Scapulohumeral abduction-adduction

Goniometer alignment:
Axis: placed on the acromion that corresponds to the projection
from the central point of the humeral head.
Fixed arm: aligned with the mid-axillary line, parallel to the sternum.
Movable arm: aligned with the longitudinal midline of the humerus taking
as bone repair the epicondyle and superimposed on the fixed arm.
Movement: abduction and anterior adduction are carried out
(the upper limb approaches the midline in front of the thorax).
The mobile arm of the goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
end of abduction and adduction.
Normal values:
Abduction: 0-160°/180° (AO) and 0-180° (AAOS)

Scapulohumeral flexion
Position : patient in supine position; scapula stabilized against
stretcher; shoulder in position 0; elbow in position 0; forearm on
pronosupination 0; wrist in position 0.
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed on the acromion that corresponds to the projection
from the central point of the humeral head.
Fixed arm: aligned with the mid-axillary line.
Movable arm: aligned with the longitudinal midline of the humerus taking
as bone repair the epicondyle and superimposed on the arm
permanent.
Movement: flexion is practiced. The moving arm of the goniometer
accompanies
the movement.
Registration: the angle formed between position 0 and position
end of flexion.
Normal values:
Flexion: 0-150°/170° (AO) and 0-180° (AAOS).

Extension
Position: patient in ventral decubitus; scapula stabilized with
examiner's hand; shoulder in position 0; arm stabilized in
the stretcher with a pillow underneath; elbow in position 0; forearm
in pronosupination 0; wrist in position 0.
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed on the acromion that corresponds to the projection
from the central point of the humeral head.
Fixed arm: aligned with the mid-axillary line.
Movable arm: aligned with the longitudinal midline of the humerus taking
as bone repair the epicondyle and superimposed on the arm
permanent.
Movement: extension is performed. The moving arm of the goniometer
accompanies
the movement.
Registration: the angle formed between position 0 and position
end of extension.
Normal values:
Extension: 0-40° (AO) and 0-60° (AAOS).
External-internal rotation
Position: patient in supine position; shoulder in 90° abduction
with the arm stabilized on the stretcher with a pillow underneath;
PART III. GONIOMETRY OF THE UPPER LIMBS 71
elbow outside the stretcher in 90° flexion; forearm and wrist
in position 0
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed on the acromion that corresponds to the projection
from the central point of the humeral head.
Fixed arm: aligned with the vertical perpendicular to the ground.
Movable arm: aligned with the longitudinal midline of the ulna, taking
as bone repair the styloid process of the ulna and superimposed
on the fixed arm.
Movement: external rotation (backwards) and rotation are carried out
internal (forward). The moving arm of the goniometer accompanies the
motion.
Registration: the angle formed between position 0 and position
end of external and internal rotation.
Normal values:
External rotation: 0-70° (AO) and 0-90° (AAOS).
Internal rotation: 0-70° (AO) and 0-70° (AAOS).

Flexion-extension
Position: patient in supine position with arm resting on a
pillow; upper limb in position 0.
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed on the projection of the pyramidal bone (ulnar edge
of the wrist, slightly in front of the ulnar styloid process).
Fixed arm: aligned with the longitudinal midline of the ulna.
Mobile arm: aligned with the longitudinal midline of the fifth metacarpal.
Movement: the elbow is flexed and extended. He
The moving arm of the goniometer accompanies the movement. Must have
Keep in mind that in normal subjects active elbow extension is
0°. In some lax people, passive extension can go as far as
10°.
Registration: the angle formed between position 0 and position
end of flexion and extension.
Normal values:
Flexion: 0-150° (AO) and 0-150° (AAOS).
Extension: 0-10° (AO - passive) and 0° (AAOS).
.

Pronation-supination
It is a movement that occurs at the level of the elbow, the membrane
interosseous and wrist.
Position: patient sitting, shoulder in position 0; elbow flexed in
90° to prevent shoulder rotation; forearm and wrist in position 0
Goniometer alignment:
Universal goniometer at 0°.
Axis: for supination, it takes the ulnar styloid process as a repair,
and for pronation, the radial styloid process.
Fixed arm: aligns parallel to the longitudinal midline of the humerus,
on the outside for pronation and on the inside for supination.
Movable arm: for supination, it is aligned with the palmar aspect of the
forearm, for pronation, with the dorsal aspect of the forearm.
Movement: pronation and supination of the elbow are performed. Arm
goniometer mobile accompanies the movement.

Registration: the angle formed between position 0 and position

end of pronation and supination.
Normal values:
Supination: 0-90° (AO) and 0-80° (AAOS).
Pronation: 0-90° (AO) and 0-80° (AAOS).

Wrist flexion-extension
Position: patient seated, forearm pronated resting on a
table.
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed on the projection of the pyramidal bone (ulnar edge
of the wrist, slightly in front of the ulnar styloid process).
Fixed arm: aligns with the longitudinal midline of the ulna.
Movable arm: aligns with the longitudinal midline of the fifth metacarpal.
Movement: flexion and extension of the wrist are practiced. Arm
goniometer mobile accompanies the movement.
Registration: the angle formed between position 0 and position
end of flexion and extension.
Normal values:
Flexion: 0-50°/60° (AO) and 0-80° (AAOS).
Extension: 0-35°/60° (AO) and 0-70° (AAOS).

Radial-ulnar deviation
Position: patient seated, forearm pronated resting on a
table.
Goniometer alignment:
Universal goniometer at 0°.

Axis: placed on the superficial projection of the capitate bone (eminence

palpable bone between the base of the third metacarpal and the
radio).
Fixed arm: aligns with the longitudinal midline of the forearm
taking the epicondyle as bone repair.
Movable arm: aligns with the midline of the corresponding hand
to the longitudinal midline of the third metacarpal.
Movement: the radial and ulnar deviation of the
doll. The mobile arm of the goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
end of radial and ulnar deviation.
Normal values:
Radial deviation: 0-25°/30° (AO), 0-20° (AAOS).
Ulnar deviation: 0-30/40° (AO), 0-30° (AAOS).

Abduction-adduction
Position: patient seated, elbow at 90°, with forearm and hand
leaning on a table, with the wrist in position 0 and the finger
thumb placed next to the index finger and second metacarpal.
Goniometer alignment:
Universal goniometer placed at the point closest to 0 that
allow alignment of the goniometer arms (actually, in
this measurement, the goniometer never reads 0°).
Axis: placed on the radial styloid process.
Fixed arm: aligns with the longitudinal midline of the second metacarpal
taking the midpoint of the joint as bone support
metacarpophalangeal of the index finger.
Movable arm: aligns with the longitudinal midline of the first metacarpal
taking the midpoint of the joint as bone support
metacarpophalangeal of the thumb.
Movement : abduction and adduction of the thumb are performed. Arm
goniometer mobile accompanies the movement.
Registration: the angle formed between position 0 and position
abduction-adduction ending.
Normal values:
Thumb abduction: 0-70° (AO) and 0-70° (AAOS).
Thumb adduction: 0° (AO) and 0° (AAOS).
Thumb adduction is 0° because the finger hits the
hand and cannot carry out this movement.

hip abduction-adduction
Abduction
Position: patient in supine position with lower limbs in
position 0 and with the pelvis stabilized, with both iliac spines
anterior superiors at the same level.
Goniometer alignment:
Universal 90° goniometer.
Axis: placed on the anterior superior iliac spine of the hip that
is examined.
Fixed arm: aligns with the opposite anterior superior iliac spine.
Movable arm: aligns with the longitudinal midline of the femur taking
the center of the kneecap as a bone repair.
Movement : hip abduction is practiced while maintaining both
anterior superior iliac spines at the same level. The moving arm
of the goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
abduction ending.
Normal values:
Hip abduction: 0-50° (AO) and 0-45° (AAOS).

Adduction
Position: patient in supine position with lower limbs in
position 0 and with the pelvis stabilized, with both iliac spines
anterior superiors at the same level.
Goniometer alignment:
Universal 90° goniometer.
Axis: placed on the anterior superior iliac spine of the hip that
is examined.
Fixed arm: aligns with the opposite anterior superior iliac spine.
Movable arm: aligns with the longitudinal midline of the femur taking
the center of the kneecap as a bone repair.
Movement : the hip being examined is adducted
bringing the other hip to abduction, but keeping both
anterior superior iliac spines at the same level. The moving arm of the
Goniometer accompanies the movement.

Registration: the angle formed between position 0 and position

end of adduction.
Normal values:
Hip adduction: 0-30° (AO) and 0-30° (AAOS).
.

Hip flexion-extension
. Flexion
Position: patient in supine position with the lower limb in position
0, with the pelvis stabilized (both anterior superior iliac spines
at same level).
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed over the greater trochanter.
PART IV. GONIOMETRY OF THE LOWER LIMBS
Fixed arm: aligns with the midline of the pelvis.
Movable arm: aligns with the longitudinal midline of the thigh taking
as bone repair the external femoral condyle.
Movement: hip flexion is carried out with the knee at maximum
flexion to relax the hamstrings. The opposite hip should
stay at 0°. The mobile arm of the goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
end of flexion.
Normal values:
Flexion: 0-140° (AO) and 0-120° (AAOS).

Extension
Position: patient in ventral decubitus with the lower limb in position
0, with the pelvis stabilized (both posterior superior iliac spines
at same level).
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed over the greater trochanter.
Fixed arm: aligns with the midline of the pelvis.
Movable arm: aligns with the longitudinal midline of the thigh taking
as bone repair the external femoral condyle.
Movement: hip extension is practiced with the knee extended.
The opposite hip should be kept at 0°. The moving arm
of the goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
end of extension.
Normal values:
Extension: 0-10° (AO) and 0-30° (AAOS).

External-internal rotation
Position: patient sitting with legs hanging; knee at 90°
flexion.
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed over the center of the kneecap.
Fixed arm: aligned with the longitudinal midline of the leg.
Movable arm: superimposed on the fixed arm.
Movement: external rotation of the hip is carried out by bringing the
leg and foot inward, and internal rotation, bringing the leg
and the foot out. The mobile arm of the goniometer accompanies the movement.
PART IV. GONIOMETRY OF THE LOWER LIMBS 9 9
Registration: the angle formed between position 0 and position
end of internal and external rotation.
Normal values:
External rotation: 0-50° (AO) and 0-45° (AAOS).
Internal rotation: 0-40° (AO) and 0-45° (AAOS).

knee flexion
Position: patient in supine position with the lower limb in position
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed on the external femoral condyle.
Fixed arm: aligns with the longitudinal midline of the thigh taking
as bone repair the greater trochanter.
Movable arm: aligns with the longitudinal midline of the leg
taking the external malleolus as bone repair.
100 GONIOMETRY
Movement: the knee is flexed with the hip
in maximum flexion to relax the quadriceps. The moving arm of the
Goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
end of flexion.
Normal values:
Flexion: 0-150° (AO) and 0-135° (AAOS).

Extension
Position: patient in ventral decubitus with the lower limb in position
0 and the femur stabilized with a pillow placed under
this..
Goniometer alignment:
Universal goniometer at 0°.
Axis: placed on the external femoral condyle.
Fixed arm: aligns with the longitudinal midline of the thigh taking
as bone repair the greater trochanter.
Movable arm: aligns with the longitudinal midline of the leg
taking the external malleolus as bone repair.
PART IV. GONIOMETRY OF THE LOWER LIMBS 101
Movement: active extension of the knee is not possible, since its
normal value is 0; therefore, passive extension is evaluated. Arm
Goniometer mobile accompanies passive movement.
Registration: the angle formed between position 0 and position
end of passive extension.
Normal values:
Active extension: 0° (AO) and 0° (AAOS).
Passive extension: 0-10° (AO) and 0-10° (A

Ankle flexion-extension
Flexion (plantar flexion)
Position: patient in supine position with the knee at 0° and the ankle at
90°; lower limb stabilized on the stretcher.
Goniometer alignment:
Universal 90° goniometer.
Shaft: placed on the external malleolus.
Fixed arm: aligns with the longitudinal midline of the leg taking
as bone repair of the head of the fibula.
Movable arm: aligns with the longitudinal midline of the fifth
metatarsal.
Movement: the ankle is flexed with the knee extended.
The mobile arm of the goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
end of flexion.
Normal values:
Flexion 0-50° (AO) and 0-50° (AAOS).
.

Extension (dorsiflexion)
Position: patient in ventral decubitus with the knee in 90° flexion.
Goniometer alignment:
Universal 90° goniometer.
Shaft: placed on the external malleolus.
Fixed arm: aligns with the longitudinal midline of the leg taking
as bone repair of the head of the fibula.
Movable arm: aligns with the longitudinal midline of the fifth
metatarsal.
Movement: ankle extension is performed with the knee flexed
90° to relax the triceps surae. The moving arm of the goniometer
accompanies the movement.
Registration: the angle formed between position 0 and position
end of extension.
Normal values:
Extension: 0-30° (AO) and 0-20° (AAOS).
.
Foot inversion
Position: patient in ventral decubitus with feet off the table,
with the lower limb stabilized on the stretcher in position 0; joint
subtalar in position 0
Goniometer alignment:
Universal goniometer at 0°.
Shaft: placed over the insertion of the Achilles tendon into the calcaneus.
Fixed arm: aligns with the longitudinal midline of the leg.
Movable arm: aligns with the longitudinal midline of the calcaneus.
Movement: the rearfoot is inverted, in which
The inner surface of the calcaneus approaches the midline of the body. He
The moving arm of the goniometer accompanies the movement.
Registration: the angle formed between position 0 and position
end of investment.
Normal values:
Subtalar inversion: 0-60° (AO) and 0-35° (AAOS).

Position: patient in ventral decubitus with feet off the table,

with the lower limb stabilized on the stretcher in position 0; joint
subtalar in position 0.
Goniometer alignment:
Universal goniometer at 0°.
Shaft: placed over the insertion of the Achilles tendon into the calcaneus.
Fixed arm: aligns with the longitudinal midline of the leg.
Movable arm: aligns with the longitudinal midline of the calcaneus.
Movement: the rearfoot is everted, in which the face
The outer part of the calcaneus moves away from the midline of the body. Arm
goniometer mobile accompanies the movement.
Registration: the angle formed between position 0 and position
end of eversion.
Normal values:
Subtalar eversion: 0-30° (AO) and 0-15° (AAOS).

Right and left lateral tilt

Position: patient sitting, therefore with the pelvis stabilized and
with the dorsolumbar spine supported against the back of the chair
Goniometer alignment:
Position 0 with goniometer at 0°.
Axis: placed on the spinous process of C7 (prominent vertebra).
Fixed arm : aligned with the vertical midline formed by the processes
dorsal spiny.
Movable arm : aligned with the midline of the head taking as
I repair the midpoint of the external occipital protuberance and the vertex.
Movement: right and left lateral inclination is performed. Arm
mobile accompanies the movement.
Registration: the angle formed between position 0 and the positions
right and left lateral tilt ends.
Normal values:
Right and left lateral inclination: 0-45° (AO) and 0-45° (AAOS).
Right and left lateral inclination from position 0
(patient sitting).
Right and left rotation
Position: patient sitting, therefore with the pelvis stabilized and
with the dorsolumbar spine supported against the back of the chair
Goniometer alignment:
Position 0 with goniometer at 90°.
Axis: placed on the vertex.
Fixed arm : aligned with the biacromial line.
Movable arm : aligned with the tip of the nose.
Movement: right and left rotation are carried out. The moving arm
accompanies the movement.
Registration: the angle formed between position 0 and the positions
ends of right and left rotation.
Normal values:

Right and left lateral tilt

Position: patient standing with anterior superior iliac spines level
on the same horizontal line which, in turn, is perpendicular to the
floor
Goniometer alignment:
Position 0 with goniometer at 0°.
Axis: placed over the spinous process of S1.
Fixed arm: aligned with the vertical midline formed by the processes
sacral thorns.
Mobile arm : aligned with the vertical midline formed by the
thoracolumbar spinous processes taking the process as a repair
spinosa of C7 (prominent vertebra).
Movement: the right and left lateral inclination is carried out.
The moving arm accompanies the movement.
Registration: the angle formed between position 0 and the positions
right and left lateral tilt ends.
Normal values:
Right and left lateral tilt: 0-30°/40° (AO) and 0-35°

Right and left dorsolumbar inclination.

Right and left rotation

Position: patient sitting on a stool without backrest, therefore,
with the pelvis stabilized and with the thoracolumbar spine free to
able to rotate).
Goniometer alignment:
Position 0 with goniometer at 0°.
Axis: placed on the vertex.
Fixed arm: aligned with the line that joins both anterior superior iliac spines.
Movable arm : aligned with the biacromial line.
Movement: right and left rotation is performed. The moving arm
accompanies the movement.
Registration: the angle formed between position 0 and the positions
ends of right and left rotation.
Normal values:
Right and left rotation: 0-30° (AO), 0-45° (AAOS).
Flexion-extension

Notorious difficulties are observed in the identification of bone repairs and in the alignment of the two-branch goniometer in
the measurement of flexion and extension of the thoracolumbar spine. Furthermore, goniometry is difficult because hip
flexion is added to lumbosacral flexion, which must be eliminated in some way for the measurement to be valid. Therefore,
in this work, the use of the fluid inclinometer instead of the universal goniometer is described.
Position: patient standing, anterior superior iliac spines level on the same horizontal line that, in
turn, is perpendicular to the floor
Alignment of inclinometers:
Head inclinometer: placed level at 0° on the spinous process of C7 (prominent vertebra).
Caudal inclinometer: placed level at 0° on the spinous process of S1.
Movement: flexion and extension of the thoracolumbar spine are practiced, keeping the
inclinometers on its bony support.
Recording: at the end of each of the movements, the measurement of each inclinometer is
recorded, and the difference that corresponds to the arc of movement of the spine between the
cephalic and caudal inclinometer is calculated. By subtracting the cephalic inclinometer
measurement from the caudal measurement, hip mobility is eliminated.
Normal values:
Flexion: 0-80° (AAOS). To measure flexion, the AO school uses the Schober method that
expresses mobility in cm.
Extension: 0-30° (AO) and 0-30° (AAOS).