Goniometer

Goniometer types,uses,principles,techniques and factors affecting ROM

1. topic ------ goniometer GONIOMETER PRATIGYA DEUJA

2. GONIOMETER In Greek, Gonio = Angle and Metry = Measurement Goniometry is the most widely used method for measuring joint motion. The starting position for measuring all ROM except rotation is in transverse plane or anatomical position. The three notation system that have been used are; 0-180º 180-0º 360º

3. Parts of goniometer 1) Stationary arm : Structural part of Goniometer that can’t be moved. 2 ) Moving arm : Moves on the body freely 3) Fulcrum/Axis

4. Types of goniometer 1) Universal Goniometer : a) Half circle Goniometer b) Full circle Goniometer 2) Finger Goniometer 3) Functional Goniometer 4) Pendular Goniometer 5) Gravity dependent or fluid Goniometer 6) Electro Goniometer

5. Principles of goniometer The axis of Goniometer is placed over the axis of the joint. Make the patient comfortable and relaxed. Select suitable starting position. Neutral zero (0) method for measuring and recording is commended. The measurement part should be exposed properly. The stationary arm is positioned to the longitudinal axis of the part proximal to the joint. The movable arm is positioned parallel to the longitudinal axis of the part distal to joints.

6. Principles of goniometer The movable arm is positioned parallel to the longitudinal axis of the part distal to joints. The stationary or immovable arm should be positioned accurately in appropriate place to get measurement accurately. The therapist should be aware about his support and goniometer part in such way that it should not restrict the joint ROM. Environmental variables should be taken in consideration. Instruct the patient to avoid any sort of trick movement while taking measurement.

7. Principles of goniometer Always the measurements should be taken from lateral aspect of the part of the joint in order to prevent obstruction. Measurement of range may be done actively or passively. Established bony marks for measurement. Stabilize the part proximal to the joint to be measured. Check PROM with AROM.

8. Factors affecting ROM Soft tissue tightness: Muscle, ligaments, capsule, cartilage, synovial membrane spasm. Adhesion formation: Lack of mobility of the joint reduce the flexibility and the nourishment circulation around the joint structure. Injuries or inflammation: Injuries or inflammation around the joint e.g ; OA,RA,TB Muscle bulk: Increase muscle bulk may cause the reduction of PROM/AROM Sex : Female is more flexible. Nervous system: Paralysis, hypomobility

9. To achieve accuracy and reliability 1) Environmental variables; - Time of the day - Temperature - Kind of goniometer - Experience of the therapist 2) Patient related factors; - Reaction of pain and fatigue - Feeling of fear, tension or stress - Therapist should put effort to relax

10. Uses of goniometer 1 ) To measure the available ROM incase of various physical problem that limit the joint motion. 2) Measurement in alternation of joint motion is useful to treat the condition and increase ROM of the joint. 3) Passive measurement gives the range of joint motion if the therapist moves joint passively. 4) If AROM is less then PROM then it indicates the problem of muscle weakness.

11. Uses of goniometer 5) Used to select appropriate treatment goals. 6) To record progression and regression in rehabilitation. 7) It should be compared with normal range and screen the hypermobility / hypomobility of joint. 8) To screen the limitation of motion of particular range. 9) To identify abnormal condition related to muscles, tendons and joints such as; contractures, decrease ROM due to disuse or injury.

12. indications Joint injury Edema pain Skin tightness Spasticity Adaptive shortening Poor muscle Muscle weakness Joint stiffness Muscle tightness, contractures Deformities

13. contraindications GENERAL HTN Hyperpyrexia Dut Unco -operative patient LOCAL Recent fractures Recent surgeries Post op surgeries Open wounds Unhealed scar Severe pain Joint inflammation Malignancy Joint dislocation/ sublux

14. Techniques of goniometer Patient should be comfortable and relaxed. Patient clothes should be removed while taking measurement of joint. Position and stabilization should be corrected. Place the joint in a starting position of zero degree. Therapist should explain about the procedure to the patient so that the patient has a clear awareness. Stable arm of the goniometer should be placed on the proximal and movable arm on the distal segment. Therapist should move the movable arm along with the joint movement.

15. Recording Goniometer measurement Numerical tables Pictoral charts Written text of an evaluation