User's Manual

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stationary arm in alignment with the dorsal midline of the middle phalanx and the movable arm in
alignment with the distal phalanx. Instruct the client to flex the DIP joint as far as possible. Record the
maximum DIP flexion angle.
Finger Middle 3
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.
EXTENSION: The client’s hand should be flat on a table with the volar head of the metacarpal supported
at the table’s edge, and neutral wrist flexion/extension and radioulnar deviation. Place the goniometer’s
pivot over the dorsal head of the metacarpophalangeal (MPJ) joint with the stationary arm in alignment
with the dorsal midline of the metacarpal and the movable arm in alignment with the dorsal midline of the
proximal phalanx. Instruct the client to extend, or straighten the MPJ as far as possible. Record the
maximum MP extension angle.
MP FLEXION: The client’s hand should be flat on a table with the volar head of the metacarpal supported
at the table’s edge, and neutral wrist flexion/extension and radioulnar deviation. Place the goniometer’s
pivot over the dorsal head of the metacarpophalangeal (MPJ) joint with the stationary arm in alignment
with the dorsal midline of the metacarpal and the movable arm in alignment with the dorsal midline of the
proximal phalanx. Instruct the client to flex the MPJ as far as possible. Record the maximum MP flexion
angle.
PIP EXTENSION: The client’s forearm should be pronated, the wrist in neutral flexion/extension and
radioulnar deviation, and the metacarpophalangeal joint in 0-degrees of extension. If possible, place the
hand to be measured flat on a table with the volar head of the proximal phalanx supported at the table’s
edge. Place the goniometer’s pivot over the dorsal head of the proximal interphalangeal joint (PIP) with
the stationary arm in alignment with the proximal phalanx and the movable arm in alignment with the
middle phalanx. Instruct the client to extend, or straighten the PIP joint as far as possible. Record the
maximum PIP extension angle.
PIP FLEXION: The client’s forearm should be pronated, the wrist in neutral flexion/extension and
radioulnar deviation, and the metacarpophalangeal joint in 0-degrees of extension. If possible, place the
hand to be measured flat on a table with the volar head of the proximal phalanx supported at the table’s
edge. Place the goniometer’s pivot over the dorsal head of the proximal interphalangeal joint (PIP) with
the stationary arm in alignment with the dorsal midline of the proximal phalanx and the movable arm in
alignment with the dorsal midline of the middle phalanx. Instruct the client to flex the PIP as far as
possible. Record the maximum PIP flexion angle.
DIP EXTENSION: The client’s forearm should be pronated or in neutral pronation/supination, and the
wrist in neutral flexion/extension and radioulnar deviation. The metacarpophalangeal joint is positioned in
0-degrees of extension and the proximal interphalangeal joint in approximately 70-90 degrees of flexion.
Place the goniometer’s pivot over the dorsal head of the distal interphalangeal joint (DIP) with the
stationary arm in alignment with the dorsal midline of the middle phalanx and the movable arm in
alignment with the distal phalanx. Instruct the client to extend, or straighten the DIP joint as far as
possible. Record the maximum DIP extension angle.
DIP FLEXION: The client’s forearm should be pronated or in neutral pronation/supination, and the wrist in
neutral flexion/extension and radioulnar deviation. The metacarpophalangeal joint is positioned in 0-
degrees of extension and the proximal interphalangeal joint in approximately 70-90 degrees of flexion.