Goniometry PPT 1

4 types of ROM? which are for assessment and which for treatment

Active Range of Motion (AROM) assessment and treating Active Assistive Range of Motion (AAROM) treatment Passive Range of Motion (PROM) assessment and treatment Active Resistive Range of Motion (ARROM) treatment

What does AAOS stand for

American Academy of Orthopedic Surgeons

Gonio Def? metron Def? Goniometry Def?

Gonio=angles metron= measure Goniometry= measure of joint angles

Convex/Concave Rule

depending on the joint surface shape the bone will slide or glide in a certain way Convex moving on Concave: the glide will occur opposite that of the osteokinematic motion (osteokinematic direction opposite that of the arthrokinematic motion) Concave on Convex: the glide will occur in the same direction of osteokinematic motion (osteokinematic and arthrokinematic motion same)

Arthrokinematics how are Osteokinematics and Arthrokinematics related?

describes motion that occurs b/w joint surfaces need to have both to have normal movement and function at the joint (if one is dysfunctional the other is dysfunctional

An instrument used to measure precise joint angles providing digital reading of angle

digital goniometer

6 Important Components of Goniometry?

1) Anatomy (joints, bones, body planes and axis) 2) Osteokinematics 3) Accuracy of the goniometer and measurer 4) Types of ROM 5) Normal ROM values 6) Joint end feels

8 steps of the goniometry procedure?

1) know what measure you want to get 2) position the patient (comfort and accuracy) 3) have patient / help patient go through the ROM/ tell patient what you are doing 4) align goniometer 5) instruct patient properly 6) record start position 7) record end position 8) interpret measures/ROM

List 6 abnormal end feels? When do end feels occur?

1)springy (Meniscal tear tissue block) 2)Empty (Pain cannot get to barrier) 3)Bone on Bone (Osteophytes) 4) Capsular Firm (Synovitis, joint edema) 5) Capsular Hard (frozen shoulder/true tissue constriction 6)spasm (muscle strain, joint instability , can be due to pain or protective at end range or can occur throughout the range of motion as well

What are the planes together called? How many? What are they individually called What is an axis? How many

3 Cardinal Planes (Frontal, Saggital, Transverse) Axis= point/ line in which something rotates 3 axis of rotation

What 3 things do you look at when interpreting joint ROM?

AAOS norms end feels patient response

What ROM do you test first in the assessment?

AROM and then move on to passive if needed but do not have to do passive if active cleared unless you are looking for end feels

Another name for the frontal plane? What is frontal plane?

Coronal plane= divides the body from side to side into anterior and posterior halves

5 health care professionals that use goniometry? What profession can measure goniometry but are not qualified to interpret it? What do scientists use goniometry for?

PT, OT, physicians, athletic trainers, chiropractors PTAs crystallography, measure surface angles, light angles

What are the axis of rotation with their corresponding plane? What is the movement that occurs at each axis/plane? How many vertical and how many horizontal axis?

Saggital= Frontal axis (flexion/extension) Frontal = Saggital axis (ab/ad) Transverse= Vertical axis (IR/ER) 2 horizontal (frontal and sagittal) and 1 horizontal (vertical)

Plane that divides the body anterior to posterior and divides the body into left and right halves?

Sagittal plane

What is the purpose of using goniometry?

To see if osteokinematics (movement of bones at their joints) are normal. If abnormal... establish a baseline for movement determine appropriate intervention document progress

What is the importance of positioning the patient appropriately?

accuracy of measure patient comfort

3 parts of a goniometer

axis stationary arm moveable arm

What do you have the patient do before you take a measure?

have them go through the motion themselves and explain what you are going to do

An instrument that measures the slope or tilt of an object with respect to gravity

inclinometer

What is the expected error of measure for using a goniometer for both interrupter and intrarater

intrarater (1 person measuring)=2-3 degrees interrater (2 people measuring)=5-6 degrees

Do you want to use the samllest possible size goniometer for the joint or the largest possible goniometer?

largest for that particular joint

Osteokinematics How is it measured?

motion of bones relative to the 3 planes of the body Goniometer

What is the gold standard for osteokinematic measure? What is comparable to that gold standard?

radiograph=gold standard goniometry is comparable

AAOS values shoulder (flexion, extension, abduction, medial rot, lateral rot) elbow (flexion, extension, supination, pronation) wrist (flexion, extension, ulnar dev, radial dev)

shoulder: flexion 180 extension 60 abduction 180 medial rot 70 lateral rot 90 elbow: flexion 150 extension180 pronation 80 supination 80 wrist flexion 80 extension 70 radial dev 20 ulnar dev 30

6 Different End feels and examples of each?

soft=knee hard=elbow muscular= stretching hamstring ligamentous= forearm supination capsular=PIP extension firm=?

2 types of goniometers?

standard/universal digital

Why is anatomy important in Goniometry?

standardization among clinicians....use bony land marks for measure

perpendicular plane to coronal and sagittal plane. divides the body into top and bottom

transverse plane

Axis that goes..... top to bottom? front to back ( anterior to posterior)? left to right (medial to lateral)

vertical axis sagittal axis frontal axis