GONIOMETRY

GONIOMETRY IS USED TO MEASURE AND

DOCUMENT THE AMOUNT OF ACTIVE AND PASSIVE
ROM AS WELL AS FIXED JOINT POSITIONS.

 Goniometry is a technique of human joint

measurement. The term Goniometry is derived
from two Greek words; Gonia meaning angle, and
Metron meaning measure.
 Goniometry refers to measurement of angles
created at human joints by bones of the body. The
examiner obtains these measurements by placing
the parts of measuring instrument, called a
goniometer, along the bones immediately proximal
and distal to the joint being evaluated.
  USES OF GONIOMETRY
To find out amount of motion
available at joint
To determine particular joint position

To determine presence or absence of

impairement
To establish a diagnosis

To develop a prognosis, treatment

goals and plan of care

Evaluating progress or lack of progress
towards rehabilitative goals
Modifying treatment

Motivating the subject

Researching effectiveness of therapeutic

techniques; for example exercise,

medications and surgical procedures
Fabricating orthoses and adaptive
equipments
 RANGE OF MOTION (ROM):-

  A joint's range of motion is the angle

through which a joint moves from the
anatomical position to the extreme limit of
the motion in a particular direction. Having
an optimal range of motion allows you to
move freely without pain or stiffness and
perform activities and work without injuries.
 Each specific joint has a normal range of
motion that is expressed in degrees.
 OSTEOKINAMATICS:

IT’S A MOVEMENT OF SHAFTS

OF BONES. GONIOMETRY
MEASURES THE ANGLE
CREATED BY THE ROTARY
MOTION OF THE SHAFTS OF
THE BONES.
 ARTHROKINAMATICS:
 It’s a movement of the joint surfaces as glides,
spins and rolls, compression and destraction.
 Slide is a translatory motion is the sliding of one
joint surface to other as LIKE BRAKED wheel
skids.
 a spin is a rotary motion like spinning of a toy top.
all point s on the moving joint surface ROTATES
at a constant distance around fixed axis of motion.
 a roll is a rotary motion like rolling a bottom of
the rocking chair.
 ROLL
A series of points on one articulating surface come into
contact with a series of points on another surface
Rocking chair analogy; ball rolling on ground
Example: Femoral condyles rolling on tibial plateau
Roll occurs in direction of movement
Occurs on incongruent (unequal) surfaces
Usually occurs in combination with sliding or spinning
 Inrolling, equidistant points touch each other in
the course of motion.
 SPIN
 Occurs when one bone rotates around a stationary longitudinal
mechanical axis
 Same point on the moving surface creates an arc of a

circle as the bone spins

 Example: Radial head at the humeroradial joint during

pronation/supination; shoulder flexion/extension; hip

flexion/extension
 Spin does not occur by itself during normal joint motion

In spinning, the contact point of one surface rotates

around a longitudinal axis.
 SLIDE

Specific point on one surface comes into contact with a

series of points on another surface
In sliding, a point of a shallow concave gliding surface
sweeps over a larger surface of the other convex joint
body. (sometimes referred to as a GLIDE)
Surfaces are congruent
.Combined rolling-sliding in a joint
The more congruent the surfaces are, the more
sliding there is
The more incongruent the joint surfaces are, the
more rolling there is
SLIDE (GLIDE)
 Compression –
Decrease in space between two joint surfaces
Adds stability to a joint
Normal reaction of a joint to muscle
contraction
 Distraction -
Two surfaces are pulled apart
Often used in combination with joint
mobilizations to increase stretch of capsule.
 STANDARD STARTING
POSITIONS

Fig 2.9

Fundamental Anatomical
Standing Standing
Position Position
 ORIENTATION OF THE BODY
Center of Gravity: imaginary
point representing the weight
center of an object
Line of Gravity: imaginary
vertical line that passes through
the center of gravity
 ORIENTATION OF THE BODY
AXES OF MOTION
 Bilateral: axis passes horizontally form side to
side
 Anteroposterior or AP: axis passes horizontally
form front to back
 Vertical: axis is perpendicular to the ground

 Rotary movement occurs in a plane and around

an axis
 Axis of movement is always at right angles to
the plane in which it occurs
 PLANES OF THE BODY

Fig
2.8

Sagittal Frontal Transverse

FUNDAMENTAL MOVEMENTS
SAGITTAL PLANE ABOUT A
BILATERAL AXIS
Flexion:
1. Tipping the head forward
2. Lifting the foot & leg backward from
knee
3. Raising entire lower extremity
forward-upward as though kicking
4. Raising forearm straight forward
5. Elbow straight, raising entire upper
extremity forward-upward
FUNDAMENTAL MOVEMENTS
SAGITTAL PLANE ABOUT A BILATERAL
AXIS

Extension: return movement from flexion

Hyperflexion: when arm is flexed beyond vertical
Hyperextension: continuation of extension beyond
starting position
Reduction of Hyperextension: return movement from
hyperextension
FUNDAMENTAL MOVEMENTS
FRONTAL PLANE ABOUT AN AP
AXIS
Abduction: movement away from the midline
Adduction: return movement from abduction
Lateral Flexion: lateral bending of head or trunk
Hyperabduction: arm abducted beyond vertical
Hyperadduction: move across in front of the body
Reduction of Hyperadduction: return movement
Reduction of Lateral Flexion: return movement
FUNDAMENTAL MOVEMENTS
TRANSVERSE PLANE ABOUT A
VERTICAL AXIS
Upper extremities is fundamental position
Rotation Left & Right: rotation of head, neck, or
pelvis
Lateral & Medial Rotation: rotation of thigh and
upper arm
Supination & Pronation: rotation of forearm
Reduction of Lateral Rotation, Medial Rotation,
Supination, or Pronation: rotation of segment
back to midposition
FUNDAMENTAL MOVEMENTS
COMBINATION OF PLANES

Circumduction: whole segment describe a

cone arm circling and trunk circling
CLASSIFICATION OF
MOTION
Rotation  Translation
 Ismotion about an  Produces a linear
movement in which all
axis, causing points points in the body travel
on the rotating body the same distance
to travel different regardless of their location
in the body, most
distances depending cartilaginous and fibrous
upon their distance joints allow translation, or
from the point of linear movements.
rotation  Synovial joints allow
rotation and translation
movements
 MUSCULOSKELETAL
FRAMEWORK
 An arrangement of bones, joints, and muscles
 Acting as a combination of levers allows for a
great number of coordinated movements
 An anatomical lever is a bone that engages in
movement when force is applied to it
 The force is from a muscle attached to the bone
or an external force (gravity or weight)
 Muscles can apply force only by shortening
 THE BONES
Skeleton: provides shape, support,
muscle attachment, & protection
Axial: skull, spinal column, sternum

Ribs
Appendicular: upper and

lower extremities and girdles.

 TYPES OF BONES
 Long: shaft or body with a medullary
canal, and relatively broad, knobby ends
Femur, tibia, humerus, ulna, radius, etc.
 Short: relatively small, chunky, solid
Carpals and tarsals
 Flat: flat & plate like
Sternum, scapulae, ribs, pelvis, & patella
 Irregular: bones of spinal column
Vertebrae, sacrum, & coccyx
 MECHANICAL AXIS OF A BONE
A straight line that
connects the midpoint of
the joint at one end of a
bone with the midpoint of
the joint at the other end
The axis may lie outside
the shaft
 SKELETAL CHANGES
 Epiphysis is a part of a bone separated
from the main bone by a layer of cartilage
 Growth occurs at Epiphyseal cartilage.
 When this cartilage ossifies and, closure is
complete, no more growth can occur
 Need to be aware of adolescent type of
epiphyseal injuries
 ARTICULATION
Structure and function of joints are so
interrelated that it is difficult to
discuss the separately
The configuration of the bones that
form an articulation, together with the
reinforcing ligaments which
determine and limit the movements of
the joint
 JOINT
Definition:
Joint is the articulation between
any of rigid component parts of the
skeleton whether bones or cartilage
by different tissues.
Joint is a junction between two or
more bones or cartilages where
movement is possible.
 TYPE OF JOINTS

Plane Hinge Pivot Condyloid

Intercarpal Elbow Atlantoaxial Radiocarpa

Condyloid Saddle Ball & Socket Ball & Socket

MCP joint Thumb Shoulder Hip
 FUNCTIONS OF THE
JOINTS:
1) Allowing movements of body segments by
providing the bones with a mean of moving or
rather of being moved.
2) Providing stability without interfering with the
desired motion.
The function of the joints depends upon:
A. The shape or the contours of the contacting
surfaces.
B. How well it fits together.
FUNCTIONAL
CLASSIFICATION
Based on degree of mobility
Diarthrosis, Amphiarthrosis or
Synarthrosis
Further classified either by shape
or nature of the tissues that
connect the bones
DIARTHROSIS:
CHARACTERISTICS
 Synovial joint,
 cavity with Articular
cartilage
 Ligamentous capsule
 Synovial membrane
Fig 2.4
 Surfaces are smooth
 Surfaces covered with
ligament or tendon
DIARTHROSIS:
CLASSIFICATION
 Irregular joint: irregular surfaces, flat or slightly
curved, permits gliding movement
 Hinge joint: convex/concave surfaces, uniaxial,
permits flexion/extension
 Pivot joint: a peglike pivot, permits rotation

 Condyloid joint: oval or egg-shape convex

surface fits into a reciprocal concave surface,
biaxial, permits flexion/extension, Ab &
adduction, and circumduction
DIARTHROSIS:
CLASSIFICATION
Saddle: modification of condyloid,
both surfaces are convex and
concave, biaxial, permits
flexion/extension, Ab & adduction,
and circumduction
Ball-and-socket: head of one bone fits
into the cup of the other bone
CLASSIFICATION
 Amphiarthrosis
 Cartilaginous joint: united by fibrocartilage
permits bending & twisting motions eg.
Intervertebral discs
 Ligamentous joints: two bodies are tied together
by ligaments, permits limited movement of no
specific type eg. tibia –fibula
 Synarthrosis suture of the skull
 Fibrous joint: edges of bone are united by a thin
layer of fibrous tissue, no movement permitted
 CLASSIFICATION OF SYNOVIAL
JOINTS
Anatomical classification Mechanical Example
Classification
Hinge joint Uniaxial Elbow joint

Pivot joint Uniaxial Atlanto axial joint,

Superior radio-ulnar joint
Codyloid joint Biaxial Knee joint

Saddle joint Biaxial Carpometacarpal joint of

the thumb
Elepsoid joint Triaxial Wrist joint

Ball and socket Triaxial hip joint and shoulder

joint
Gliding joint Nonaxial Midtarsal joints of foot
TERMINOLOGY
 Concave :
hollowed or rounded inward.
 Convex :

curved or rounded outward.

 Congruent:

The surfaces of the joint are equal.

 Incongruent :

The surfaces of the joint are not equal

 JOINT SHAPES
 Ovoid – one surface is convex-male ovoid,
other surface is concave- female ovoid
wrist joint

 Sellar
(saddle) – one surface is concave in
one direction & convex in the other, with
the opposing surface convex & concave
respectively –hip joint
RELATIONSHIP BETWEEN
PHYSIOLOGICAL & ACCESSORY
MOTION
Biomechanics of joint motion
Physiological motion
Result of concentric or eccentric
active muscle contractions
Bones moving about an axis or

through flexion, extension,

abduction, adduction or rotation
Accessory Motion
Motion of articular surfaces relative to
one another
Generally associated with physiological

movement
Necessary for full range of physiological

motion to occur
Ligament & joint capsule involvement is

there in motion
 CONGRUENCE OF ARTICULAR SURFACES

 CLOSE-PACKED POSITION OF THE

JOINT .
The joint position with maximum
contact between the two joint surfaces
and in which the ligaments are taut,
forcing the two bones to act as a single
unit.eg. Elbow and knee- extension
 LOOSE- PACKED POSITION
 It is a least packed position where joint structures are
relax. Eg- knee semiflex position
 Articular surfaces are relatively free to move in relation
to one another.
 Ligaments and capsule are slack.
KINEMATIC CHAIN

 It is a combination of several successively arranged

joints constituting a complex motor system.
 Kinematic chain is when a number of links are united in
series.
 Some of the joints of human body are linked together in
to a series in such a way that motion of one joint in the
series is accompanied by motion of adjacent joint.
BODY LINK SYSTEM AND
KINEMATIC CHAINS:

 Body link system:

 Body link is the distance between joint axes and it unites
joint axes.
 A body link is the central straight link that extends
between two joint axes of rotation. In the case of hands
and feet, the terminal links are considered to extend from
the wrist and ankle joint centers to the center of the mass
of these so- called and members.
 Link systems are interconnected by joints that
predetermine the particular type of motion permitted to
the functional segments.
 The link system is used to make calculations regarding
different body segments in different positions.
THE KINEMATIC CHAIN MAY BE OPEN OR
CLOSED.
 In an open kinematic chain, the
 In a closed kinematic chain, distal segment terminates free in
space to move without causing
the distal segment is fixed and motion at other joint..
the end segments are unite to
form a ring or a circuit.
 Each segment of an open chain
has a characteristic degree of
 When one link moves all the freedom of motion; the distal
other links will move in a possessing a higher degree of
predictable pattern. e.g. the rib freedom than the proximal ones.
cage.  Such linkage system allows the
 Both ends of the chain are degrees of freedom of the many
fixed. joints in the chain to be pooled
giving the segments (particularly
 Motion at one joint will those more distal) greater potential
produce motion of all joint in for achieving a variety of
the link. movements than any one joint
could possibly have on its own.
 e.g. when reaching forward to
pick up a small object from a high
shelf.
 KINEMATIC CHAINS
OPEN CHAIN
CLOSED CHAIN
The distal end terminates free in space.
The distal segment is fixed and

It has a characteristic degree of the terminal joint meets with great

freedom. resistance which restraints its
The distal segments possess higher free motion.
degrees of freedom than the proximal e.g. chinning oneself on horizontal
one. bar or stance phase of gait
Such linkage system allows the degree cycle.
of freedom of many joints in the chain 2) end segments are united to form a
to be pooled giving the segments ring when one link moves, the other
greater potential for achieving a variety links will move in a predictable
of movements than can any one joint
pattern e.g. rib cage
could possibly have on its own
 Walking and ascending and descending stairs are
examples of alternation between open and closed chains
 Open kinematic chains are the most common type in the
human body
JOINT STABILITY

 Secondary functions is to provide stability without

interfering with the desired motions
 All joint do not have the same degree of stability

 Emerson’s law: “For everything that is given, something is

taken”
 Movement is gained at the expense of stability
JOINT STABILITY
 Resistance to displacement
 Factors responsible for stability

1. Ligaments
2. Muscle tension
3. Fascia
4. Atmospheric pressure
5. Bony structure
SHAPE OF BONY STRUCTURE
 May refer to kind of joint
 Hinge, condyloid, or ball-and-socket
 Or specific characteristics of a joint
 Depth of socket
LIGAMENTOUS ARRANGEMENTS
 Ligaments are strong, flexible, stress-resistant, somewhat
elastic, fibrous tissues that form bands or cords
 Help maintain relationship of bones

 Check movement at normal limits of joint

 Resist movements for which joint is not constructed

 Will stretch when subject to prolonged stress

 Once stretched, their function is affected

MUSCULAR
ARRANGEMENT

 Muscle that span joints aid

in stability
 Especially when bony
structure contributes little to Fig 5.13
stability
FASCIA AND SKIN
 Fascia consist of fibrous connective tissue
 May form thin membranes or tough, fibrous sheets

 Intense or prolonged stress may cause permanent stretch

 Iliotibial tract and thick skin covering the knee joint are
examples
ATMOSPHERIC PRESSURE
 Atmospheric pressure pushes on the outside of the joint
with a greater force that the outward pushing force
within the joint cavity
 The suction created is an important factor in resisting
dislocation of a joint
FACTORS AFFECTING JOINT STABILITY
( RESISTANCE TO DISPLACEMENT)
1. Shape of the bony structure: e.g. depth of the acetabulum of the hip joint and
shallowness of the glenoid fossa of the shoulder joint.

2. Ligaments Arrangement: the ligaments attach the ends of the bones that form a
movable joint and help in maintaining them in the right relationship to each
other.They check the movement when it reaches its normal limits and the resist the
movements for which the joint is not constructed, e.g collateral ligament of the
knee. The importance of this factor remains as long as the ligaments remain
undamaged.

3. Fascia: Accordingly to the location and function of the fascia, it may vary from
thin to tough and fibrous membranes.

4. Muscular Arrangement: They play part in the stability of joints especially in those
joints whose bony structure contribute little to stability; e.g. rotator cuff of the
shoulder have strong inwards pull on the humeral head toward the glenoid fossa.

5. Atmospheric Pressure: It plays a role mainly in the hip joint.

 FACTORS AFFECTING RANGE OF
MOTION:
1. Shape of articular surfaces.
2. Restraining effect of the ligaments and muscles crossing the joint as well
as overlying skin.
3. Controlling and restraining action of the muscles e.g. hamstring muscles
tightness when attempting to touch the floor.
4. Body build: Mesomorph and ectomorph have usually a greater flexibility
than endomorph.
5. The bulk of tissue in the adjacent segments.
6. Personal exercise habits.
7. Current state of physical fitness.
8. Age.
9. Heredity.
10. Gender.
11. Occupation.
 N.B.: Apparent range of motion can be affected by the close relationship
that exists between certain joints. E.g. relationship of pelvic tilting to
movement of the hip and relationship of the shoulder girdle articulation
to movement of the shoulder joint
FACTORS AFFECTING ROM
 Shape of articular surfaces
There is several different types of joint in the
human body. Some intrinsically have a greater
range of motion (ROM) than others. The ball and
socket joint of the shoulder for example, has the
greatest range of motion of all the joints and can
move in each of the anatomical planes. Compare
the shoulder joint to the ellipsoidal joint of the
wrist. It moves primarily in the sagittal and
frontal planes.
 Connective Tissue
 Deep connective tissue such as fascia and tendons can limit
ROM. In particular, two characteristics of connective tissue
 elasticity and plasticity are related to ROM. Elasticity is
defined as the ability to return to the original resting length after
a passive stretch .
 Plasticity can be defined as the tendency to assume a new and
greater length after a passive stretch.
 Ligaments do not seem to display any elastic properties.
However, with exposure to stretching they may extend to a new
length which tend to increase mobility in the ligaments reduces
the stability of the joint - often an unfavorable adaptation.
 Type of movement:- Passive ROM is greater than
active ROM
 Body size:- greater body size usually decreases
ROM. BMI may affect ROM
 Age: - ROM and flexibility decreases with age. This
is due, in part to the fibrous connective tissue that
takes the place of muscle fibers through a process
called fibrosis
 Gender: - Females have greater flexibility due to
their hormonal influence and so have greater ROM
compared to males.
 Pregnancy- In pregnancy, due to secretion of
relaxin hormone, range of motion increases,
especially in the pelvic and lumbosacral spine.
This increase in joint and connective tissue
laxity may increase pregnant woman’s
susceptibility to injury.
 Occupational activities:- may increase ROM
due to increased flexibility or decrease ROM due
to repeated trauma on the structures.
 body Asymmetry: People who play asymmetrical
sports, like tennis and baseball, are likely to have
less range of motion in the dominant shoulder or hip
than the nondominant side, although the dominant
side may have more coordination, strength and
stability than the other side.
 This also applies to other daily activities, such as
sweeping, vacuuming, writing and carrying a purse.
Dominant side joints have usually less ROM in
later part of life due to more use and more stress
 Temperature:

Increase in body temperature causes a decrease in muscle stiffness.

Can be environmental temperature or temperature increases induced
by friction of muscle contraction. We therefore tend to be less stiff
around 2.00 in the afternoon.
 Recreational activities and lifestyle may also increase or decrease
ROM.
 Injury or disease to contractile and non-contractile structures may
also affect ROM
 ERRORS IN MEASUREMENT
May affect ROM in the following way:
 Reading wrong side of goniometer

 Tendency to read round-about values (example -

40 degrees instead of 38 degrees)
 Having expectation of what reading “should be”

 Taking measurements at different times of day

 Different therapists, different instruments and

different positions also affect ROM
 Change in patient’s motivation level affect ROM

 Experience of therapist.
 ROM OF THE JOINT SHOULD BE
COMPARED WITH THE SAME JOINT OF
THE INDIVIDUAL’S CONTRALATERAL
SIDE PROVIDING THAT THE
CONTRALATERAL EXTREMITY IS NOT
IMPAIRED OR USED SELECTIVELY IN
SPORTS OR OCCUPATION.
 ROM IN DOMINANT SIDE AS COMPARED
TO CONTRALATERAL SIDE MAY BE LESS IN
SOME CASES DUE TO STRESS.
RANGE OF MUSCLE WORK:

THE EXCURSION OF MUSCLES

(AMOUNT OF SHORTENING OR
LENGTHENING POSSIBLE DURING
CONTRACTION) IS ESTIMATED TO BE
ABOUT 50% OF THE MUSCLE’S
MAXIMUM EXTENDED LENGTH.
THE MAXIMUM EXCURSION
POSSIBLE IS CALLED THE FULL
RANGE.
 RANGE OF MUSCLE
NNER RANGE: IS THE PART NEAREST
I

TO THE POINT AT WHICH THE MUSCLE

IS IN ITS SHORTEST POSITION.
 OUTER RANGE: IS THE PART WHICH IS
NEAREST TO THE POINT AT WHICH THE
MUSCLE IS MOST FULLY EXTENDED.
MIDDLE RANGE: INDICATES THAT THE
MUSCLE IS NEITHER FULLY SHORTENED
NOR FULLY EXTENDED AS IT WORKS.
 FULL RANGE:

 THE JOINT IS MOVED AS THE MUSCLES WORK

FROM THE POSITION IN WHICH THEY ARE
FULLY STRETCHED, TO THE POSITION IN WHICH
THEY ARE FULLY CONTRACTED,
CONCENTRICALLY OR FROM THE POSITION OF
FULL CONTRACTION TO THE POSITION OF
MAXIMUM EXURSION IF THEY ARE WORKING
ECCENTRICALLY.
 UNDER ORDINARY CIRCUMSTANCES MUSCLES
ARE RARELY REQUIRED TO WORK IN FULL
RANGE BUT IN EMERGENCIES THEY MAY HAVE
TO DO SO.
 INNER RANGE:

 THE MUSCLE WORKS EITHER

CONCENTRICALLY FROM THE POSITION IN
WHICH IT IS PARTIALLY CONTRACTED TO A
POSITION OF FULL CONTRACTION OR VICE
VERSA IF IT WORKS ECCENTRICALLY.
 EXERCISE IN INNER RANGE IS USED TO GAIN
OR MAINTAIN MOVEMENT OF A JOINT IN THE
DIRECTION OF THE MUSCLE PULL AND TO
TRAIN SOME EXTENSOR MUSCLES
RESPONCIBLE FOR STABILISING JOINTS.
 OUTER RANGE:

 THE MUSCLES WORK CONCENTRICALLY

FROM THE POSITION IN WHICH THEY
ARE FULLY STRETCHED TO A POSITION
IN WHICH THEY ARE PARTIALLY
CONTRACTED OR VICEVERSA IF
WORKING ECCENTRICALLY.
 THE OUTER RANGE OF MUSCLE WORK IS
USED EXTENSIVELY IN MUSCLE
REEDUCATION AS A CONTRACTION IS
INITIATED MORE EASILY FROM
STRECTH IN MOST MUSCLES.
 MIDDLE RANGE:

 THE MUSCLES ARE NEVER EITHER

FULLY STRETCHED OR FULLY
CONTRACTED. THIS IS THE RANGE IN
WHICH MUSCLES ARE MOST OFTEN
USED IN EVERYDAY LIFE AND IN WHICH
THEY ARE MOST EFFICIENT. EXERCISES
IN THIS RANGE MAINTAIN MUSCLE
TONE AND NORMAL POWER, BUT FULL
JOINT MOVEMENT IS NEVER ACHIEVED.
 LENGTH TENSION
RELATIONSHIP
 Tension refers to force built up within the muscle which
is necessary for a muscle to contract or recoil stretching
releases tension.
 A muscle is capable of shortening approx one half of its
normal resting length position for exercise.
 A muscle can be stretched twice as far as it can be
shortened.
 A muscle that is 6” long can shorten to approx 3” and
stretched 3” beyondits restingposition, so overall length
relation is 9”.
 Excursion is 6”
 The excursion of muscle is therefore the distance from
maximum shortening to maximum elongation.
 For most of the muscles excursion ratio from maximum
elongation to maximum shortening is approx 2:1.
 Usually a muscle has a sufficient excursion to allow full
ROM at a joint. (one joint cross)
 But muscle crosses two joints may not have sufficient
excursion to allow the joint to move through its full ROM.
 The muscle is strongest if put on a slight stretch prior to
contraction.
 e.g. to kick a ball first hip hyperextension to stretch hip
flexors and than contract.
 There is optimum range of a muscle where it contracts effectively.
 As with rubber band a muscle contraction is strongest when it is on
a stretch and loses power quickly as it become shortened.
 Therefore two joint muscles have the advantage, over one joint
muscles for maintaining maximum contractile force through a
greater range.
 This is due to contracting over one joint while being elongated over
other joint.
 e.g. Hamstrings: as you climb the stairs – extension of hip and
flexion of knee.
 Downstairs – hip and knee extension.here muscle is shortened over
hip and elongated over knee. So instead of being actively
insufficient they maintain optimum length tension relationship
throughout the range.
 MUSCLE LENGTH TESTING
 MUSCLE LENGTH IS THE GREATEST
EXTENSIBILITY OF A MUSCLE TENDON UNIT.
IT IS A MAXIMAL DISTANCE BETWEEN
THE PROXIMAL AND THE DISTAL
ATTACHMENTS OF A MUSCLE TO BONE.
 THE PURPOSE OF TESTING MUSCLE LENGTH
IS TO ASCERTAIN WHETHER HYPO MOBILITY
OR HYPER MOBILITY IS CAUSED BY THE
LENGTH OF THE INACTIVE ANTAGONIST
MUSCLE OR OTHER STRUCTURES
. USUALLY ONE JOINT MUSCLE HAS SUFFICIENT
LENGTH TO ALLOW FULL PASSIVE ROM AT THE
JOINT THEY CROSS. IF IT IS SHORTER THERE IS
REDUCTION IN OPPOSITE MOVEMENT AND FIRM
END FEEL OWING TO MUSCLE STRETCH. AT THE
END OF ROM PAIN IN THE REGION OF TIGHT
MUSCLE AND TENDON HELPS TO CONFIRM
MUSCLE TIGHTNESS.
 IF MUSCLE IS ABNORMALLY LAX PASSIVE
TENSION IN CAPSULE AND LIGAMENTS
INITIALLY MAINTAIN A NORMAL RANGE BUT
WITH THE TIME PASSIVE ROM IS INCREASED.
 WALKING
 Walking is a form of locomotion by self propulsion on
feet.
 Reflex action. No conscious control is necessary, if
attention is focused on any part of the gait tension is
likely to develop and natural rhythm and coordination
are disturbed.
 Reflexes control not only the movement of the limbs but
also the extension of both the supporting limbs and the
trunk in resting the downward pull of gravity.
 Thus extension serves to give stability to the body in the
supporting phase of locomotion which provides effective
muscle action to produce necessary movements.
 SYSTEM OF MEASURMENT
 ROM is the arc of motion that occurs at a joint
or a series of joints. The starting position for
measuring all ROM, except rotations in
transverse plane, is the anatomical position.
Three notation systems have been used to define
ROM;
The 0 to 180 degree system

The 180 to 0 degree system

The 360 degree system

 The 0 to 180 degree system
In this system, the upper and lower extremity
joints are at 0 degree for flexion-extension
and abduction-adduction in anatomical
position and extremity joints are halfway
between medial and lateral rotation is 0
degree for rotation ROM. An ROM normally
begins at 0 degree and proceeds in an arc
towards 180 degrees. This system, also called
as neutral zero method.
 widely used through out the world.

 
 THE 180 TO 0 DEGREE
SYSTEM
 defines anatomical position as 180 degree.
An ROM begins at 180 degrees and
proceeds in an arc towards 0 degrees
 E.g.. Extension ROM from shoulder
flexion back to the zero starting position is
not needed to measure as it represent the
same arc of motion in flexion. But
movement available beyond the 0 starting
position must be measured
 THE 360 DEGREE SYSTEM
 It defines anatomical position as 180 degrees. The
motions of flexion and abduction begins at 180 degrees
and proceeds in an arc towards 0 degrees, whereas
motions of extension and adduction begins at 180
degrees and proceeds in an arc towards 360 degrees.
 The 180 to 0 degree notation and the 360 degree
notation system are difficult to interpret and are
infrequently used.
 As measurement results will vary by the degree of
resistance, two levels of range of motion results are
recorded in most cases.
 
 ACTIVE ROM
 is the arc of motion attained by a subject
during unassisted voluntary joint motion.
Active ROM gives idea about the subject’s
willingness to move, co-ordination,
muscle strength and joint ROM.
 . A good screening technique of physical
examination.
 
 If pain occurs during active ROM, it may be
due to contracting or stretching of
“contractile” tissues such as muscles,
tendons and their attachments to bone.
 pain also may be due to stretching or
pinching of non-contractile tissues like
ligaments, joint capsules, bursa, fascia and
skin.
 If active ROM is full without pain and with
ease further testing is not needed.
 PASSIVE ROM
 It is the arc of motion attained by an examiner
without assistance from the subject. The subject
remains relaxed and plays no active role in
producing the motion. Normally passive ROM is
slightly greater than active ROM because each joint
has a small amount of available motion that is not
under voluntary control. The additional passive
ROM (is due to the stretch of tissues surrounding
the joint and the reduced bulk of relaxed muscles)
helps to protect joint structures because it allows
the joint to absorb extrinsic forces.
 Testing passive ROM provides the
examiner with information about the
integrity of articular surfaces and the
extensibility of joint capsule, associated
ligaments, muscles, fascia and skin.
 Unlike active ROM, passive ROM does
not depend on the subject’s muscle
strength and co-ordination.
 Comparisons between active and passive
ROM provides information about the
amount of motion permitted by joint
structure (passive ROM) relative to the
subject’s ability to produce motion at a
joint (active ROM). In cases of
impairement such as muscle weakness,
passive and active ROM varies
considerably.
 The examiner should test passive ROM prior
to test MMT for muscle strength because the
grading of manual muscle tests is based on
completion of AROM.
 If pain occurs during passive ROM, it is often
due to moving, stretching or pinching of non-
contractile structures. Pain occurring at the end
of passive ROM may be due to stretching of
contractile structures as well as non-contractile
structures. Pain during passive ROM is not due
to active shortening of contractile structures.
 By comparing which motions (active versus
passive) cause pain and noting the location
of pain, the examiner can determine which
injured tissues are involved. Having the
subject perform resisted isometric
contractions midway through the ROM, so
that no tissues are stretched, can help to
isolate contractile structures.
 
 END-FEEL:-
 It is the quality of resistance at the end of range.
Each joint has a normal end feel at a normal point in
the range of motion (ROM) .
 joint limitation is due to capsule, ligaments, passive
tension in soft tissues, soft tissue approximation,
contact of joint surfaces.
 The type of structure that limits a ROM has a
characteristic feel. This feeling, which is
experienced by an examiner as a barrier to
further motion at the end of a passive ROM is
called end-feel. There are normal and abnormal
end-feels.
NORMAL END-FEELS:- PHYSIOLOGICAL
 
Hard end-feel occurs when bone contacts bone
and a hard stop to further movement is felt.
 Example – elbow extension where contact between
olecranon process of ulna and olecranon fossa of
humerus limits further motion.
  Soft end-feel occurs when soft tissue approximation
limits further motion.
 Example – knee flexion where approximation
between soft tissues of posterior leg and posterior
thigh limits motion.
 Firm end-feel is of three types;
1.  Muscular stretch end-feel occurs when passive tension
in muscles limits ROM.
 Example – when performing hip flexion with knee
straight, passive elastic tension in hamstring muscles
limits ROM.
2. Capsular stretch end-feel occurs when passive tension
in joint capsule limits ROM.
 Example – when performing extension of MCP joint of
fingers, passive tension in anterior joint capsule limits
ROM.
 3. Ligamentous stretch end-feel occurs when
passive tension in ligaments limits ROM.
 Example – when performing forearm supination,
passive tension in the palmar radioulnar ligament
of inferior radioulnar joint, interroseus
membrane and oblique cord limits further ROM.
  ABNORMAL END- FEELS
Hard pathological end-feel is felt as a sudden bony
block to movement. It may occur in cases like
osteoarthritis, loose bodies in joint, myositis
ossificans, fracture, etc. bony grating or bony block
is felt.
  Soft pathological end-feel is felt as a boggy feeling
which restricts movement. It may occur due to soft
tissue edema or synovitis.
  Firm pathological end-feel occurs due to capsular,
muscular, ligamentous or fascial shortening and is felt
as a springy sensation (hard arrest to movement with
some give).
  Empty end-feel occurs where there is no real end-feel
because pain prevents reaching end of ROM. No resistance
is felt except for patient’s protective muscle splinting or
muscle spasm. It may occur in acute joint inflammation,
bursitis, abscess, psychogenic disorders, fracture etc.
 Springy block end-feel is felt as a sudden rebound to
movement at any time in ROM. It may occur in meniscal
injury.
  Spasm felt as a hard sudden stop to passive movement
accompanied by pain, is indicative of acute arthritis, active
lesion, fracture. But in absence of pain, spasm indicates lesion
of CNS with resultant increased muscular tonus.
 
 HYPO MOBILITY
A decrease in passive ROM of a joint or body
part as may result from an articular surface
dysfunction, inflammation or passive shortening
of joint capsule, ligament, muscle, fascia and
skin. Ortho conditions like arthritis, capsulitis,
spinal disorders, immobilization after fractures,
scar after burns, neurological conditions like
stroke, CP where voluntary movement lost,
increased tone and metabolic condition such as
diabetes associated with limited joint motion.
 
 CAPSULAR PATTERNS OF RESTRICTED
MOTION
 Cyriax has proposed that pathological condition
involving the entire joint capsule cause a particular
pattern of restriction involving all or most of the passive
motion of the joint.
 This pattern of restriction is called a capsular pattern
which involves all or most motion of the joint.
 The restriction do not involve a fixed number of degrees
for each motion, but rather, a fixed proportion of one
motion relative to another motion.
 Capsular pattern varies from joint to joint and is as
follows;
  Glenohumeral joint :- greatest loss of lateral
rotation, moderate loss of abduction, minimal loss
of medial rotation
 Elbow complex :- loss of flexion greater than loss
of extension. Rotation full and painless except in
advanced cases
 Proximal and distal radioulnar joint:- equal loss
of supination and pronation if elbow has marked
restriction of flexion extension
 Wrist joint:- equal loss of flexion and
extension, slight loss of ulnar and radial
deviation
 CMC joint thumb:- loss of abduction
greater than extension
 CMC joint fingers:- equal loss of all
motions
 MCP and IP joints:- equal loss of flexion
and extension
 Hip joint:- greatest loss of medial rotation
and flexion, some loss of abduction, slight
loss of extension, little or no loss of
adduction and lateral rotation
 Knee joint:- loss of flexion greater than
extension
 Ankle joint:- loss of plantar flexion
greater than dorsiflexion
 Subtalar joint:- loss of inversion
 Midtarsal joint:- loss of inversion, other
motion full
 MTP joint great toe:- loss of extension
greater than flexion
 MTP joint toes:- loss of flexion greater
than extension
 IP joint toes:- loss of extension greater
than flexion
 TM joint :- limitation of mouth opening
 Atlantooccipetal joint: - Extension and
side flexion equally limited
NON- CAPSULAR PATTERNS OF RESTRICTED
MOTION

 Non capsular pattern involves only

one or two motions of the joint. The
loss or restriction of ROM may be
due to loss of the extensibility of
contractile structures or dysfunction
with it or any surrounding structures
which may be intraarticular or extra
articular.
 Intra-articular Extra-articular
 Synovial membrane Skin
 Intra-articular ligament Muscle
 Articular cartilage Ligaments
 Synovial fluid Bursa
Capsule
Bone
Tendon
 Skin:-
 Clinical conditions like burns, skin grafting, incision, tendon
graft, etc cause adhesion and scar tissue formation which restricts
mobility of adjacent tissues and lead to insufficient force
transmission causing restriction to ROM. It can be corrected by
friction massage, kneading, stretching and ultrasound application.


 Muscle:-
 Clinical conditions like strain, trauma, surgery and
prolonged immobilization cause adhesion, muscle fatigue, spasm
and myositis ossificans resulting in restricted ROM. It can be
corrected by stretching and strengthening of muscle and hold-
relax PNF technique.
 
 Ligaments:

Clinical condition affecting ligaments like sprain cause

instability and laxity of joint and restrict ROM. It can
be corrected by tapping, ultrasound application and
PRICE protocol (P = positioning, R = rest, I = icing, C
= compression and E = elevation).
  Bursa:

Clinical conditions like bursitis (subacromial bursitis,

popliteal bursitis, etc.) cause pain and stiffness and
result in restricted ROM. Correction can be done with
postural advice, exercise and ultrasound application.
 Capsule:
Capsulitis cause adhesion formation and result in
restricted ROM. Correction can be done by PRICE
protocol, ultrasound application, relaxed passive
stretching and muscle strengthening.
  Tendon:

Clinical conditions like tendon rupture, tendonitis,

tendenosis, tenosynovitis, etc cause pain and loss of
movement and result in restricted ROM. Friction
massage, kneading and ultrasound can correct it.
 
 Bone:

Fracture, congenital deformity,

osteoporosis, osteopenia, etc result in
restricted ROM.
  Synovial membrane:

Synovitis results in effusion and restricts

ROM. Correction can be done by
elevation, compression and efflurage.
 Joint Structure
There are several different types of joint in the human
body. Some intrinsically have a greater range of motion
(ROM) than others. The ball and socket joint of the
shoulder for example, has the greatest range of motion of
all the joints and can move in each of the anatomical
planes .
 Compare the shoulder joint to the ellipsoidal joint of the
wrist. It moves primarily in the sagittal and frontal
planes.
 Hyper mobility:
 An increase in passive ROM that exceeds
normal values for that joint.
 It is due to laxity of soft tissues such as
ligaments, capsules and muscles which
normally prevent excess motion,
abnormality of joint surface, truma,
hereditary disorders like RA, downs
syndrome- hypotonia .
 
 TWO JOINT MUSCLES:
 PASSIVE INSUFFICIENCY AND ACTIVE
INSUFFICIENCY
 PRINCIPLES OF GONIOMETRY
 Explanation and Instruction to the patient regarding
the procedure. 
 Positioning:-

 Positioning affects the amount of passive tension in soft

tissue structures surrounding the joint, if they are taut
than ROM measurement would be inaccurate. So testing
position should be such that;
 It places the joint in 0 degrees of starting position
 It permits full ROM
 It provides stabilization for the proximal joint
segment. 
 Use same position during successive
measurements of joint ROM.
 If testing position can not be attained due to
restriction alternate position must be create and
describe in patient’s subjective record for all
subsequent measurements.
 Joint being measured should be exposed
whenever possible to find bony land marks and
also for clothes do not restrict the motion.
 Therapist should be in walk-standing or
comfortable position.
 Stabilization:-

 Testing position helps to stabilize the

subject’s body and proximal joint segment so
that motion can be isolated to the joint being
examined. Isolating the motion to one joint helps
to ensure that true measurement of motion is
obtained rather than a measurement of combined
motions that occur at a series of joints. Positional
stabilization may be supplemented by manual
stabilization wherever required.
Poor Stabilization for Elbow Extension
 Determining End-feel:-
 Therapist performs passive movement and
examines the end-feel present
 Demonstrate movement:-

 Show the patient the movement to perform

if you need active ROM or ask patient to relax
when you want passive ROM. Move a body part
through the appropriate ROM.
 Visual Observation:-
 Asking the patient to perform the movement
actively gives information about the patient’s
problem and helps in laying down an assessment
plan.
 Palpation:-

 Palpation of the patient’s body surface helps

to find out bony landmarks for goniometer
placement. Well defined anatomical landmarks
give accuracy. If soft tissues are more around joint
area error can be frequent.
 Goniometer Alignment:- use bony land marks
 Stationary arm is aligned parallel to the longitudinal axis of
proximal segment of body.
 Moving arm aligned parallel to the longitudinal axis of distal
segment of body.
 Fulcrum of goniometer placed over the approximate location of
the axis of motion of the joint being measured.
 Because the axis of motion changes during movement, careful
alignment of proximal and distal arms ensures that the fulcrum of
goniometer is located at the approximate axis of motion.
 When aligning the arms and reading the scale of the goniometer
the examiner must be at eye level with the goniometer to avoid
parallax.
 Recording:-

 Asking the patient to perform the

movement, measure and record the ROM
correctly. Measurements are recorded in numerical
tables, pictorial charts or written text form of
evaluation. Recording should provide enough
information to permit an accurate interpretation of
measurement.
 Comparison:-

 Movement of the other limb should be

measured for comparison.
 . RECORDING INCLUDES

 Name, age, gender

 Examiners name
 Date and time of measurement
 Make and type of goniometer used
 Side of body, joint and motion measured
 ROM- range in degrees with beginning and end of the
motion
 Type of motion- active or passive
 Subjective information – pain during test
 Objective information – during test – spasm, crepitus
 Deviation in position recommended for test
 NUMERICAL TABLES
 It typically list joint motion in a column down the center
of the form. Space to the left from the center is for left
side of the body, space to the right is for right side of the
body.
 Patient’s name, age and sex are noted at the top.

 examiners initial name and date of the testing are noted

at top of the measurement column.
 Subsequent measurements are recorded on the same
form and identified by examiner’s initial and date at the
top of appropriate column.
 Easy to compare a series of measurement to identify
progress of motion and effectiveness of treatment.
NAME: AGE: GENDER
LEFT RIGHT
BD BD examiner BD

30/6/14 23/6/14 date 23/6/14

elbow

0-140 0-120 flexion 15-0-100

0 0 extension 0- 15
 PICTORIAL CHARTS
 It may be used in isolation or combination
with numerical tables to record ROM.
Measurements.
 Usually includes diagram of the normal
starting and ending positions of the
motion.
 SAGITTAL- FRONTAL- TRANSVERSE-
ROTATION METHOD
 It is a written text method SFTR method.
 First and last number indicates the end point of range in a given
plane. Middle number indicates starting position which would
be 0 in normal motion.
 In sagittal plane represented S , first number indicates extension
ROM, the middle – starting position and last –flexion ROM.
 In frontal plane represents F, first number indicates abduction
ROM, the middle – starting position and last –adduction ROM.
 In transverse plane T first number indicates end of horizontal
abduction ROM, the middle – starting position and last –end of
horizontal adduction ROM.
 Rotation is represented by R
 Lateral rotation, eversion and supination recorded first.

 Medial rotation, inversion and pronation last.

 Spinal rotation to the left is first and last is to the right.

 Limb position is notified by angle, if alter from

anatomical position, eg F90 indicates movement
measured with limb in 90 degee of flexion
 Sometimes measured as –ve or +ve value when
hypomobility or hypermobility is present.
 Areas Commonly Tested for Range of Motion
 Range of motion is commonly tested in the
cervical spine, thoracic spine, lumbar spine the
upper and lower extremities. The measured
degrees are compared with the expected norm
and also from a healthy joint with an injured
joint. After a treatment series, range of motion is
tested again for functional improvement in the
care plan.
  
 Documentation
 ROM provides objective, reproducible outcome measurements.
 Documentation helps to determine the effectiveness and progression
of treatment.
 It can promote continuous patient care between practitioners when a
patient is seeing by two different practitioners or interns for the
same condition, such as shoulder pain.
 Proper ROM documentation needs to include date, joint
measured, active or passive movement, types of ROM (flex, extend,
etc.), testing position, equipment used, and the range measurement.
METHODS : ASSESSING A JOINT’S
ROM
 Measure degrees from starting position to its maximal
movement.
 Most accurate techniques are arthrographs, radiographic
images, photographs and video. But are expensive, complex
equipment and required extensive training.
 Goniometer is a device used to measure joint angle or ROM
either AROM or PROM.
 Easily available, cheaper.
METHODS OF ASSESSING A JOINT’S RANGE OF
MOTION

 Film or Videotape: joint

centers are marked to be
visible in projected
image Fig 2-7
 Joint angles can be
taken from images
 Segment action must
occur in picture plane
 ANALYZING JOINT MOTIONS
Alignment: optimum alignment
should be based on efficiency,
effectiveness, and safety while
measuring of angles created by the
bones of the body at the joints.
These joints are measured by a
goniometer.
 purpose: the aim of this test is to measure the
flexibility of a joint, which is important for
injury prevention, planning for exercises and
execution of many sporting movements.
 procedure: To measure the range of motion at a
joint, the center of the goniometer is positioned
at the axis of rotation of a joint, and the arms of
the goniometer are aligned with the long axis of
the bones of the adjacent segments or to an
external reference.
 scoring: The measurement is the angle in
degrees as read off the goniometer.
 disadvantages: It is sometimes difficult to
position and maintain the arms of the
goniometer along the bones of the
segments throughout the measurement,
and the axis of rotation is not always clear,
especially for complex joints.
 SUMMARY OF PROCEDURE
 Determine which joint and motion is tested accordingly Organize testing
sequence by body position- supine, prone, sitting etc.
 Collect necessary instrument- goniometer, towel rolls, pillows. Marker
pen, recording forms.
 Explain procedure to the patient.
 Place the patient in testing position.
 Stabilize proximal part of the body.
 Move the distal segment from zero starting position to the end of ROM
passively to detect end feel. Return to the 0 position.
 Palpate bony landmarks.
 Align goniometer.
 Read and record starting position.
 Move the distal segment through full ROM.
 Repeat for the same.
EXPLANATION OF PROCEDURE
 Introduce yourself and explain purpose of
test
 Explain and demonstrate goniometer
 Explain and demonstrate bony landmarks.
 Explain about testing positions
 Explain role of patient and therapist
during active and passive motion.
 Confirm that patient understand your
explanation
 UNIVERSAL GONIOMETER
 Itis the most commonly used instrument to
measure joint position and motion in clinical
setting. It is called universal because of its
versatility to measure joint position and ROM of
almost all joints of body.
 Universal goniometers are constructed of metal
or Plastic and of various size and shapes and
typically include a body and two thin extensions
called arms – a stationary arm and movable arm.
A body of a universal goniometer
resembles a protractor and may form a
half circle or a full circle. The scales on a
half circle goniometer read from o to 180
degree and 180 to 0 degree. The scales on
a full circle goniometer may read either
from 0 t0 180 degrees and 180 to 0
degrees or from 0 to 360 degrees and 360
to 0 degrees.
 The stationary arm (proximal arm) is a
structural part of the body of goniometer
and cannot be moved independently from
the body. The stationary arm is placed
parallel to the proximal stationary part of
the joint being measured whereas movable
arm is placed parallel to distal moving part
of the joint bring measured. Fulcrum
(axis) is placed on a fixed point near the
joint.
 The moving arm (distal arm) is attached to the center
of the body of most plastic goniometers by a rivet that
permits the arm to move freely on the body. In some
metal goniometers, a screw-like device (thumb knob) is
used to attach the moving arm. Often the screw-like
device may be tightened to hold the moving arm in a
certain position or loosened to allow free movements.
The moving arm may have one of the following features:
a pointed end, a black or white line extending the length
of the arm or a cut-out portion (window). The length of
arm varies among instruments from approximately 1 to
14 inches.
  
GRAVITY DEPENDENT
GONIOMETER- INCLINOMETER
 Inclinometers use gravity’s effect on pointers and fluid levels to
measure joint position and motion.
 A pendulum goniometer consists of a 360 degree protractor
with a weighted pointer hanging from the center of the
protractor. This device was first described by Fox and Van
Breemen in 1934.
 The fluid (bubble) goniometer, which was developed by
Schenkar in 1956, has a fluid-filled circular chamber containing
an air bubble. It is contains a 360 degree scale.
 Inclinometers are attached to or held to the distal segment of the
joint being measured. The angle between the long axis of distal
segment and line of gravity is noted.
 Inclinometers may be easier to use in
certain situations than universal
goniometers because they do not have to
be aligned with bony landmarks or
centered over the axis of motion.
Inclinometers are difficult to use on small
joints and in conditions of soft tissue
deformity or edema.
 
 ELECTROGONIOMETER
 Electrogoniometers, introduced by Karpovich
and Karpovich in 1959, are used primarily in
research to obtain dynamic joint measurements.
Most device have two arms, similar to those of
universal goniometer, which are attached to the
proximal and distal segments of the joint being
measured. A potentiometer is connected to the
two arms. Changes in joint position cause the
resistance in the potentiometer to vary. The
resulting change in voltage can be used to
indicate the amount of joint motion.
 Electrogoniometers are expensive and
take time to calibrate accurately and
attached to the subject. Given this
drawbacks, electrogoniometers are used
more often in research then in clinical
settings.
 
ELECTROGONIOMETER
MECHANICAL GONIOMETER
WALL GONIOMETER
DIGITAL GONIOMETER
EXTENDED ARM GONIOMETER
OBJECTIVES
1. Classify joints according to structure, and explain the
relationship between a joint structure and its capacity
for movement
2. Name the factors that contribute to joint range of
motion and stability, and explain the relationship that
exists between range of motion and stability
3. Assess a joint’s range of motion, evaluate the range, and
describe desirable procedures for changing it when
indicated
OBJECTIVES
5. Name and define the orientation positions and planes of
the body and the axes of motion
6. Demonstrate and name fundamental movement patterns
using correct movement terminology
7. Isolate and name single joint actions that are part of
complex movements
8. Perform an anatomical analysis of the joint actions and
planes of motion for a selected motor skill
What is goniometry ?
Importance of goniometry ?
Normal Ranges of the joints ?
What is AROM & PROM ?
What is degree of freedom ?
REFERENCES
KINESIOLOGY- Scientific Basis of Human Motion, 10th edition
Luttgens & Hamilton
Measurement of joint motion- a guide to goniometry 1ft indian
edition, 2011 by cynthia norkin and white