User's Manual

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EXTENSION: The client should be standing with the arm to be measured extended at the elbow in
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 extension angle up to the 0-degree/neutral position.
SUPINATION: The client should be sitting on a flat surface, or standing with the arm to be measured in
midposition with the palm vertical in relation to the floor (“thumbs up” position), with the upper arm close
to the side of the body, and the elbow flexed at 90-degrees. The goniometer’s pivot should be placed
medial to the ulnar styloid process. The stationary arm of the goniometer should be parallel to the anterior
midline of the humerus, and the movable arm across the volar aspect of the forearm, just proximal to the
styloid processes. Instruct the client to turn “palm up” as far as possible. Record the maximum supination
angle.
PRONATION: The client should be sitting on a flat surface, or standing with the forearm to be measured
in midposition with the palm vertical in relation to the floor (“thumbs up” position), with the upper arm close
to the side of the body, and the elbow flexed at 90-degrees. The goniometer’s pivot should be centrally
placed lateral to the ulnar styloid process. The stationary arm of the goniometer should be parallel to the
anterior midline of the humerus, and the movable arm across the dorsal aspect of the forearm just
proximal to the styloid processes of the radius and ulna. Instruct the client to turn “palm down” as far as
possible. Record the maximum pronation angle.
Wrist
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. Similarly, movements of
the digits are first evaluated as a unit by having the client make a complete fist, and then individually by
extending the digits fully over several repetitions. In determining the range of motion of individual joints,
the examiner must evaluate both the active and passive motion.
FLEXION: The client should start with the elbow flexed, the forearm positioned in neutral
pronation/supination, and the wrist to be measured in neutral flexion/extension and radioulnar deviation.
The fingers should be relaxed to avoid active finger flexion. The goniometer’s pivot is placed over the
dorsal surface of the wrist joint using the capitate as a reference. Align the stationary arm with the dorsal
midline of the forearm using the lateral epicondyle of the humerus as a reference. Align the movable arm
in between the dorsal heads of the index and middle metacarpals. Record the maximum wrist flexion
angle.
EXTENSION: The client should start with the elbow flexed, the forearm positioned in neutral pronation,
and the wrist to be measured in neutral flexion/extension and radioulnar deviation. The goniometer’s pivot
is placed over the volar surface of the wrist joint at the level of the capitate with the stationary arm in
alignment with the volar midline of the forearm, and the movable arm in between the volar heads of the
index and middle metacarpals. Record the maximum wrist extension angle.
RADIAL DEVIATION: The client should start with the hand to be measured in forearm pronation and the
wrist in neutral flexion/extension and radioulnar deviation. The goniometer’s pivot is placed over the
middle dorsal aspect of the wrist in line with the capitate. Align the stationary arm with the dorsal midline
of the forearm using the lateral epicondyle of the humerus for a reference. Align the moving arm with the
dorsal midline of the third metacarpal. Instruct the client to move the hand towards the thumb in the same
plane as the table. Record the maximum radial deviation angle.
ULNAR DEVIATION: The client should start with the hand to be measured in forearm pronation and the
wrist in neutral flexion/extension and radioulnar deviation. The goniometer’s pivot is placed over the
middle dorsal aspect of the wrist in line with the capitate. Align the stationary arm with the dorsal midline