Measurement Devices Norkin

1
Measurement Devices (Norkin White, 1995)
Documentation

• by
• Vince Lepak, MPH, PT
• October 22, 1998

2
Range of Motion (ROM)Measurement Devices

• Goniometers
• Tape
• Inclinometers
• Bubble
• Digital
• CROM BROM
• Arthrodial Protractors

3
Goniometers

• Plastic
• Steel
• Gravity dependent
• They use a weighted pointer.
• See page 20 of Norkin and White (1995)

4
Universal Goniometers

• Most commonly used
• Measures almost any joint on the body
• Alignment is easy
• Stationary Arm
• Moveable Arm
• Fulcrum
• Read the beginning and end ROM

5
Universal Goniometer Validity

• Does the angle of the goniometer represent the
  angle created by the proximal and distal bones of
  the joint?
• Yes

6
Universal Goniometer Reliability

• It varies from joint to joint.
• Generally peripheral joints showed greater
  reliability than spinal measurements
• Generally intra-rater is greater than inter-rater
• No difference between the small and large
  goniometers when measuring shoulder ROM.

7
Improving Reliability

• Use the preferred position and stabilize the
  proximal joint component
• Explain and demonstrate the desired motion to
  your patient
• Move the joint passively to the completed rom
• Determine the end-feel and make a clinical
  estimate on the ROM
• Palpate the appropriate bony landmarks
• Align the goniometers SA and MA with the
  landmarks
• Determine the axis of motion

8
Improving Reliability (cont.)

• Read and record the measurement
• Compare to the opposite side
• Try to re-measure at the same time of day when
  your patient returns for their follow-up visit.
• Successive measurements should be taken by the
  same examiner who strives to utilize the same
  amount of force for the end-feel
• Inexperienced examiners should take an average of
  several measurements

9
Tape

• C7 to S1
• Schober Technique
• lumbosacral junction
• 10 cm above
• .90
• Modified Schober Technique
• lumbosacral junction
• 10 cm above
• 5 cm below
• .97

10
Inclinometer
11
(No Transcript)
12
(No Transcript)
13
CROM

• Intra-rater .76 to .94
• Inter-rater .66 to .90
• You can measure the amount of forward head or ROM

14
CROM BROM
15
Arthrodial Protractors
16
Documentation

• Be as specific and objective as possible
• Be concise
• Become familiar with what is acceptable at your
  clinic
• Be open-minded for differing opinions

17
Recording (p.26)

• Do not use WNL (within normal limits)
• Instead say Bilateral UE AROM is equal and
  available in all directions while sitting. There
  were no restrictions that appeared to interfere
  with dressing or reaching into a cabinet.
• Record the beginning and ending position using
  the 0 to 180 degree notation method.
• Do not use Total Joint Range of Motion (TJROM).

18
Table Example
All motions for both shoulders revealed a
capsular end-feels.
19
Other Examples

• Left elbow PROM extension to flexion is 10-0-150
  degrees
• Prone PROM of left knee flexion is 0-150 degrees
• AROM of sitting left knee extension is 20 degrees
  from neutral.

20
Reference

• Norkin, C., White, D. (1995). Measurement of
  joint motion A guide to goniometry (2nd ed.).
  Philadelphia F. A. Davis.