User's Manual

172
extremities should be compared. Individual joints are then evaluated separately. In determining the range
of motion of individual joints, the examiner must evaluate both the active and passive motion.
FLEXION: The client should be standing erect, with the arm to be measured at the side of the body. Place
the goniometer’s pivot on the outside of the shoulder joint to be measured with the stationary arm
perpendicular to the ground. The movable arm will remain parallel to the humerus. Instruct the client to
move the arm in a forward upward motion in the anterior sagittal plane of the body. Record the maximum
forward flexion angle.
EXTENSION: The client should be standing erect, with the arm to be measured at the side of the body.
Place the goniometer’s pivot on the outside of the shoulder joint to be measured with the stationary arm
perpendicular to the ground. The movable arm will remain parallel to the humerus. Instruct the client to
move the arm in an upward motion in the posterior sagittal plane of the body. Record the maximum
backward extension angle.
ABDUCTION: The client should be standing erect, with the arm to be measured at the side of the body,
palm in. Place the goniometer’s pivot in front of the shoulder joint to be measured with the stationary arm
perpendicular to the ground.; The movable arm will remain parallel to the humerus. Instruct the client to
move the arm in an upward motion away from the side of the body in the coronal plane as far as possible.
Record the maximum abduction angle.
ADDUCTION: The client should be standing erect, with the arm to be measured at the side of the body,
palm in. Place the goniometer’s pivot in front of the shoulder joint to be measured with the stationary arm
perpendicular to the ground. The movable arm will remain parallel to the humerus. Instruct the client to
move the arm toward the midline of the body, and beyond it in an upward plane as far as possible.
Record the maximum adduction angle.
INTERNAL ROTATION: The client should be supine on a flat surface, with the arm to be measured in 90-
degrees of abduction, the elbow in 90-degrees of flexion, and the forearm in neutral. Place the
goniometer’s pivot at approximately the lateral epicondyle with the stationary arm perpendicular to the
floor. The movable arm will remain in alignment with the ulna. Instruct the client to move the arm as far as
possible in a rotational orientation so that the palm goes down, toward the floor. Record the maximum
internal rotation angle.
EXTERNAL ROTATION: The client should be supine on a flat surface, with the arm to be measured in
90-degrees of abduction, the elbow in 90-degrees of flexion, and the forearm in neutral. Place the
goniometer’s pivot at approximately the lateral epicondyle with the stationary arm perpendicular to the
floor. The movable arm will remain in alignment with the ulna. Instruct the client to move the arm as far as
possible in a rotational orientation so that the back of the hand goes back, toward the floor. Record the
maximum external rotation angle.
Elbow
In assessing motion, the examiner should first observe what an individual can and cannot do by asking
them to move each joint of the extremity, from the shoulder down, through its full range of motion. Both
extremities should be compared. Individual joints are then evaluated separately. In determining the range
of motion of individual joints, the examiner must evaluate both the active and passive motion.
FLEXION: The client should be standing with the arm to be measured flexed at the elbow in a forearm
supination, and 90-degrees of shoulder forward flexion. The goniometer’s pivot should be centrally placed
lateral to the lateral epicondyle with the stationary arm in alignment to the lateral aspect/midline of the
humerus, and the movable arm in alignment to the lateral aspect/midline of the radius. Record the
maximum flexion angle.