The document discusses goniometry techniques for measuring range of motion of the wrist and fingers. It provides details on positioning, goniometer alignment, and normal range of motion values for various wrist, hand, and finger motions according to sources like the American Academy of Orthopedic Surgeons. A variety of goniometry tools are presented, from universal goniometers to electrogoniometers, digital tools, and 3D motion analysis systems.

1. GONIOMETRY
FOR WRIST & FINGERS

2. WHY HAND IS SO SPECIAL…
• 27 bones
• 27 Joints
• 34 muscles
• 3 major nerves
• 100 ligaments & tendons
• 2 major arteries
• Major representation in Brain
• & so on…..

3. THE REAL MAN…

4. HAND PHYSIOTHERAPY
– A SUPER SPECIALITY
• Micro & Macro surgeries – Vascular, Orthopaedic, Plastic surgeons, Neuro
surgeons etc
• Hand surgeons, Thumb surgeons etc.,
• Toe to thumb transfers
• Tendon repair & transplants
• Hand transplant – Transplants from cadaver.
• & Many more
HAND PHYSIOTHERAPY

7. UNIVERSAL FULL CIRCLE
GONIOMETER

8. UNIVERSAL FINGER GONIOMETER

9. ROLYAN FINGER/TOE GONIOMETER

10. DEVORE POCKET GONIOMETER

11. BASELINE DIGIT FINGER GONIOMETER

12. EXTENDABLE GONIOMETERS

13. NORMAL WRIST ROM

14. NORMAL FINGER ROM

15. NORMAL THUMB ROM

16. WRIST FLEXION
Test Position
• Subject sitting
• Forearm stabilized on table
• Flex wrist (fingers relaxed)
Goniometer Alignment
• Axis – lateral wrist
• Stationary arm – aligned with ulna
• Moving arm – aligned with fifth
metacarpal
Normal Range
• 75° ± 6.6° (American Academy of
Orthopaedic Surgeons)
• 60° (American Medical
Association)
• 76.4° (mean) 6.3° (standard
deviation), (Boone and Azen)

17. WRIST EXTENSION
Test Position
• Subject sitting
• Forearm stabilized on table
• Extended wrist (fingers relaxed)
Goniometer Alignment
• Axis – lateral wrist (triquetrum)
• Stationary arm – aligned with ulna
• Moving arm – aligned with fifth
metacarpal
Normal Range
74° ± 6.6° (American Academy of
Orthopaedic Surgeons)
60° (American Medical Association)
74.9° (mean) 6.4° (standard deviation),
(Boone and Azen)

18. WRIST RADIAL DEVIATION
Test Position
• Subject sitting with forearm resting on
table
• Stabilize forearm to prevent pronation
or supination
Goniometer Alignment
• Axis – capitate
• Stationary arm – aligned with forearm
(lateral epicondyle)
• Moving arm – aligned with metacarpal
of middle finger
Normal Range
• 21° ± 4.0° (American Academy of
Orthopaedic Surgeons)
• 20° (American Medical Association)
• 21.5° (mean) 4.0° (standard
deviation), (Boone and Azen)

19. WRIST ULNAR DEVIATION
Test Position
• Subject sitting with forearm resting on
table
• Stabilize forearm to prevent pronation
or supination
Goniometer Alignment
• Axis – capitate
• Stationary arm – aligned with forearm
(lateral epicondyle)
• Moving arm – aligned with metacarpal
of middle finger
Normal Range
• 35° ± 3.8° (American Academy of
Orthopaedic Surgeons)
• 30° (American Medical Association)
• 36.0° (mean) 3.8° (standard
deviation), (Boone and Azen)

20. METACARPOPHALANGEAL JOINT
FLEXION
Test Position
• Subject sitting with forearm resting on
table
• Wrist and interphalangeal joints
relaxed
• Forearm neutral
• Stabilize metacarpal to prevent motion
Goniometer Alignment
• Dorsal metacarpophalangeal joint
• Stationary arm - aligned with
metacarpal
Normal Range
• 86° (index), 91° (ring), 105° (little)
(American Academy of Orthopedic
Surgeons - active motion)
• 90° (American Medical Association)

21. METACARPOPHALANGEAL JOINT
EXTENSION
Test Position
• Subject sitting with forearm resting on
table
• Wrist and interphalangeal joints
relaxed
• Forearm neutral
• Stabilize metacarpal to prevent motion
Goniometer Alignment
• Dorsal metacarpophalangeal joint
• Stationary arm - aligned with
metacarpal
Normal Range
• 22° (index), 18° (long), 23° (ring), 19°
(little) (American Academy of
Orthopedic Surgeons - active motion)
• 20° (American Medical Association)

22. METACARPOPHALANGEAL JOINT
ABDUCTION
Test Position
• Subject sitting with forearm resting on
table
• Wrist neutral
• Forearm neutral
• Stabilize metacarpal to prevent motion
Goniometer Alignment
• Dorsal metacarpophalangeal joint
• Stationary arm - aligned with
metacarpal
• Moving arm – aligned with proximal
Normal Range
• 25° (Physiopedia)

23. METACARPOPHALANGEAL JOINT
ADDUCTION
Test Position
• Subject sitting with forearm resting on
table
• Wrist neutral
• Forearm neutral
• Stabilize metacarpal to prevent motion
Goniometer Alignment
• Dorsal metacarpophalangeal joint
• Stationary arm - aligned with
metacarpal
• Moving arm – aligned with proximal
Normal Range
• Either 0° or usually not measured.

24. INTERPHALANGEAL JOINT FLEXION
Test Position
• Subject sitting with forearm resting on
table
• Wrist, metacarpal, and non-tested
interphalangeal joints relaxed
• Forearm neutral
• Stabilize proximal bone to prevent
motion
Goniometer Alignment
• Dorsal proximal interphalangeal joint
• Stationary arm - aligned with proximal
phalange
• Moving arm – aligned with middle
phalange
Normal Range
American Academy of Orthopedic
Surgeons
• PIP fingers - 102° (index), 105° (long),
108° (ring), 106° (little) (active motion)
• DIP fingers - 72° (index), 71° (long),
63° (ring), 65° (little) (active motion)
• IP thumb - 73°
American Medical Association
• 100° (PIP finger), 70° (DIP fingers),
80° (IP thumb)

25. INTERPHALANGEAL JOINT
EXTENSION
Test Position
• Subject sitting with forearm resting on
table
• Wrist, metacarpal, and non-tested
interphalangeal joints relaxed
• Forearm neutral
• Stabilize proximal bone to prevent
motion
Goniometer Alignment
• Dorsal proximal interphalangeal joint
• Stationary arm - aligned with proximal
phalange
• Moving arm – aligned with middle
phalange
Normal Range
American Academy of Orthopedic
Surgeons
• PIP fingers - 7° (index), 7° (long), 6°
(ring), 9° (little) (active motion)
• DIP fingers - 8° (all finger DIPs)
• IP thumb - 5°
American Medical Association
• 0°

26. THUMB CARPOMETACARPAL JOINT
FLEXION
Test Position
• Subject sitting with forearm resting on
table
• Wrist neutral
• Stabilize carpals to prevent wrist motion
Goniometer Alignment
• Axis - carpometacarpal joint
• Stationary arm - aligned with radius
• Moving arm – aligned with metacarpal of
thumb
Normal Range
• 15° (American Academy of Orthopedic
Surgeons)

27. THUMB CARPOMETACARPAL JOINT
EXTENSION
Test Position
• Subject sitting with forearm resting on
table
• Wrist neutral
• Stabilize carpals to prevent wrist
motion
Goniometer Alignment
• Axis - carpometacarpal joint
• Stationary arm - aligned with radius
• Moving arm – aligned with metacarpal
of thumb
Normal Range
• 20° (American Academy of Orthopedic
Surgeons)

28. THUMB CARPOMETACARPAL JOINT
ABDUCTION
Test Position
• Subject sitting with forearm resting on
table
• Wrist neutral
• Forearm neutral
• Stabilize carpals to prevent wrist
motion
Goniometer Alignment
• Axis - radial styloid
• Stationary arm - aligned with
metacarpal of index finger
• Moving arm – aligned with metacarpal
of thumb
Normal Range
• 70° (American Academy of Orthopedic
Surgeons)

29. THUMB CARPOMETACARPAL JOINT
ADDUCTION
Test Position
• Subject sitting with forearm resting on
table
• Wrist neutral
• Forearm neutral
• Stabilize carpals to prevent wrist
motion
Goniometer Alignment
• Axis - radial styloid
• Stationary arm - aligned with
metacarpal of index finger
• Moving arm – aligned with metacarpal
of thumb
Normal Range
• Either 0° or usually not measured.
NOTE: Thumb adduction is the return to neutral from thumb
abduction. Thumb adduction is rarely measured, probably because it

30. THUMB CARPOMETACARPAL JOINT
OPPOSITION
Test Position
• Subject sitting with forearm
supinated and resting on table
• Wrist neutral
• Stabilize fifth metacarpal
Goniometer Alignment
• Goniometer cannot be used
• Use a ruler to measure distance
between tip of thumb and base of
fifth finger
Normal Range
• Able to touch tip of thumb to base
of fifth finger (American Academy
of Orthopedic Surgeons)
NOTE: The American Academy of Orthopedic Surgeons suggests
that opposition range is normal when the tip of thumb can touch the
base of fifth finger. When range is not adequate, a ruler can be used
to measure the distance between the tip of thumb and the base of the

31. NORMAL ROM VALUES (AAOS VALUES)

32. FINGERS: COMPOSITE FLEXION OF
THE MCP, PIP, AND DIP JOINTS

33. GRAVITY
GONIOMETER/INCLINOMETER
One arm has a weighted pointer that remains vertical under the
influence of gravity

34. BUBBLE INCLINOMETER

36. SOFTWARE/SMARTPHONE-BASED
GONIOMETER APPS
• Goniometer Records
• Goniometro Advance
• Goniometer Pro App (G-Pro)
• Goniometer Plus
• DrGoniometer

37. DIGITAL LASER GONIOMETER

38. THE E-LINK ROM GONIOMETRY

39. ELECTRO GONIOMETER
(Fariborz et al.,
2015)

40. ELECTROGONIOMETER
SIN GLE A XIS
ELEC TR OGON IOMETER
TW IN A XIS
ELEC TR OGON IOMETER

41. FIBER OPTIC GONIOMETRIC
GLOVE
(Sam Wise et al.,
1990)

42. CYBERGLOVE – VIRTUAL
GONIOMETRY
G. Drew Kessler et al.,

43. NON-CONTACT MEASUREMENT SYSTEM
(INTEL PERCEPTUAL TECHNOLOGY AND A SENZ3D CAMERA)
(Trieu Pham et al.,
2015)

44. 3D MOTION ANALYSIS
(Gabriella Fischer et al.,

45. REFERENCES
• American Academy of Orthopedic Surgeons (Green WB, Heckman JD eds.): The Clinical Measurement
of Joint Motion. 6300 North River Road, Rosemont, IL 60018, 1994, ISBN 0-89203-090-9.
• American Medical Association: Guide to the Evaluation of Permanent Impairment. AMA, Chicago, 1988.
• Boone DC, Azen SP: Normal range of motion of joints in male subjects. Journal of Bone and Joint
Surgery 1979;61A:756-759.
• Magee DJ: Orthopedic Physical Assessment, 3rd ed. WB Saunders Co, Philadelphia, 1997, ISBN 0-
7216-6290-0.
• Norkin CC, White DJ: Measurement of Joint Motion: A Guide to Goniometry, 2nd ed. FA Davis Co,
Philadelphia, 1995, ISBN 0-8036-6579-2.
• Physiopedia