This document provides information on measuring range of motion for various joints using a goniometer. It describes testing positions, stabilization techniques, and placement of the goniometer arms for measuring flexion, extension, abduction, adduction, and rotation at the hip, knee, ankle, and toes. Standard ranges of motion are provided for each movement as well as common substitutions and normal end feels. The document explains that a goniometer is an instrument used to measure joint angles and derives its name from the Greek words for angle and measure.

3. Topic:

4.  A Goniometer is an instrument that
measures an angle of joints or allows an
object to be rotated to a precise angular
position.
 The term goniometry is derived from two
Greek words, gōnia, meaning angle, and
metron, meaning measure.

5. 3 Parts of
Goniometer.

9. 1. Hip Flexion
2. Hip Extension
3. Hip Abduction
4. Hip Adduction
5. Hip Internal and External Rotation
6. Knee Flexion
7. Knee Extension
8. Tibial Internal and External Rotation
9. Dorsiflexion
10. Plantarflexion
11. Inversion and Eversion
12. Metatarsophalangeal and Interphalangeal
Flexion and Extension

10. Hip Flexion
 Measurement Tool: Universal Goniometer
 Testing Position: Supine lying with hips and
knees in neutral rotation
 Stabilization: Trunk stabilized by body position
 Goniometer Axis: Femoral Greater Trochanter
 Proximal Arm: Parallel to midaxillary line of the
trunk
 Distal Arm: Parallel to longitudinal axis of the
femur in line with lateral femoral condyle
 Movement: Hip flexion with knee flexion allowed
 Expected ROM: 120
 Substitutions: Lumbar Spine flexion
 Normal End Feel: Capsular

11. 120o

12. Hip Extension
 Measurement Tool: Universal Goniometer
 Testing Position: Prone with hips & knees in
neutral and feet extending off end of the table
 Stabilization: Pelvis is stabilized through straps or
manual fixation
 Goniometer Axis: Greater Trochanter
 Proximal Arm: Parallel to midaxillary line of the
trunk
 Distal Arm: Parallel to longitudinal axis of femur in
line with lateral femoral condyle
 Movement: Hip extension with knee extended.
ASIS must remain on table.
 Expected ROM: 30
 Substitutions: Lumbar spine extension
 Normal End Feel: Capsular or ligamentous

14. Hip Abduction
 Measurement Tool: Universal Goniometer
 Testing Position: Supine with hips and knees in
neutral and pelvis level
 Stabilization: Opposite in nominate
 Goniometer Axis: ASIS on measured side
 Proximal Arm: Along a line between the two
anterior superior iliac spines
 Distal Arm: Parallel to the long axis of the femur
 Movement: Abduction until motion is detected at
the opposite anterior superior iliac spine
 Expected ROM: 45
 Substitutions: Hip external rotation, knee
flexion/internal rotation, or lateral pelvic tilt
 Normal End Feel: Capsular or ligamentous

17. Hip Adduction
 Measurement Tool: Universal Goniometer
 Testing Position: Supine lying with the opposite
extremity abducted
 Goniometer Axis: ASIS on measured side
 Proximal Arm: Along a line between the two
anterior superior iliac spines
 Distal Arm: Parallel to the long axis of the femur
 Movement: Adduction
 Expected ROM: 30
 Substitutions: Hip internal rotation or lateral pelvic
tilt
 Normal End Feel: Capsular or ligamentous

19. Hip Internal and
External Rotation
 Measurement Tool: Universal Goniometer
 Testing Position: Sitting with the hip and knee
flexed 90 . Opposite extremity abducted and
resting on a foot stool
 Stabilization: prevent thigh abduction/adduction
 Goniometer Axis: mid-patella
 Proximal Arm: Perpendicular to the floor
 Distal Arm: Parallel to long axis of the tibia
 Movement: internal and external rotation
 Expected ROM: 45 internal and external rotation
 Substitutions: thigh abduction/adduction
 Normal End Feel: Capsular

20. Alternate Test Position
for Hip Internal/External
Rotation:
 Test Position: prone with knees flexed 90
 Stabilization: strap or manual fixation of pelvis

21. HIP INTERNAL ROTATION HIP EXTERNAL ROTATION

22. HIP INTERNAL ROTATION HIP EXTERNAL ROTATION

23. Knee Flexion
 Measurement Tool: Universal Goniometer
 Testing Position: Supine with hip and knee in neutral
rotation
 Stabilization: Trunk and pelvis stabilized by body weight
and position
 Goniometer Axis: Lateral epicondyle of the femur
 Proximal Arm: Parallel to the long axis of the femur &
pointing at the greater trochanter
 Distal Arm: Parallel to the long axis of the fibula and
pointing at the lateral malleolus
 Movement: The hip and knee are flexed as the heel
moves toward the buttock
 Expected ROM: 135
 Normal End Feel: Soft tissue approximation
 Alternate Position: Prone lying with the femur
stabilized. Knee flexion motion may be decreased as the
rectus femoris is now stretched over two joints. Prevent

24. With Supine lying

25. With Prone lying

26. Knee Extension
 Measurement Tool: Universal Goniometer
 Testing Position: Prone with hips and knees in neutral
rotation; distal leg on bolster
 Stabilization: Trunk and pelvis stabilized by body
weight and position
 Goniometer Axis: Lateral Epicondyle of the femur
 Proximal Arm: Parallel to the long axis of the femur &
pointing at the greater trochanter
 Distal Arm: Parallel to the long axis of the fibula and
pointing at the lateral malleolus
 Movement: Knee extension
 Expected ROM: 0 . Hyperextension may be present up
to 10-15
 Normal End Feel: Capsular
 Alternate Position: Supine lying heel height technique

29. Tibial Internal and
External Rotation
 Measurement Tool: Universal Goniometer
 Testing Position: sitting with knee flexed 90
degrees
 Stabilization: Therapist manually stabilizes the
femur
 Goniometer Axis: Parallel to the long axis of the
tibia
 Stationary Arm: Parallel to the long axis of the
tibia
 Moving Arm: Parallel to and in line with the
bisection of the heel and the 2nd metatarsal shaft
 Movement: Internal and external tibial rotation
 Expected ROM:
 30 internal ,40 external
 Normal End Feel: soft tissue

33. Dorsiflexion
 Measurement Tool: Universal Goniometer
 Testing Position: Prone with ankle off edge of table
and knee extended
 Stabilization: Manual stabilization of tibia against the
supporting surface
 Goniometer Axis: Lateral malleolus
 Proximal Arm: pointing towards the fibular head
 Distal Arm: Parallel to the long axis of the 5th
metatarsal
 Movement: The ankle is actively dorsiflexed
 Expected ROM: 10 with knee extended; increased to
20 with the knee flexed
 Normal End Feel: Capsular

35. Plantarflexion
 Measurement Tool: Universal Goniometer
 Testing Position: Prone or supine with the knee in
slight flexion
 Stabilization: Therapist stabilizes the lower leg
 Goniometer Axis: Lateral malleolus
 Proximal Arm: pointing towards the fibular head
 Distal Arm: Parallel to the long axis of the 5th
metatarsal
 Movement: The ankle is actively plantarflexed
 Expected ROM: 30-50 degrees.
 Normal End Feel: Capsular
 Alternate Position: Prone lying

37. Inversion / Eversion
 Measurement Tool: Universal Goniometer
 Testing Position: Standing with bilateral stance
 Stabilization: No stabilization necessary
 Goniometer Axis: Just proximal to the achilles insertion
on the calcaneus
 Proximal Arm: Parallel to the distal bisection of the
lower leg
 Distal Arm: Parallel to the bisection of the calcaneus
 Movement: Patient can perform trunk or tibial rotation to
maximally invert and evert the calcaneus
 Expected ROM: Approximately
 10 eversion
 20 inversion
 Normal End Feel: Capsular
 Alternate Position: Prone lying positions.

38. ACHILLES
INSERTION OF
THE
CALCANEUS
Inversion Eversion

39. Metatarsophalangeal and
Interphalangeal Flexion and
Extension
 Measurement Tool: Universal or Digit Goniometer
 Testing Position: Ankle in resting position of mild plantar flexion and the
STJ (Superconducting Tunnel Junction) is in neutral.
 Stabilization: Careful stabilization of metatarsals without metatarsal
compression
 Goniometer Axis: Over the dorsum of the measured joint. If measuring the
1st or 5th the axis can be placed over the medial or lateral aspect of the
joints, respectively.
 Proximal Axis: Parallel to the longitudinal axis of the metatarsal of the digit
being measured
 Distal Axis: Parallel to the longitudinal axis of the metatarsal of the digit
being measured
 Movement: Active flexion and/or extension of the distal digit being
measured
 Expected ROM:
 Extension :1st - 50o , 2nd - 40o , 3rd - 30o , 4th - 20o , 5th - 10o
 Flexion : 1st - 30o , 2nd - 30o , 3rd - 20o , 4th - 10o , 5th - 10o
 Normal End Feel: Capsular
 Substitutions: The long toe flexors and extensors will effect ROM according
to the positioning of the more proximal joints that they cross.

42. References
www.google.com.pk
http://3.bp.blogspot.com
http://www.medicineppt.com
www.dpt-1.blogspot.com
MacDermid, et al. J Hand
Therapy 12:187-192, 1999.