NP1042 Kemahiran Asas Fisioterapi Upper Limbs Assessment(PDF)

NP1042: Kemahiran Asas Fisioterapi Topic 2: Assessment of joint muscles (Upper limbs) By Prof Madya Dr. Azlin, Physiotherapy, FSK, UKM Improvised by Dr. Hafifi, Physiotherapy, FSK, UKM 1  Learning outcomes...

NP1042: Kemahiran Asas Fisioterapi Topic 2: Assessment of joint muscles (Upper limbs) By Prof Madya Dr. Azlin, Physiotherapy, FSK, UKM Improvised by Dr. Hafifi, Physiotherapy, FSK, UKM 1  Learning outcomes Demonstrate the procedure for joint range of motion measurements by using goniometry 2024 NP 1042 KAF Physiotherapy 2 RANGE OF MOTION Range of motion can be defined as the amount of motion available at a joint. Each specific joint has a normal range of motion that is expressed in degrees. Joint ranges are divided into Active range of motion (AROM) Passive range of motion (PROM) The structure involved with the movement of the bones and the bony arrangements are factors in limiting motion. 2024 NP 1042 KAF Physiotherapy 3 DEFINITION The term goniometer is derived from the Greek words ‘gonia’ meaning angle and ‘metron’ meaning measure. Goniometer refers to the measurement of angles created at human joints by the bones of the body. Goniometer is used to measure and document the amount of active and passive joint motion as well as abnormal fixed joint positions. 2024 NP 1042 KAF Physiotherapy 4  UNIVERSAL GONIOMETER Constructed of metal or plastic and it has three parts. Body with a fulcrum Stationary arm Moving arm The body of the goniometer is designed like a protractor and may form a full or half circle, and on it is a scale from 0 to 180° or 0 to 360°. Fulcrum - a rivet of the screw-like device at the centre of the body that allows the moving arm to move freely on the body of the device. 2024 NP 1042 KAF Physiotherapy 5 2024 NP 1042 KAF Physiotherapy 6 2024 NP 1042 KAF Physiotherapy 7 2024 NP 1042 KAF Physiotherapy 8 USES OF GONIOMETRY DATA Determine the presence of joint impairment Determine treatment goals and plan of care Evaluate the progress of treatment Modify treatment Determine prognosis Motivate the subject Choose orthoses of adaptive equipment As research data 2024 NP 1042 KAF Physiotherapy 9 PRINCIPLES OF GONIOMETER The patient should be positioned in a suitable, comfortable position. Provide an explanation and relevant instructions. The measurement part should be exposed properly. Axis of the Goniometer is placed over the joint axis. The stationary arm is positioned to the longitudinal axis of the part proximal to the joint. The movable arm is positioned parallel to the longitudinal axis of the part distal to joints. 2024 NP 1042 KAF Physiotherapy 10  END FEELS 2024 NP 1042 KAF Physiotherapy 11  END FEELS 2024 NP 1042 KAF Physiotherapy 12  END FEELS 2024 NP 1042 KAF Physiotherapy 13  IMPORTANT TO NOTE : The starting position for measuring all ROM is the anatomical position Zero degrees is the neutral starting position. Stabilize the part of the body that is proximal (stationary portion) to the joint you are testing. The patient does not move his body while moving the joint; this step isolates the joint motion for a more accurate measurement. There are three situations for goniometric measurement which are 0-180°, 180-0° and 0-360°. Consistently use the same stationary and movable landmarks on the body each time when measuring. 2024 NP 1042 KAF Physiotherapy 14  IMPORTANT TO NOTE : The angle of the movement from the stationary arm to the moving arm is read off the body. Look at the reading on the goniometer at eye level before removing it from the patient’s body. Be sure to record the ROM of the joint. Compare reading with the contralateral side. 2024 NP 1042 KAF Physiotherapy 15  Deep Vein Thrombosis Recent fractures Recent surgeries CONTRAINDICATIONS Open wounds Unhealed scar Severe pain Joint inflammation Joint dislocation/subluxation 2024 NP 1042 KAF Physiotherapy 16  Reliability varies depending on the joint being measured. Intratester reliability is found to be higher than intertester reliability. Advantages VALIDITY Good reliability and validity. Ease of use. AND Inexpensive. Limitations RELIABILITY Reliability dependent on examiner experience. Requires consistency in positioning, stabilization and alignment. Some disagreement between sources for normal values of ROM. 2024 NP 1042 KAF Physiotherapy 17 2024 NP 1042 KAF Physiotherapy 18  The Shoulder ROM Measurement 2024 NP 1042 KAF Physiotherapy 19  Shoulder flexion 2024 NP 1042 KAF Physiotherapy 20  Pre-measurement 2024 NP 1042 KAF Physiotherapy 21 2024 NP 1042 KAF Physiotherapy 22  The measurement 2024 NP 1042 KAF Physiotherapy 23 2024 NP 1042 KAF Physiotherapy 24  Shoulder Extension 2024 NP 1042 KAF Physiotherapy 25  Pre-measurement 2024 NP 1042 KAF Physiotherapy 26 2024 NP 1042 KAF Physiotherapy 27  The measurement 2024 NP 1042 KAF Physiotherapy 28 2024 NP 1042 KAF Physiotherapy 29  Shoulder Abduction 2024 NP 1042 KAF Physiotherapy 30  Pre-measurement 2024 NP 1042 KAF Physiotherapy 31 2024 NP 1042 KAF Physiotherapy 32  The measurement 2024 NP 1042 KAF Physiotherapy 33 2024 NP 1042 KAF Physiotherapy 34  Shoulder Adduction 2024 NP 1042 KAF Physiotherapy 35  Pre-measurements 2024 NP 1042 KAF Physiotherapy 36 2024 NP 1042 KAF Physiotherapy 37  The measurement 2024 NP 1042 KAF Physiotherapy 38 2024 NP 1042 KAF Physiotherapy 39  Shoulder lateral rotation 2024 NP 1042 KAF Physiotherapy 40  Pre-measurement 2024 NP 1042 KAF Physiotherapy 41 2024 NP 1042 KAF Physiotherapy 42  The measurement 2024 NP 1042 KAF Physiotherapy 43 2024 NP 1042 KAF Physiotherapy 44  Shoulder internal rotation 2024 NP 1042 KAF Physiotherapy 45  Pre-measurement 2024 NP 1042 KAF Physiotherapy 46 2024 NP 1042 KAF Physiotherapy 47  The measurement 2024 NP 1042 KAF Physiotherapy 48 2024 NP 1042 KAF Physiotherapy 49  The Elbow ROM Measurement 2024 NP 1042 KAF Physiotherapy 50  Elbow flexion 2024 NP 1042 KAF Physiotherapy 51  Pre-measurement 2024 NP 1042 KAF Physiotherapy 52 2024 NP 1042 KAF Physiotherapy 53  The measurement 2024 NP 1042 KAF Physiotherapy 54 2024 NP 1042 KAF Physiotherapy 55  Elbow Extension 2024 NP 1042 KAF Physiotherapy 56  Pre-measurement 2024 NP 1042 KAF Physiotherapy 57 2024 NP 1042 KAF Physiotherapy 58 2024 NP 1042 KAF Physiotherapy 59  The measurement 2024 NP 1042 KAF Physiotherapy 60 2024 NP 1042 KAF Physiotherapy 61  The measurement 2024 NP 1042 KAF Physiotherapy 62  Elbow supination 2024 NP 1042 KAF Physiotherapy 63  Pre-measurement 2024 NP 1042 KAF Physiotherapy 64 2024 NP 1042 KAF Physiotherapy 65 2024 NP 1042 KAF Physiotherapy 66  The measurement 2024 NP 1042 KAF Physiotherapy 67 2024 NP 1042 KAF Physiotherapy 68 2024 NP 1042 KAF Physiotherapy 69  Elbow pronation 2024 NP 1042 KAF Physiotherapy 70  Pre-measurement 2024 NP 1042 KAF Physiotherapy 71 2024 NP 1042 KAF Physiotherapy 72 2024 NP 1042 KAF Physiotherapy 73  The measurement 2024 NP 1042 KAF Physiotherapy 74 2024 NP 1042 KAF Physiotherapy 75 2024 NP 1042 KAF Physiotherapy 76  The Wrist ROM Measurement 2024 NP 1042 KAF Physiotherapy 77  The wrist flexion 2024 NP 1042 KAF Physiotherapy 78  Pre-measurement 2024 NP 1042 KAF Physiotherapy 79 2024 NP 1042 KAF Physiotherapy 80 2024 NP 1042 KAF Physiotherapy 81  The measurement 2024 NP 1042 KAF Physiotherapy 82 2024 NP 1042 KAF Physiotherapy 83 2024 NP 1042 KAF Physiotherapy 84  The wrist extension 2024 NP 1042 KAF Physiotherapy 85  Pre-measurement 2024 NP 1042 KAF Physiotherapy 86 2024 NP 1042 KAF Physiotherapy 87 2024 NP 1042 KAF Physiotherapy 88  The measurement 2024 NP 1042 KAF Physiotherapy 89 2024 NP 1042 KAF Physiotherapy 90 2024 NP 1042 KAF Physiotherapy 91  CONCLUSION Goniometric measurement is an important skill for physiotherapists as it is employed in almost all area of physiotherapy practice. The universal goniometer remains the gold standard for ROM measurement due its’ excellent validity and reliability. It is also easy to be used, inexpensive and easily available. 2024 NP 1042 KAF Physiotherapy 92  93 Classroom activities Please demonstrates the joint measurements using goniometry