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Goniometry for Wrist & Fingers

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.

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GONIOMETRY FOR WRIST & FINGERS
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UNIVERSAL FULL CIRCLE GONIOMETER
UNIVERSAL FINGER GONIOMETER
ROLYAN FINGER/TOE GONIOMETER
DEVORE POCKET GONIOMETER
BASELINE DIGIT FINGER GONIOMETER
EXTENDABLE GONIOMETERS
NORMAL WRIST ROM
NORMAL FINGER ROM
NORMAL THUMB ROM
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)
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)
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)
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)
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)
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)
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)
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.
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)
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°
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)
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)
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)
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
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
NORMAL ROM VALUES (AAOS VALUES)
FINGERS: COMPOSITE FLEXION OF THE MCP, PIP, AND DIP JOINTS
GRAVITY GONIOMETER/INCLINOMETER One arm has a weighted pointer that remains vertical under the influence of gravity
BUBBLE INCLINOMETER
SOFTWARE/SMARTPHONE-BASED GONIOMETER APPS • Goniometer Records • Goniometro Advance • Goniometer Pro App (G-Pro) • Goniometer Plus • DrGoniometer
DIGITAL LASER GONIOMETER
THE E-LINK ROM GONIOMETRY
ELECTRO GONIOMETER (Fariborz et al., 2015)
ELECTROGONIOMETER SIN GLE A XIS ELEC TR OGON IOMETER TW IN A XIS ELEC TR OGON IOMETER
FIBER OPTIC GONIOMETRIC GLOVE (Sam Wise et al., 1990)
CYBERGLOVE – VIRTUAL GONIOMETRY G. Drew Kessler et al.,
NON-CONTACT MEASUREMENT SYSTEM (INTEL PERCEPTUAL TECHNOLOGY AND A SENZ3D CAMERA) (Trieu Pham et al., 2015)
3D MOTION ANALYSIS (Gabriella Fischer et al.,
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