for forearm supination? | Capsular. |
What is the test position for forearm pronation? | Sitting, shoulder neutral at side, elbow flexed to 90°, stabilize arm, and pronate forearm. |
What is the normal ROM for forearm pronation? | 75° ± 5.3° according to AAOS; 80° according to AMA. |
What is the axis for forearm pronation? | Lateral to ulnar styloid. |
What is the stationary arm for forearm pronation? | Parallel to humerus. |
What is the moving arm for forearm pronation? | Aligned with dorsum of radius. |
What is the normal end feel for forearm pronation? | Capsular. |
What is the test position for elbow flexion? | Supine, shoulder neutral at side, forearm supinated, and elbow flexed. |
What is the normal ROM for elbow flexion? | 141.0° ± 4.9° according to AAOS; 140° according to AMA. |
What is the axis for elbow flexion? | Lateral epicondyle of humerus. |
What is the stationary arm for elbow flexion? | Aligned with humerus toward center of acromion process. |
What is the moving arm for elbow flexion? | Aligned with radius toward styloid process. |
What is the normal end feel for elbow flexion? | Soft tissue approximation; capsular for thick clients. |
What is the test position for elbow extension? | Supine, shoulder neutral at side, forearm supinated, and elbow extended. |
What is the normal ROM for elbow extension? | 0.3° ± 2.0° according to AAOS; 0.0° according to AMA. |
What is the axis for elbow extension? | Lateral epicondyle of humerus. |
What is the stationary arm for elbow extension? | Aligned with humerus toward center of acromion process. |
What is the moving arm for elbow extension? | Aligned with radius toward styloid process. |
What is the normal end feel for elbow extension? | Bone on bone. |
What is the test position for shoulder internal rotation? | Supine, shoulder abducted 90°, forearm neutral, elbow flexed 90°. |
What is the normal ROM for shoulder internal rotation? | 69° ± 4.6° according to AAOS; 90° according to AMA. |
What is the axis for shoulder internal rotation? | Olecranon process of ulna. |
What is the stationary arm for shoulder internal rotation? | Aligned vertically. |
What is the moving arm for shoulder internal rotation? | Aligned with ulna toward styloid process. |
What is the normal end feel for shoulder internal rotation? | Capsular. |
What is the test position for shoulder external rotation? | Supine, shoulder abducted 90°, forearm neutral, elbow flexed 90°. |
What is the normal ROM for shoulder external rotation? | 104° ± 8.5° according to AAOS; 90° according to AMA. |
What is the axis for shoulder external rotation? | Olecranon process of ulna. |
What is the stationary arm for shoulder external rotation? | Aligned vertically. |
What is the moving arm for shoulder external rotation? | Aligned with ulna toward styloid process. |
What is the normal end feel for shoulder external rotation? | Capsular. |
What is the test position for shoulder flexion? | Supine with flexed knees and no accessory motion, abduction, adduction, or rotation. |
What is the normal ROM for shoulder flexion? | 167° ± 4.7° according to AAOS; 150° according to AMA. |
What is the axis for shoulder flexion? | Center of humeral head near acromion process. |
What is the stationary arm for shoulder flexion? | Parallel to mid-axillary line. |
What is the moving arm for shoulder flexion? | Aligned with midline of humerus toward lateral epicondyle. |
What is the test position for shoulder extension? | Prone or supine for modified measure with no abduction, adduction, or rotation. |
What is the normal ROM for shoulder extension? | 62° ± 9.5° according to AAOS; 50° according to AMA. |
What is the axis for shoulder extension? | Center of humeral head near acromion process. |
What is the stationary arm for shoulder extension? | Parallel to mid-axillary line. |
What is the moving arm for shoulder extension? | Aligned with midline of humerus toward lateral epicondyle. |
What is the normal end feel for shoulder extension? | Capsular or ligamentous. |
What is the test position for shoulder abduction? | Supine with no shoulder flexion or extension and shoulder abducted. |
What is the normal ROM for shoulder abduction? | 184° ± 7.0° according to AAOS; 180° according to AMA. |
What is the axis for shoulder abduction? | Center of humeral head near acromion process. |
What is the stationary arm for shoulder abduction? | Parallel to sternum. |
What is the moving arm for shoulder abduction? | Aligned with midline of humerus. |
What is the normal end feel for shoulder abduction? | Muscle stretch. |
What cervical and trunk landmarks are important in goniometry? | Lumbar spine, thoracic spine, external auditory meatus, spinous process of C7, and occipital protuberance. |
What is the test position for cervical flexion? | Subject sitting with back support and stabilize lumbar and thoracic spines. |
What is the normal ROM for cervical flexion? | 60° according to AMA. |
What is the axis for cervical flexion? | External auditory meatus. |
What is the stationary arm for cervical flexion? | Vertical alongside the head. |
What is the moving arm for cervical flexion? | Aligned with nostrils. |
What is the normal end feel for cervical flexion? | Capsular or ligamentous. |
What is the test position for cervical extension? | Subject sitting with back support, stabilize lumbar and thoracic spines, mouth relaxed and slightly open. |
What is the normal ROM for cervical extension? | 75° according to AMA. |
What is the axis for cervical extension? | External auditory meatus. |
What is the stationary arm for cervical extension? | Vertical alongside the head. |
What is the moving arm for cervical extension? | Aligned with nostrils. |
What is the normal end feel for cervical extension? | Bony or capsular. |
What is the test position for cervical lateral flexion? | Subject sitting with back support, stabilize lumbar and thoracic spines, and sidebend cervical spine. |
What is the normal ROM for cervical lateral flexion? | 45° unilateral according to AMA. |
What is the axis for cervical lateral flexion? | Spinous process of C7. |
What is the stationary arm for cervical lateral flexion? | Aligned with spinous processes of thoracic spine. |
What is the moving arm for cervical lateral flexion? | Posterior midline of head at occipital protuberance. |
What is the normal end feel for cervical lateral flexion? | Capsular or ligamentous. |
What is the test position for cervical rotation? | Subject sitting with back support, stabilize lumbar and thoracic spines, and rotate cervical spine. |
What is the normal ROM for cervical rotation? | 80° unilateral according to AMA. |
What is the axis for cervical rotation? | Center of superior aspect of head. |
What is the stationary arm for cervical rotation? | Aligned with acromion processes. |
What is the moving arm for cervical rotation? | Aligned with tip of nose. |
What is the normal end feel for cervical rotation? | Capsular or ligamentous. |
What is the test position for trunk lateral flexion? | Subject standing, stabilize pelvis, and sidebend thoracic and lumbar spines. |
What is the normal ROM for trunk lateral flexion? | 25° according to AMA and 35° according to AAOS. |
What is the axis for trunk lateral flexion? | S1 spinous process. |
What is the stationary arm for trunk lateral flexion? | Vertical. |
What is the moving arm for trunk lateral flexion? | C7 spinous process. |
What is the normal end feel for trunk lateral flexion? | Capsular or ligamentous. |
What is the test position for trunk rotation? | Subject sitting, stabilize pelvis, no sidebending, and no forward or backward bending. |
What is the normal ROM for trunk rotation? | 45° unilateral according to AMA. |
What is the axis for trunk rotation? | Center of superior aspect of head. |
What is the stationary arm for trunk rotation? | Aligned with ASISs. |
What is the moving arm for trunk rotation? | Aligned with acromion processes. |
What lower extremity motions are commonly measured in goniometry? | Hip flexion, extension, abduction, adduction, internal rotation, external rotation; knee flexion and extension; ankle dorsiflexion, plantarflexion, inversion, and eversion. |
What lower extremity landmarks are important in goniometry? | Greater trochanter, pelvis, lateral epicondyle of femur, ASIS, patella, crest of tibia, lateral malleolus, fibular head, metatarsals, and calcaneus. |
What is the test position for hip flexion? | Subject supine, allow knee to flex, and stabilize pelvis to prevent rotation. |
What is the normal ROM for hip flexion? | 121.0° ± 6.4° according to AAOS; 100.0° according to AMA. |
What is the axis for hip flexion? | Greater trochanter. |
What is the stationary arm for hip flexion? | Aligned with midline of pelvis. |
What is the moving arm for hip flexion? | Aligned with femur toward lateral epicondyle. |
What is the normal end feel for hip flexion? | Capsular. |
What is the test position for hip extension? | Subject prone and stabilize pelvis to prevent rotation. |
What is the normal ROM for hip extension? | 12.0° ± 5.4° according to AAOS; 30.0° according to AMA. |
What is the axis for hip extension? | Greater trochanter. |
What is the stationary arm for hip extension? | Aligned with midline of pelvis. |
What is the moving arm for hip extension? | Aligned with femur toward lateral epicondyle. |
What is the normal end feel for hip extension? | Capsular or ligamentous. |
What is the test position for hip abduction? | Subject supine and stabilize pelvis. |
What is the normal ROM for hip abduction? | 41.0° ± 6.0° according to AAOS; 40.0° according to AMA. |
What is the axis for hip abduction? | Anterior superior iliac spine. |
What is the stationary arm for hip abduction? | Aligned with opposite ASIS. |
What is the moving arm for hip abduction? | Aligned with femur toward center of patella. |
What is the test position for hip adduction? | Subject supine, stabilize pelvis, and abduct opposite hip to allow room for tested limb to adduct. |
What is the normal ROM for hip adduction? | 27.0° ± 3.6° according to AAOS; 20.0° according to AMA. |
What is the axis for hip adduction? | Anterior superior iliac spine. |
What is the stationary arm for hip adduction? | Aligned with opposite ASIS. |
What is the moving arm for hip adduction? | Aligned with femur toward center of patella. |
What is the normal end feel for hip adduction? | Capsular or ligamentous. |
What is the test position for hip internal rotation? | Subject sitting on table with knee flexed and stabilize distal thigh. |
What is the normal ROM for hip internal rotation? | 44.0° ± 4.3° according to AAOS; 40.0° according to AMA. |
What is the axis for hip internal rotation? | Center of patella. |
What is the stationary arm for hip internal rotation? | Aligned vertically. |
What is the moving arm for hip internal rotation? | Aligned with anterior midline of lower leg toward crest of tibia. |
What is the normal end feel for hip internal rotation? | Capsular. |
What is the test position for hip external rotation? | Subject sitting on table with knee flexed and stabilize distal thigh. |
What is the normal ROM for hip external rotation? | 44.0° ± 4.8° according to AAOS; 50.0° according to AMA. |
What is the axis for hip external rotation? | Center of patella. |
What is the stationary arm for hip external rotation? | Aligned vertically. |
What is the moving arm for hip external rotation? | Aligned with anterior midline of lower leg toward crest of tibia. |
What is the test position for knee flexion? | Subject supine and allow hip to flex. |
What is the normal ROM for knee flexion? | 141° ± 5.3° according to AAOS; 150° according to AMA. |
What is the axis for knee flexion? | Lateral epicondyle of femur. |
What is the stationary arm for knee flexion? | Aligned with greater trochanter. |
What is the moving arm for knee flexion? | Aligned with lateral malleolus. |
What is the test position for knee extension? | Subject prone or supine for modified measure and stabilize femur. |
What is the normal ROM for knee extension? | Minus 2.0° ± 3.0° according to AAOS. |
What is the axis for knee extension? | Lateral epicondyle of femur. |
What is the stationary arm for knee extension? | Aligned with greater trochanter. |
What is the moving arm for knee extension? | Aligned with lateral malleolus. |
What is the normal end feel for knee extension? | Capsular. |
What is the test position for ankle dorsiflexion? | Subject prone, supine, or sitting; flex knee; and stabilize subtalar joint in neutral. |
What is the normal ROM for ankle dorsiflexion? | 13° ± 4.4° according to AAOS; 20° according to AMA. |
What is the axis for ankle dorsiflexion? | Lateral malleolus. |
What is the stationary arm for ankle dorsiflexion? | Aligned with fibular head. |
What is the moving arm for ankle dorsiflexion? | Aligned with fifth metatarsal. |
What is the normal end feel for ankle dorsiflexion? | Capsular. |
What is the test position for ankle plantarflexion? | Subject supine or sitting, extend knee, and stabilize leg. |
What is the normal ROM for ankle plantarflexion? | 56° ± 6.1° according to AAOS; 40° according to AMA. |
What is the axis for ankle plantarflexion? | Lateral malleolus. |
What is the stationary arm for ankle plantarflexion? | Aligned with fibular head. |
What is the moving arm for ankle plantarflexion? | Aligned with fifth metatarsal. |
What is the normal end feel for ankle plantarflexion? | Capsular. |
What is the test position for subtalar inversion? | Subject prone, stabilize tibia in sagittal plane, and invert calcaneus. |
What is the normal ROM for subtalar inversion? | 37.0° ± 4.5° according to AAOS. |
What is the axis for subtalar inversion? | Midpoint between malleoli. |
What is the stationary arm for subtalar inversion? | Aligned with midline of leg. |
What is the moving arm for subtalar inversion? | Aligned with midline of calcaneus. |
What is the test position for subtalar eversion? | Subject prone, stabilize tibia in sagittal plane, and evert calcaneus. |
What is the normal ROM for subtalar eversion? | 21.0° ± 5.0° according to AAOS. |
What is the axis for subtalar eversion? | Midpoint between malleoli. |
What is the stationary arm for subtalar eversion? | Aligned with midline of leg. |
What is the moving arm for subtalar eversion? | Aligned with midline of calcaneus. |
What is the normal end feel for subtalar eversion? | Capsular. |