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Measurement Review:

The goniometer will be the tool you will be required to use if asked to measure a
patient’s ROM. So lets make sure you understand how to properly use the device before
we begin. The goniometer is made up of an axis (the hinge), a stable arm,
and the mobilizing arm.

  1. Axis (AX): The center of the goniometer should always be placed next to the axis of the anatomical joint.
  2. Stable arm (SA): Placed proximal to the anatomical.
  3. Mobile arm (MA): placed distal to the joint and as the name refers will be moving.

Always assure that the patient is in a stable position and to support the extremity being tested.

Before preforming the actual measurement ensure the patient is in a favorable position. Then assist them through the desired motion (PROM), while explaining what you would like them to do. Once you have your goniometer in place, have the subject perform the desired motion unassisted. The below will walk you through the starting position (SP) to have the patient in, as well as, how to position the goniometer.

Testing:Starting PositionAxisStationary ArmMobilizing ArmMotion
Hip Flexion (120-130º)Lying on back (supine) with hips extendedGreater trochanterLateral longitudinal axis of trunkLateral longitudinal axis of femurBend hip and knee up towards the chest and contralateral leg flat on table.
Thomas Test-hip flexion contracture test.SupineGreater trochanterLateral longitudinal axis of trunkLateral longitudinal axis of femur-Bring both legs up towards chest.
-Lower one leg to table, while keeping other flexed.
-Angle between table and extended leg determines amount of hip flexion contracture
Hip Extension (0º)Lying on stomach (prone) with hips relaxedGreater trochanterLateral longitudinal axis of trunkLateral longitudinal axis of femurLift leg off table towards buttocks
Straight Leg Raise (90º)-(Testing for proximal hamstring tightness.)SupineGreater trochanterLateral longitudinal axis of trunkLateral longitudinal axis of femurRaise the leg upwards, making sure to keep knee extended and contralateral leg straight on table.
Hip Abduction/Adduction (45º/30º)SupineASISASIS-from side being measure to contralateral (horizontal)Anterior longitudinal axis of femurABD: with all joints extended move leg away from midline.
ADD: move towards and past midline
Internal/ External Hip Rotation (45º)Sitting (can also be preformed lying down with different method)Middle patellaPerpendicular to floorAnterior longitudinal axis of tibia (midline)Keep pelvis level.
INT: move leg out and away from midline
EXT: move leg out and towards midline
Femoral Anteversion (20º)Prone with hip extended and knee flexed 90ºMiddle patellaPerpendicular with the floorAnterior longitudinal axis of tibiaRotate the limb to until you feel the prominence of the trochanter reach it's max.
Knee Flexion (135º)ProneThrough lateral epicondyleLateral longitudinal axis of femur longitudinal axis of fibulaBend knee up towards buttocks as far as possible.
Knee Extension (0º)Prone or supineLateral epicondyleLateral longitudinal axis of femur Lateral longitudinal axis of fibulaExtend knee
Ankle Dorsiflexion (20º)Supine
-knee bent
-knee straight (gastoc tightness)
Just distal and posteriorLateral longitudinal axis of fibulaLateral longitudinal axis of 5th metatarsalAlign subtalar joint in neutral to slight inversion while bending foot up.
Ankle Plantarflexion (45º)Align subtalar joint in neutral to slight inversion while bending foot up.Just distal and posterior to lateral malleolusLateral longitudinal axis of fibulaLateral longitudinal axis of 5th metatarsalKeep knee extended, moving foot down towards table
Hindfoot Inversion/Eversion (5º ea)PronePosterior calcaneusParallel to posterior longitudinal axis of tibiaParallel to line bisecting calcaneus into right and left halves Bring hind foot medially (inversion) or laterally (eversion)
Forefoot Inversion/Eversion (35º/15º)Supine or sittingMidway between malleoliParallel to anterior longitudinal axis of tibiaAnterior longitudinal axis of 2nd metatarsalKnee flexed or extended, bring forefoot medial (inversion) or laterally (eversion)
Toe OutProne with hip extended and knee flexed to 90ºCenter of heel subtalar joint in neutral Parallel to long axis of thighBisecting the heel towards the 2nd toeExternally rotate-Focus on alignment of the hind foot to thigh rather than the foot.

Subtalar Neutral: