Transcript Goniometric Assessment

Goniometric
Assessment
Joints
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NASM only chose a select number of joints to be measured
Foot
 Dorisflexion
Hip
 Flexion (Bent knee and 90/90 position)
 Internal Rotation
 External Rotation
 Extension
 Abduction
Shoulder
 Flexion
 External Rotation
 Internal Rotation
Measurements were selected because of their overall importance to
optimum human movement as well as their ability to correlate to
the overhead squat and single movement assessment.
The Foot
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Joint motion being assessed
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Muscles being assessed
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Gastrocnemius and soleus
Posterior tibialis, peroneus longus, flexor hallicus longus, and flexor
digitorum longus.
Antagonists potentially underactive if ROM is limited
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Dorsiflexion of talocrural joint
Anterior tibialis
Extensor digitorum longus, extensor digitorum brevis, extensor hallicus
longus and peroneus tertius.
Normal Value- 20o
Client Positioning
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Supine with Knee extended
Ankle is subtalar neutral
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Placement of Goniometer
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Pressure
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Axis (A)- Directly below the lateral mallelous near the base
Stationary Arm (SA) – Lateral aspect of fibula
Movement Arm- (MA) Midline of 5th metatarsal.
Hold planter surface of foot right below MTP joints
Client/Patient actively DF while you are passively assisting the glide of
motion
Compensation during Goniometer Assessment
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Everson of the ankle
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Flexing of the knee
Over Head Squat/ Single Leg Squat
Foot compensations ( feet going outward
Flattening and/or heels rising)
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Excessive forward leaning
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A lack of DF in the ankle has been know
to lead to knee injuries.
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Hip Flexion
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Joint motion being assessed
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Muscles being assessed
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Extension of the tibiofemoral joint
Flexion of iliofemoral joint
Hamstrings, Gastrocnemius, neural tissue (sciatic nerve)
Antagonists potentially underactive if ROM is limited
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Hip flexor complex
Quadriceps complex
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Normal Value- 20o
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Client Positioning
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Supine with Hip flexed and knee flexed to 90o
Hip is in neutral (0o rotation, abduction and adduction)
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Placement of Goniometer
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Pressure
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Hold lower leg and thigh of client
Passively extend the knee until first compensations
Compensation during Goniometer Assessment
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Axis (A)- lateral joint line of the tibiofemoral joint
Stationary Arm (SA) – Lateral midline of femur
Movement Arm (MA)- lateral midline of fibula
Posterior tilting of the pelvis
Hip extension
Over Head Squat/ Single Leg Squat
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Feet turned out (External rotated)
Feet flattening
Knee moving inward or outward
Low back rounding
Hip Flexion (Bent Knee)
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Joint motion being assessed
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Muscles being assessed
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Flexion of iliofemoral joint
Gluteus maximus, adductor magnus, upper portion of hamstrings
Psoas, rectus femoris, hip capsule.
Antagonists potentially underactive if ROM is limited
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Hip flexor complex
Hip extensor complex (gluteus maximus)
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Normal Value- 120o
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Client Positioning
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Supine with knee flexed
Hip is in neutral (0o rotation, abduction and adduction)
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Placement of Goniometer
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Pressure
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Hold clients knee
Passively flex the hip until first compensation.
Compensation during Goniometer Assessment
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Axis (A)- Great trochanter
Stationary Arm (SA) – Lateral midline of pelvis
Movement Arm (MA)- lateral midline of femur
Posterior tilting of the pelvis
Adbuction of the femur
Over Head Squat/ Single Leg Squat
 Rounding of the lower back
Hip (Internal Rotation)
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Joint motion being assessed
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Muscles being assessed
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Internal rotation of iliofemoral joint
Piriformis and hip external rotators and adductor magnus, ischiofemoral
ligaments
Gluteus medius, gluteus maximus
Antagonists potentially underactive if ROM is limited
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Adductor magnus, TFL, gluteus minimus, glutues medius, adductor
longus, adductor brevis, pectineus, gracilis, medial hamstrings.
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Normal Value- 45o
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Client Positioning
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Supine with Hip flexed and knee flexed to 90o
0o of abduction and adduction
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Placement of Goniometer
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Pressure
 Hold lower leg and thigh of client
 Passively rotate the femur internally until first compensation
Compensation during Goniometer Assessment
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Axis (A)- Anterior aspect of patella
Stationary Arm (SA) – parallel to imaginary line down the center of the
body
Movement Arm (MA)- Anterior midline of the lower leg (referencing the
tibial tuberosity).
Hip hike ( lateral flexion of spine) on side of measurement
Over Head Squat/ Single Leg Squat
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Knee moving inward or outward
Asymmetrical weight shift
The Hip (External Rotation)
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Joint motion being assessed
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Muscles being assessed
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External rotation of iliofemoral joint
Adductor magnus, iliofemoral ligament, and pubofemoral ligament
TFL, gluteus minimus, and gluteus medius
Antagonists potentially underactive if ROM is limited
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Piriformis and hip external rotators and adductor magnus
Gluteus medius and gluteus maximus.
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Normal Value- 45o
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Client Positioning
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Supine with hip and knee flexed to 90o
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Placement of Goniometer
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Pressure
 Hold lower leg and thigh of client
 Passively rotate the femur externally until first compensation
Compensation during Goniometer Assessment
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Axis (A)- Anterior aspect of patella
Stationary Arm (SA) – parallel to imaginary line down the center of the body
Movement Arm (MA)- Anterior midline of the lower leg (referencing the tibial
tuberosity).
Motion of ASIS
Over Head Squat/ Single Leg Squat
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Knee moving inward or outward
Asymmetrical weight shift
Hip (Extension)
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Joint motion being assessed
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Muscles being assessed
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Extension of iliofemoral joint
Psoas, iliacus, rectus femoris, tensor fascia latae and sartorius
Adductor complex and anterior hip capsule
Antagonists potentially underactive if ROM is
limited
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Gluteus maximus, glutues medius
Hamstring complex, adductor magnus
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Normal Value- 0-10o
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Client Positioning
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Supine with opposite hip flexed
Knee of testing leg should be flexed to ~ 90o
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Placement of Goniometer
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Pressure
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Axis (A)- Greater Trochanter
Stationary Arm (SA) – lateral midline of the trunk
Movement Arm (MA)- Lateral midline of the femur
Hold thigh of client
Passively allow the hip to extend until first compensation.
Compensation during Goniometer Assessment
 Anterior tilting
 Low back arching
Over Head Squat/ Single Leg Squat
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Arching of the lower back
Excessive forward lean
Hip (Abduction)
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Joint motion being assessed
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Muscles being assessed
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Abduction of iliofemoral joint
Adductor complex, pubofemoral ligament, iliofemoral ligament, medial
hip capsule
Medial Hamstrings
Antagonists potentially underactive if ROM is limited
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Gluteus medius, Gluteus minimus, TFL, Satorius
Bicep Femoris
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Normal Value- 40o
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Client Positioning
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Supine with knee extend
Hip is neutral
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Placement of Goniometer
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Pressure
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Holding Clients lower leg
Passively abduct the leg until first compensation
Compensation during Goniometer Assessment
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Axis (A)- ASIS
Stationary Arm (SA) – Imaginary line b/w ASIS’s
Movement Arm (MA)- Anterior midline of femur
Motion of opposite ASIS
Hip Hike on side of movement
Over Head Squat/ Single Leg Squat
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Knees moving inward
Asymmetrical weight shift
Shoulder (Flexion)
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Joint motion being assessed
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Muscles being assessed
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Flexion of Shoulder complex
Latissimus dorsi, teres major, teres minor, infraspinatus, subscapularis,
pectoralis major, triceps
Antagonists potentially underactive if ROM is limited
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Anterior deltoid, pectoralis major, middle deltoid
Lower and middle trapezius, rhomboids.
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Normal Value- 160o
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Client Positioning
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Supine with should neutral
Knee’s in hook-lying position
Arm in external rotation
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Placement of Goniometer
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Pressure
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Axis (A)- Distal to the acromion process
Stationary Arm (SA) – mid-axillary line of upper thorax
Movement Arm (MA)- Lateral epicondyle of the humerus
Hold arm in external rotation
Place thumb on the lateral border of the scapula and passively flex the
shoulder until excessive scapular movement is felt or resistance is felt.
Over Head Squat/ Single Leg Squat
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Arching of the lower back
Arms falling forward
Shoulder (External Rotation)
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Joint motion being assessed
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Muscles being assessed
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External rotation of glenohumeral joint
Subscapularis, latissimus dorsi, teres major, pectoralis major, anterior
deltoid and anterior glenohumeral joint capsule.
Antagonists potentially underactive if ROM is limited
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Infraspinatus, teres minor, posterior glenohumeral joint capsule
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Normal Value- 90o
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Client Positioning
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Supine with humerus abducted to 90o
Elbow flexed to 90o
Towel is placed under humerus
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Placement of Goniometer
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Pressure
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Hold arm in external rotation till first resistance
Compensation during Goniometer Assessment
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Axis (A)- Olecranon process
Stationary Arm (SA) – Perpendicular to the arm
Movement Arm (MA)- Ulnar styloid
Upward migration of the humeral head into the hand over the anterior
shoulder.
Over Head Squat/ Single Leg Squat
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Arms falling forward
Shoulder (Internal Rotation)
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Joint motion being assessed
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Muscles being assessed
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Internal rotation of glenohumeral joint
Infraspinatus, teres minor, posterior glenohumeral joint capsule
Antagonists potentially underactive if ROM is limited
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Subscapularis, latissimus dorsi, teres major, pectoralis major, anterior deltoid.
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Normal Value- 70o
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Client Positioning
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Supine with humerus abducted to 90o
Elbow flexed to 90o
Towel is placed under humerus
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Placement of Goniometer
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Pressure
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Hold arm in internal rotation until first resistance.
Compensation during Goniometer Assessment
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Axis (A)- Olecranon process of elbow
Stationary Arm (SA) – Perpendicular to the floor
Movement Arm (MA)- Ulnar styloid and olecranon process
Upward migration of the humeral head into the hand over the anterior
shoulder.
Over Head Squat/ Single Leg Squat
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Arms falling forward
Reference
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National Academy of Sports Medicine. Goniometric assessments.
California, 2005 (1-38).
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