UPPER EXTREMITY

SHOULDER
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
[1] Scapula to prevent
Supine: 0º abduction-adduction, Lateral aspect of
posterior tilting, upward Lateral midline of the
pronation-supination, and rotation; the greater tubercle Parallel to
rotation and elevation. humerus (lateral
Flexion elbow extension; palm faces body. or midaxillary line of Firm 0-180º
[2] Thorax to prevent epidondyle or olecranon
Use of towel under arm to level Lateral aspect of the thorax
extension of the spine and process as reference)
surface. acromion process
movement of the ribs
[1] Scapula at the inferior
angle or at the acromion and
Prone: face turned away; no pillow; 0º
coracoid processes to prevent Lateral aspect of
abduction-adduction, pronation-
elevation and anterior tilting the greater tubercle Parallel to Lateral midline of the
supination, rotation; slight elbow
Extension of the scapula. or midaxillary line of humerus (lateral Firm 0-60º
flexion; palm faces body.
[2] Thorax to prevent forward Lateral aspect of the thorax condyle as reference)
Use of towel under arm to level
flexion of the spine and trunk acromion process
surface.
to prevent rotation of the
spine.
Supine: shoulder in lateral rotation; 0º [1] Scapula to prevent upward Anterior midline of
Parallel to midline of
flexion-extension; palm faces rotation and elevation. Anterior aspect of humerus (medial
Abduction anterior aspect of Firm 0-180º
anteriorly; humerus laterally rotated; [2] Thorax to prevent lateral acromion process epicondyle as
sternum
elbow extension flexion of the spine. reference)
[1] Beginning: distal end of
humerus to keep shoulder in
90º of abduction. End:
Supine: 90º shoulder abduction; clavicle, acromion and
forearm perpendicular to surface; 0º coracoid processes of scapula
Either parallel or Ulna (olecranon process
Medial pronation-supination; palm faces feet; to prevent anterior tilting and
Olecranon process perpendicular to the and ulnar styloid Firm 0-70º
rotation elbow not supported; pad under protraction of the scapula.
floor process as reference)
humerus so it is level with the [2] Distal end of humerus to
acromion process keep shoulder in 90º of
abduction, and thorax to
prevent flexion or rotation of
the spine.
[1] Beginning: distal end of
humerus to keep the shoulder
in 90º of abduction. End: spine
Supine: 90º shoulder abduction;
of scapula to prevent posterior
forearm perpendicular to surface; 0º Either parallel or Ulna (olecranon process
Lateral tilting and retraction.
pronation-supination; palm faces feet; Olecranon process perpendicular to the and ulnar styloid Firm 0-90º
rotation [2] Distal end of humerus to
pad under humerus so it is level with floor process as reference)
keep the shoulder in 90º of
the acromion process
abduction and thorax to
prevent extension or rotation
of the spine
^NOTE: [1] For glenohumeral testing. [2] For shoulder complex testing. ***ADDUCTION: Not usually measured: Return to origin— starting position from full abduction.

NORIKIN: Goniometry— UST CRS AJG Notes 1

 ELBOW
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Supine: towel under distal end of Lateral midline of Lateral midline of
Soft [1]
humerus; upper arm close to side of Humerus to prevent flexion Lateral epicondyle humerus (center of radius (radial head and
Flexion Firm [2] 0-150º
body; forearm in full supination; palm and shoulder extension of humerus acromion process for radial styloid process as
Hard [3]
facing ceiling reference) reference)
0º
Note: start
Supine: towel under distal end of Lateral midline of Lateral midline of from
humerus; upper arm close to side of Humerus to prevent flexion Lateral epicondyle humerus (center or radius (radial head and Hard / maximal
Extension
body; forearm in full supination; palm and shoulder extension of humerus acromion process as radial styloid process as Firm degree of
facing ceiling reference) reference) flexion
back to
extension.
^NOTE: *** FLEXION: [1] Soft EF: Approximation of forearm to biceps. [2] Firm EF: Muscle atrophy, triceps ligament stretch. [3]: Hard EF: Coronoid process as it enters fossa.
FOREARM
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Distal end of humerus to Dorsal aspect of
Sitting: upper arm close to side of
prevent medial rotation and Lateral and forearm; proximal and
body; elbow flexed to 90º; forearm in Parallel to anterior
Pronation towel tucked between arm and proximal to ulnar parallel to the styloid Firm 0-80º
midprone; thumb points towards midline of humerus
trunk to prevent shoulder styloid process processes of radius and
ceiling
abduction ulna
Distal end of humerus to Ventral aspect of
Sitting: upper arm close to side of
prevent lateral rotation and Medial and forearm; proximal and
body; elbow flexed to 90º; forearm in Parallel to anterior
Supination towel tucked between arm and proximal to ulnar parallel to the styloid Firm 0-80º
midprone; thumb points towards midline of humerus
trunk to minimize shoulder styloid process processes of radius and
ceiling
adduction ulna
WRIST
Normal
Action Testing Position Stabilization Fulcrum Proximal Distal End Feel Remarks
Values
Lateral aspect of Lateral midline of ulna Lateral Do not use soft tissue
Sitting: shoulder abducted Radius and ulna to prevent
the wrist over (olecranon and ulnar midline of of hypothenar
Flexion to 90º; elbow flexed to pronation-supination of forearm Firm 0-80º
the triquetrum styloid process as 5th eminence for distal
90º; palm facing ground and motion of the elbow arm.
(ulnar styloid) reference) metacarpal
Lateral aspect of Lateral midline of ulna Lateral Do not use soft tissue
Sitting: shoulder abducted Radius and ulna to prevent
the wrist over (olecranon and ulnar midline of Hard / of hypothenar
Extension to 90º; elbow flexed to pronation-supination of forearm 0-70º
the triquetrum styloid process as 5th Firm eminence for distal
90º; palm facing ground and motion of the elbow arm.
(ulnar styloid) reference) metacarpal
Dorsal midline of Dorsal
Sitting: shoulder abducted Radius and ulna to prevent Dorsal aspect of Do not use third
Radial forearm (lateral midline of Hard /
to 90º; elbow flexed to pronation-supination of forearm, wrist over the 0-20º phalanx as reference
deviation epicondyle as third Firm
90º; palm facing ground and elbow flexion beyond 90º capitate for the distal arm.
reference) metacarpal
NORIKIN: Goniometry— UST CRS AJG Notes 2
 Dorsal midline of Dorsal
Sitting: shoulder abducted Radius and ulna to prevent Dorsal aspect of Do not use third
Ulnar forearm (lateral midline of
to 90º; elbow flexed to pronation-supination of forearm, wrist over the Firm 0-30º phalanx as reference
deviation epicondyle as third
90º; palm facing ground and elbow flexion beyond 90º capitate for the distal arm.
reference) metacarpal

MCP OF THUMB
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Sitting: forearm in full supination; wrist
in 0º flexion-extension, and radial-ulnar
flexion. CMC of thumb in 0º flexion-
1st metacarpal to prevent wrist
extension, abduction-aduction, and Dorsal aspect of Dorsal midline of the Dorsal midline of Hard /
Flexion motion and flexion of the 0-50º
opposition. the MCP joint metacarpal proximal phalanx Firm
CMC joint of the thumb
IP of thumb in 0º flexion-extension.
Forearm and hand rest on supporting
surface.
Sitting: forearm in full supination,
resting on a surface; wrist in 0º flexion-
1st metacarpal to prevent
extension, radial-ulnar deviation. CMC Dorsal aspect of Dorsal midline of Dorsal midline of
Extension motion at the wrist and at the Firm 0º
of thumb in 0º flexion-extension, MCP joint metacarpal proximal phalanx
CMC joint of the thumb
abduction, and opposition.
IP of thumb in 0º flexion-extension

IP OF THUMB
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Sitting: forearm in full supination,
Firm
resting on a surface; wrist in 0º flexion-
Proximal phalanx to prevent usually /
extension, radial-ulnar deviation. CMC Dorsal surface of Dorsal midline of the Dorsal midline of distal
Flexion flexion or extension of MCP Hard in 0-80º
in 0º flexion-extension, abduction, and the IP joint proximal phalanx phalanx
joint some
opposition.
people
MCP of thumb in 0º flexion-extension.
Sitting: forearm in full supination,
resting on a surface; wrist in 0º flexion-
Proximal phalanx to prevent
extension, radial-ulnar deviation. CMC Dorsal surface of Dorsal midline of the Dorsal midline of the
Extension flexion or extension of MCP Firm 0-20º
in 0º flexion-extension, abduction, and the IP joint proximal phalanx distal phalanx
joint
opposition.
MCP of thumb in 0º flexion-extension.

NORIKIN: Goniometry— UST CRS AJG Notes 3

 CMC OF THUMB
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Ventral midline of
Sitting: forearm in supination, resting Palmar aspect of the radius (ventral
on a surface; wrist in 0º flexion- 1st CMC joint surface of radial head
Carpals, radius, and ulna to Ventral midline of 1st Soft /
Flexion extension, radial-ulnar deviation. CMC or and styloid as 0-15º
prevent wrist motions metacarpal Firm
in 0º abudction-adduction. MCP and IP (Old Gionio: reference)
of thumb relaxed in slight flexion. Trapezium) Lateral midline of
2nd MCP
Sitting: Forearm and hand resting on a
Ventral midline of
surface; Forearm in full supination;
the radius (ventral 0-20º
wrist in 0º flexion-extension, radial- Carpals, radius, and ulna to Palmar aspect of Ventral midline of 1st
Extension surface of radial head Firm or
ulnar deviation. CMC in 0º abduction- prevent wrist motions 1st CMC joint metacarpal
and styloid as 0-80º
adduction.
reference)
MCP and IP of thumb in slight flexion.
Sitting: forearm and hand rest on
Lateral midline of Lateral midline of 1st
supporting surface; forearm midway Stabilize carpal bones and 2nd Lateral aspect of
2nd metacarpal metacarpal (center of
Abduction midprone; wrist in 0º flexion-extension, metacarpal to prevent wrist radial styloid Firm 0-70º
(center of 2nd MCP 1st MCP joint as
radial-ulnar deviation. CMC, MCP, and motions process
joint as reference) reference)
IP in 0º flexion-extension.
Sitting: forearm and hand rest on
Stabilize 5th metacarpal to
supporting surface; forearm in full Use ruler to measure distance between tip of thumb and proximal Soft /
Opposition prevent CMC joint and wrist
supination; wrist in 0º flexion- digital crease of little finger or at the MCP joint Firm
motions
extension, and radial-ulnar deviation.
^NOTE: ***ADDUCTION: Not usually measured: Return to origin— starting position from full abduction at 0º.
DIP OF FINGER
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Sitting: forearm and hand on
supporting surface; 0º forearm
Middle and proximal phalanx
pronation-supination; 0º wrist flexion- Dorsal aspect of Dorsal midline of the Dorsal midline of the
Flexion to prevent further flexion of Firm 0-90º
extension, radial-ulnar deviation; 0º DIP joint middle phalanx distal phalanx
PIP joint
MCP flexion-extension, abduction-
adduction. PIP joint in 70-90º flexion.
Sitting: forearm and hand on
supporting surface; 0º forearm
Middle and proximal phalanx
pronation-supination; 0º wrist flexion- Dorsal aspect of Dorsal midline of the Dorsal midline of distal
Extension to prevent extension of PIP Firm 0º
extension, radial-ulnar deviation; 0º DIP joint middle phalanx phalanx
joint
MCP flexion-extension, abduction-
adduction. PIP joint in 70-90º flexion.

NORIKIN: Goniometry— UST CRS AJG Notes 4

 PIP OF FINGERS
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Sitting: forearm and hand on
supporting surface; 0º forearm Hard
pronation-supination; 0º wrist flexion- Dorsal aspect of Dorsal midline of Dorsal midline of the usually /
Flexion Proximal phalanx 0-100º
extension, radial-ulnar deviation; 0º PIP joint proximal phalanx middle phalanx Soft in
MCP flexion-extension, abduction- some
adduction.
Sitting: forearm and hand on
supporting surface; 0º forearm
pronation-supination; 0º wrist flexion- Dorsal aspect of Dorsal midline of Dorsal midline of the
Extension Proximal phalanx Firm 0º
extension, radial-ulnar deviation; 0º PIP joint proximal phalanx middle phalanx
MCP flexion-extension, abduction-
adduction.

MCP OF FINGERS
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Metacarapal.
Sitting: forearm and hand on a surface;
Do not hold the MCP joints of
forearm midprone; 0º wrist flexion-
other fingers in extension Dorsal aspect of Dorsal midline of the Dorsal midline of the Hard /
Flexion extension, radial-ulnar deviation; MCP 0-90º
because tension in the the MCP joint metacarpal proximal phalanx Firm [1]
in neutral position relative to
transverse metacarpal
abduction-adduction.
ligament will restrict motion
Metacarpal to prevent wrist
Sitting: forearm and hand on a surface;
motion. Do not hold the MCP
forearm midprone; 0º wrist flexion-
joints of other fingers because Dorsal aspect of Dorsal midline of the Dorsal midline of the
Extension extension, radial-ulnar deviation; MCP Firm 0-45º
tension in the transverse the MCP joint metacarpal proximal phalanx
in neutral position relative to
metacarpal ligament will
abduction-adduction.
restrict motion
Sitting: forearm and hand resting on a
surface; 0º wrist flexion-extension,
Metacarpal to prevent wrist Dorsal aspect of Dorsal midline of the Dorsal midline of the
Abduction radial-ulnar deviation. Forearm in Firm
motions MCP joint metacarpal proximal phalanx
pronation, palm facing ground; 0º MCP
flexion-extension.
^NOTE: ***FLEXION: [1] Firm EF: Due to the tension from the dorsal joint capsule and collateral ligament.
***ADDUCTION: Not usually measured: Return to origin— starting position from full abduction at 0º.

NORIKIN: Goniometry— UST CRS AJG Notes 5

LOWER EXTREMITY
HIP
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Stabilize the pelvis with one hand
Lateral midline of the
Flexion Supine above ASIS to prevent posterior Greater trochanter Lateral epicondyle Soft 0-120º
pelvis
tilting or rotation
Hold the pelvis with one hand below Lateral midline of the
Extension Prone Greater trochanter Lateral epicondyle Firm 0-20 º
ASIS to prevent anterior tilt pelvis
Midline of the patella.
Keep a hand on iliac crest to prevent Clinically: anterior
Abduction Supine lateral tilting and rotation. Watch the Same side ASIS Other ASIS midline of thigh if Firm 0-45 º
trunk for lateral flexion patella’s deviated from
normal.
Midline of the patella.
Supine: contralateral leg Clinically: anterior
Stabilize the pelvis to prevent lateral
Adduction abducted to permit full Same side ASIS Other ASIS midline of thigh if Firm 0-30º
tilting and hip hiking
adduction patella’s deviated from
normal.
Anterior midline of the
Stabilize the distal end of the femur
Perpendicular to floor or lower leg (crest of the
Internal to prevent abduction, adduction or Anterior aspect of
Short sitting parallel to the supporting tibia and a point midway Firm 0-45º
Rotation further flexion of the hip; avoid the patella
surface between the two malleoli
lateral tilting of the pelvis
for reference)
Anterior midline of the
Stabilize distal end of the femur to
Perpendicular to floor or lower leg (crest of the
External prevent abduction, or further flexion Anterior aspect of
Short sitting parallel to the supporting tibia and a point midway Firm 0-45 º
rotation of the hip; avoid rotation and lateral the patella
surface between the two malleoli
tilting of the pelvis
for reference)

KNEE
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Supine: knee in extension, Usually
hip in 0º degrees extention soft,
Femur to prevetn rotation, abduction, Lateral epicondyle
Flexion and abduction and Along greater trochanter Along lateral malleolus may 0-135º
and adduction of hip of femur
adduction; towel under also be
ankle firm
Supine: knee in extension,
hip in 0º extention and Femur to prevetn rotation, abduction, Lateral epicondyle
Extension Along greater trochanter Along lateral malleolus Firm 0-10º
abduction and adduction; and adduction of hip of femur
towel under ankle
^NOTE: ***EXTENSION: Not usually measured: Just a return to starting position after knee flexion.

NORIKIN: Goniometry— UST CRS AJG Notes 6

 TALOCRUTAL
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Lateral midline of fibula
Sitting: knee flexed to 90º, Stabilize tibia and fibula to prevent Lateral aspect of Parallel to lateral aspect
Dorsiflexion in reference to fibular Firm 0-20º
foot in neutral knee motion and hip rotation lateral malleolus of 5th metatarsal
head
1. Sitting: knee flexed to 1. Parallel to lateral aspect
Lateral midline of fibula
90º, foot in neutral. Stabilize tibia and fibula to prevent Lateral aspect of of 5th metatarsal. 2.
Plantarflexion in reference to fibular Firm 0-50º
knee motion and hip rotation lateral malleolus Inferior aspect of
2. Supine. head
calcaneus.

TARSAL
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
1. Sitting: knee flexed to
90º and lower leg over
Stabulize tibia and fibula to prevent Anterior aspect of Anterior midline of lower
edge of supporting Anterior midline of 2nd
Inversion knee extension and medial rotation, knee midway leg, tibial tuberosity as Firm 0-35º
surface, hip in neutral. MTP
and hip abduction and lateral rotation between malleoli reference
2. Supine: foot over edge
of surface.
1. Sitting: knee flexed to
90º and lower leg over Anterior aspect of Anterior midline of lower
Stabilize tibia and fibula to prevent Hard
edge of supporting Anterior midline of 2nd
Eversion knee flexion and lateral rotation, and knee midway leg, tibial tuberosity as [1] / 0-15º
surface, hip in neutral. hip adduction and medial rotation MTP Firm [2]
between malleoli reference
2. Supine: foot over edge
of surface.
^NOTE: ***EVERSION [1] Hard EF: Due to contact between calcaneus and sinus tarsi. [2] Firm EF: Due to tension between joint capsules and ankle ligaments.
SUBTALAR
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Posterior aspect of
Prone: Hip and knee in Stabilize the tibia and fibula to
ankle, midway Posterior midline of lower Posterior midline of
Inversion neutral; foot over edge of prevent medial hip and knee rotation, Firm 0-5º
between the two leg calcaneus
supporting surface and hip abduction
malleoli
Posterior aspect of
Prone: hip and knee in Stabilize tibia and fibula to prevent
ankle, midway Posterior midline of lower Posterior midline of
Eversion neutral; foot over edge of medial hip and knee rotation and hip Hard 0-5º
between the two leg calcaneus
supporting surface abduction
malleoli

NORIKIN: Goniometry— UST CRS AJG Notes 7

 TRANSVERSE TARSAL
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
1. Sitting: 90º knee
flexion, lower leg over Anterior aspect of
Stabilize calcaneus to prevent ankle Anterior midline of lower
edge of supporting ankle slightly distal Anterior midline of 2nd
Inversion dorsiflexion and inversion of subtalar leg using tibial tuberosity Firm 0-35º
surface. Hip in neutral. to point midway metatarsal
joint. as reference
2. Supine with foot on between malleoli
supporting surface edge.
1. Sitting: 90º knee
flexion, lower leg over Anterior aspect of
Stabilize calcaneus to prevent ankle Anterior midline of lower
edge of supporting ankle slightly distal Anterior midline of 2nd
Eversion dorsiflexion and inversion of subtalar leg using tibial tuberosity Firm 0-15º
surface. Hip in neutral. to point midway metatarsal
joint. as reference
2. Supine: foot on between malleoli
supporting surface edge.
MTP OF TOES
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Dorsal midline of the
Stabilize the metatarsal and Dorsal aspect of Dorsal midline of the
Suppine or sitting: ankle proximal phalanx.
calcaneus to prevent ankle the MTP joint. metatarsal. 1st MTP:
Flexion and foot in neutral. MTP 1st MTP: medial midline Firm
dorsiflexion and subtalar joint 1st MTP: medial 1st MTP: medial midline 0-45º
and IP in neutral. of proximal phalanx of 1st
inversion aspect of joint. of 1st metatarsal
toe
Dorsal midline of the
Dorsal aspect of Dorsal midline of the
Suppine or sitting: ankle Stabilize metatarsal to prevent ankle proximal phalanx.
the MTP joint. metatarsal. 1st MTP:
Extension and foot in neutral. MTP dorsiflexion, and foot inversion- 1st MTP: medial midline Firm
eversion. 1st MTP: medial 1st MTP: medial midline 0-70º
and IP in neutral. of proximal phalanx of 1st
aspect of joint. of 1st metatarsal
toe
Supine or sitting: foot in Stabilize the metatarsal to prevent Dorsal aspect of Dorsal midline of the Dorsal midline of the
Abduction
neutral foot inversion-eversion. the MTP joint metatarsal proximal phalanx
^NOTE: ***ADDUCTION: Not usually measured: Motion is in the transverse plane around vertical axis; return position from abduction.
IP OF FIRST TOE AND PIP JOINTS OF THE FOUR LESSER TOES
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Stabilize the metatarsal and proximal
Suppine or sitting: ankle Dorsal aspect of Dorsal midline of the
phalanx to prevent ankle Dorsal midline of the
Flexion and foot in neutral. MTP the interphalangeal phalanx distal to the joint Soft
dorsiflexion-plantarflexion and foot proximal phalanx
and IP in neutral. joint being tested being tested.
joint inversion-eversion
Stabilize the metatarsal and proximal
Suppine or sitting: ankle Dorsal aspect of Dorsal midline of the
phalanx to prevent ankle Dorsal midline of the
Extension and foot in neutral. MTP the interphalangeal phalanx distal to the joint Firm
dorsiflexion-plantarflexion and foot proximal phalanx
and IP in neutral. joint being tested being tested.
joint inversion-eversion

NORIKIN: Goniometry— UST CRS AJG Notes 8

 DIP OF THE FOUR LESSER TOES
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal
Feel Values
Metatarsal: proximal and middle
Suppine or sitting: ankle phalanx to prevent ankle
Over distal aspect Over dorsal midline of Dorsal midline of the
Flexion and foot in neutral. MTP
dorsiflexion-plantarflexion and foot Firm 0-30º
of DIP joint middle phalanx distal phalanx
and IP in neutral.inversion-eversion; avoid MTP and
PIP flexion-extension
^NOTE: ***EXTENSION: Not usually measured: Return from flexion to the starting position.

HEAD
TEMPOROMANDIBULAR
Action Testing Position Stabilization General Considerations End Feel Normal Values
Use a millimeter ruler to measure the
Posterior aspect of head and neck to 35-50mm /
Depression Sitting: 0º cervical spine flexion-extension, vertical distance between edge of upper
prevent flexion, extension, lateral Firm 2-3 knuckles /
(Opening) lateral flexion, and rotation. and lower incisor. May use tape
flexionm and rotation of cervical spine 4 fingers
measure/ruler, knuckles, or fingers.

Posterior aspect of head and neck to Use a millimeter ruler to measure the
Sitting: 0º cervical spine flexion-extension,
Protrusion prevent flexion, extension, lateral vertical distance between edge of upper Firm 6-9mm
lateral flexion, and rotation. TMJ opened slightly.
flexionm and rotation of cervical spine and lower incisor.

Mouth closed: draw a horizontal line on the

lower central incisors at the bottom edge of the
Posterior aspect of head and neck to Use a millimeter ruler to measure the
Retrusion overlapping upper central incisor.
prevent flexion, extension, lateral vertical distance between edge of upper Firm 2-3mm
(Overbite) Mouth opened: measure between horizontal line
flexionm and rotation of cervical spine and lower incisor.
and upper edge of mandibular (lower) central
incisor.
Use a millimeter ruler to measure the
Excursion Posterior aspect of head and neck to
Sitting: 0º cervical spine flexion-extension, vertical distance between edge of upper
(Lateral prevent flexion, extension, lateral Firm 8-12mm
deviation) lateral flexion, and rotation. TMJ opened slightly. and lower cuspids (may also use
flexionm and rotation of cervical spine
bicuspids).

NORIKIN: Goniometry— UST CRS AJG Notes 9

NECK
CERVICAL SPINE
End Normal
Action Testing Position Stabilization Fulcrum Proximal Distal Remarks
Feel Values
Flexion
External Parallel or
Sitting: 0º head rotation Base of nares (may use
Goniometer auditory perpendicular to the Firm 0-45º
and lateral flexion Shoulder girdle and tongue depressor)
meatus ground
chest -May use strap
Sitting: starting position, Posterior aspect of the
Inclinometer N/A T1 Firm 0-45º around chest of back
both inclinometers at 0º head
Extension of chair to stabilize.
Shoulder girdle and External Parallel or
Unversal Sitting: 0º head rotation Base of nares (may use
chest, to prevent auditory perpendicular to the Firm 0-45º -Mark the
goniometer and lateral flexion tongue depressor)
thoracic and lumbar meatus ground landmarks (ask
Tape measure Sitting spine extension; and N/A Tip of chin Sternal notch Firm patient’s
lateral flexion and Posterior aspect of the
Inclinometer Sitting N/A T3 Firm 0-45º permission).
extension of the head head
Lateral Flexion
-Mouth remains
Spinous process of
Sitting: head in neutral Shoulder girdle, chest, closed.
Goniometer C7 thoracic vertebrae, Vertex of the head Firm 0-45º
position (and mandible to
parallel to the ground
prevent contralateral
Sitting: head in neutral
Inclinometer rotation) N/A T1 Vertex of head Firm 0-45º
position
Rotation
Shoulder girdle and Parallel to the -PT should be able
Center of to read
chest to prevent imaginary line between Tip of nose (may use
Goniometer Sitting cranial Firm 0-60º measurements above
thoracic and lumbar the two acromion tongue depressor)
aspect the pt’s head.
spine rotation processes
-May use a tongue
depressor with the pt
Supine: starting position, biting on it, midline
Shoulder girdle and
Inclinometer inclinometer at 0º along N/A Middle of forehead Firm 0-60º
chest to the tip of the
pt’s transverse plane
nose.

^NOTE: ***TAPE MEASURE: Difference of initial and final measurements.

NORIKIN: Goniometry— UST CRS AJG Notes 10

TRUNK
THORACOLUMBAR SPINE
Proximal / End Normal
Action Testing Position Stabilization Fulcrum Distal / Subsequent marks
Initial Landmark Feel Values
Flexion Standing: cervical, thoracic,
Stabilize the pelvis to prevent
Inclinometer and lumbar spines at 0º lateral C7 S2 (dimple of Venus, PSIS level) 0-80º
anterior tilting. Knees kept Firm
flexion, and rotation. N/A
Tape Measure straight. C7 S2 10cm / 4in
Patient asked to forward flex.
Extension Standing with cervical,
Inclinometer thoracic, and lumbar spines at Stabilize the pelvis to prevent C7 S2 (dimple of Venus, PSIS level) 0-25º
0º lateral flexion, and rotation. posterior tilting. Knees kept Firm
Patient asked to bend straight. N/A
Tape Measure C7 S2 2-4cm
backwards facing ceiling.
Lateral Flexion
Standing: cervical, thoracic,
Inclinometer and lumbar spines at 0º lateral Stabilize the pelvis to prevent N/A T1 S2 Firm 0-35º
flexion, and rotation lateral tilting.
Perpendicular to the
Goniometer End of motion: lateral tilting S1 C7 Firm 0-35º
ground
of pelvis and heel rise on the
Mark the tip of the Terminal distance on the thigh of
Fingertip-Thigh Standing: cervical, thoracic, contralateral side.
middle finger on the the tip of the middle finger as it Firm ~21cm
Method and lumbar spines at 0º lateral
pt’s thigh slid down
flexion, and rotation. Use tape measure and take the N/A
difference in value of the two Initial distance of tip Terminal distance of the tip of the
Fingertip-Floor Hands at the side, with palms
marks. of the middle finger middle finger from the floor after Firm 15-16cm
Method on thighs.
from the floor lateral flexion
Rotation
Standing with cervical,
Stabilize the pelvis to prevent
Inclinometer thoracic, and lumbar spines at N/A C7 S2 Firm 0-45º
rotation
0º lateral flexion, and rotation
Center of Parallel to imaginary
Parallel to imaginary line between
Goniometer cranial line between iliac Firm 0-45º
acromion processes
aspect crests
^NOTE: ***Inclinometer: Sacral inclinometer represents hip flexion, take difference from the two readings.

NORIKIN: Goniometry— UST CRS AJG Notes 11

 LUMBAR SPINE
Proximal / End Normal
Action Testing Position Stabilization Fulcrum Distal / Subsequent marks
Initial Landmark Feel Values
Flexion
Inclinometer T12 S2 (dimple of Venus, PSIS level) 0-60º
Stabilize the pelvis to prevent
Standing: cervical, thoracic, and Lumbosacral
Schober’s anterior tilting. Knees kept 10cm above 2-3cm
lumbar spines at 0º lateral flexion, junction
straight. Firm
and rotation. N/A Lumbosacral
Modified-Schober’s -Difference between the two 10cm above, 5cm below 5-6cm
Patient asked to forward flex. junction
inclinometers.
Modified-modified
S2 15cm above 5-6cm
Schober’s
Extension
0-20º to
Inclinometer T12 S2 (dimple of Venus, PSIS level) 25º
Standing with cervical, thoracic, Stabilize the pelvis to prevent
and lumbar spines at 0º lateral posterior tilting. Knees kept Lumbosacral
Schober’s 10cm above 2-3cm
flexion, and rotation. straight. junction Firm
Patient asked to bend backwards -Difference between the two N/A
Lumbosacral
Modified-Schober’s facing ceiling. inclinometers. 10cm above, 5cm below 5-6cm
junction
Modified-modified
S2 15cm above 5-6cm
Schober’s
^NOTE: ***Modified-Schober’s: Using the 15cm marks, take difference from the two readings.

NORIKIN: Goniometry— UST CRS AJG Notes 12