Goniometry
Hypomobility can occur from: a) tight joint capsule b) tight ligaments around a joint c) too much muscle tone d) capsular pattern of loss
All of the above
T or F: Using + or - in documenting ROM is only okay if a patient is substantially lacking/overachieving in a joint.
False - do NOT use pluses or minuses when documenting ROM
T or F: Goniometers usually measure active ROM.
False - passive ROM
How to document the following: Patient has 115 degrees of right hip flexion.
Hip flexion 0-115
How to document the following: Patient has knee flexion and extension ROM of 130 degrees.
Knee ROM 0-130
The _____________ of the goniometer lines up with the distal segment and moves through the joint ROM.
Moving Arm
Elbow extension represents a _________ end-feel because the olecranon process juts into the olecranon fossa, limiting the end-range of motion. a) Soft b) Medium c) Firm d) Hard
d) Hard
____________ type of end-feel is when bone-to-bone contact limits the motion of the joint. a) Soft b) Medium c) Firm d) Hard
d) Hard
When pain stops the ROM from occurring, this is a __________ end-feel. a) abnormal soft b) abnormal firm c) abnormal hard d) empty
d) empty
When taking ROM measurements, you want to always have the patient start in a _______________ position. a) relaxed b) extended c) flexed d) neutral/anatomical
d) neutral/anatomical
Which of the following is important to document with ROM? a) subjective info - ex: pain b) objective info - ex: end-feel c) number of degrees at beginning and end of motion d) position if not considered standard e) all of the above
e) all of the above
Which of the following is NOT true about using goniometry to determine ROM in a patient's joint? a) helps us "sell" PT to a patient b) helps determine impairments c) helps motivate individuals d) shows insurance companies the progress made in their patients e) de-motivates patients who don't make progress f) used diagnostically in PT plan of care
e) de-motivates patients who don't make progress
List the steps of the procedure for positioning a patient prior to ROM measurements.
1) Ensure patient comfort, safety, and stable position. 2) Place the joint in the starting position of 0 degrees. 3) Permit complete and unobstructed motion of the joint. 4) Provide stabilization for proximal joint segment.
List the correct order of Testing Procedure: - stabilize - visual estimate - find landmarks - PROM - record end - zero start - position - align and record start - visual estimate - PROM - end-feel
1) Position 2) Stabilize 3) Zero start 4) PROM - end-feel 5) Visual estimate 6) Return to zero 7) Find landmarks 8) Align and record start 9) PROM - record end
__________ end-feels are any time that an end-feel feels different than expected.
Abnormal end-feels
How to document: Patient has 10 degrees elbow hyperextension and 150 degrees elbow flexion.
Elbow ROM 10-0-150
____________ is the way the joint motion feels to the examiner when applying passive ROM to the joint at end-range.
End-Feels
T or F: When documenting ROM, it is only necessary to document the ending position so the PT after you will know where you left off.
FALSE - important to write the beginning AND ending positions!!!!
T or F: Women typically have less ROM in their joints compared to men.
FALSE - women have more ROM than men
Stabilization when taking ROM measurements is important because
Patients will try to cheat to get to correct ROM!!!
_____________ is an arc of motion taken in degrees that is a range from the beginning to the end of motion.
ROM
The __________ of the goniometer lines up with the proximal segment and does not move.
Stationary Arm
T or F: Goniometers measure passive ROM - when muscles aren't contracting - which allows the PT to compare what the patient can do actively to what can be done to the joint by someone (passively).
True
T or F: Inclinometers are apps on most phones now.
True
T or F: Muscle length-tension affects ROM.
True
T or F: ROM has a very large role in evaluation, letting us know if the joint is moving properly or not and where pathologies may lie.
True
T or F: The goniometer is decently reliable at measuring ROM in joints.
True
T or F: Younger adults have more ROM in their joints than older.
True
T or F: It is important to always record the ENTIRE range of motion.
True!!!!
T or F: The position a patient is in while the PT takes ROM measurements can affect the results.
True!!!! ALWAYS consider the patient's positioning!!!
_________ ROM tells us about a patient's willingness or ability to move. a) Active b) Active Assisted c) Passive
a) Active
__________ are most commonly used on the spine. a) inclinometers b) universal goniometers c) rulers
a) Inclinometers
Which of the following represent the 5 things to know when performing ROM testing? SELECT ALL THAT APPLY. a) Positioning b) Using a standard procedure c) Stabilization d) Measurement instruments e) Patient limitations f) Documenting ROM
a) Positioning b) Using a standard procedure c) Stabilization d) Measuring instruments f) Documenting ROM
Elbow flexion represents a _________ end-feel because the forearm muscles will run into the biceps, limiting the end-range of motion. a) Soft b) Medium c) Firm d) Hard
a) Soft
____________ type of end-feel is when the ROM of the joint is limited by soft-tissue approximation. a) Soft b) Medium c) Firm d) Hard
a) Soft
A joint or tissues around a joint that are swollen represent a ___________ end-feel. a) abnormal soft b) abnormal firm c) abnormal hard d) empty
a) abnormal soft
What are 3 things to consider before checking a patient's ROM in a joint?? Select all that apply. a) check for precautions/contraindications b) prepare individual for testing c) explain the procedure d) properly examine patient
a) check for precautions - ex: new fracture b) prepare individual for testing - appropriate draping - explain where you will touch/stabilize - explain what the goniometer is measuring c) explain the procedure
Hypermobility can occur from: a) numerous sprains b) lax capsules c) heighted Beighton criteria d) too much activity
a) numerous sprains c) heightened Beighton criteria
Which type of end-feel: Elbow Flexion - sitting a) Soft b) Firm c) Hard
a) soft
Which type of end-feel: Knee Flexion - supine a) Soft b) Firm c) Hard
a) soft
Which type of end-feel: hip flexion w/ knee flexion - supine a) Soft b) Firm c) Hard
a) soft
Standard Error of goniometer in upper extremities - a) 2 b) 5 c) 10 d) 15
b) 5
__________ ROM is the active voluntary contraction of muscles producing motion but also an external force that is being applied by a machine, therapist, or the patient. a) Active b) Active Assisted c) Passive
b) Active Assisted
Which of the following is not a type of "Normal End-Feel"? a) Soft b) Medium c) Firm d) Hard
b) Medium
Patient X presents with limited active ROM in their thoracic spine but is fine when the PT checks passive ROM. What does this imply? a) Patient is weak and needs strengthening exercises in upper back b) Patient has pain upon contracting their muscles actively c) Patient has motor control deficit in T-spine d) Patient has defective T-spine joints and needs to see a specialist
b) Patient has pain upon contracting their muscles actively OR c) Patient has motor control deficit in T-spine
______________ are instruments used for bigger joints, such as the hip, knee, shoulder, and elbow. a) inclinometers b) universal goniometers c) rulers
b) Universal goniometers
A tight capsule or tight muscle that shouldn't be tight represents a _________ end-feel. a) abnormal soft b) abnormal firm c) abnormal hard d) empty
b) abnormal firm
Which of the following is not an abnormal end-feel? a) abnormal soft b) abnormal medium c) abnormal firm d) abnormal hard e) empty
b) abnormal medium
What is this an example of: Patient X has been diagnosed with adhesive capsulitis, exhibiting - - greatest limitation in E.R. - significant limitation in adduction - mild limitation in I.R. a) hypomobility b) capsular pattern of loss c) hypermobility d) adhesive constrictions
b) capsular pattern of loss
When documenting ROM, you typically write the _____________ ROM first, then if they achieved neutral, and then ___________ ROM. a) flexion - neutral - extension b) extension - neutral - flexion
b) extension - neutral - flexion
Which type of end-feel: Ankle dorsiflexion - supine a) Soft b) Firm c) Hard
b) firm
Which type of end-feel: Hip flexion w/ knee extension - supine a) Soft b) Firm c) Hard
b) firm
Which type of end-feel: Knee Flexion - prone a) Soft b) Firm c) Hard
b) firm
Which type of end-feel: MCP Extension - sitting a) Soft b) Firm c) Hard
b) firm
Goniometry is a(n) ____________ measure on the osteokinematics of joints. a) subjective b) objective c) absolute d) direct
b) objective
Standard Error of goniometer in lower extremities - a) 2 b) 5 c) 10 d) 15
c) 10
What is the standard error of a goniometer? a) 1-5 b) 2-6 c) 5-10 d) 10-15
c) 5-10 standard error
____________ type of end-feel is the feeling of some type of capsular limitation at the joint, ligaments, or muscle tone that limits the motion. a) Soft b) Medium c) Firm d) Hard
c) Firm
__________ ROM is when motion is being produced by an external force only. a) Active b) Active Assisted c) Passive
c) Passive
Patient Z presents with normal active ROM in their glenohumeral joint flexion ROM but is limited in passive ROM. What might this imply? a) Patient is weak and needs strengthening exercises b) Patient has pain upon contracting their muscles actively c) Patient has motor control deficit in GH joint d) Patient has a GH joint issue that needs to be addressed
c) Patient has motor control deficit in GH joint
A grating or crepitus bony feeling in a joint represents a __________ end-feel. a) abnormal soft b) abnormal firm c) abnormal hard d) empty
c) abnormal hard
Which type of end-feel: Elbow Extension - sitting a) Soft b) Firm c) Hard
c) hard
Limited AROM and PROM - a) joint issue b) strength issue c) motor control issue d) mobility issue
c) motor control issue d) mobility issue
Limited passive ROM and normal active ROM - a) joint issue b) strength issue c) motor control issue
c) motor control/stability issue
Which of the following is important to document with ROM? SELECT ALL THAT APPLY. a) PROM only b) AROM only c) side of body d) joint and motion being examined e) PROM, AROM, and AAROM
c) side of body d) joint and motion being examined e) PROM, AROM, AAROM
The __________ of the goniometer goes over the approximate axis of rotation of each joint.
fulcrum
The _____________ is the middle circle on a goniometer.
fulcrum