, CHAPTER LIST
Chapter 1: Basic Concepts
Chapter 2: Procedures
Chapter 3: Validity and Reliability of Goniometric Measurement
Chapter 4: The Shoulder
Chapter 5: The Elbow and Forearm
Chapter 6: The Wrist
Chapter 7: The Hand
Chapter 8: The Hip
Chapter 9: The Knee
Chapter 10: The Ankle and Foot
Chapter 11: The Cervical Spine
Chapter 12: The Thoracic and Lumbar Spine
Chapter 13: The Temporomandibular Joint
, Chapter 1: Basic Concepts of Measurement of Joint
Motion: A Guide to Goniometry.
1. Which of the following best describes the difference between osteokinematics
and arthrokinematics in the context of joint measurement?
A. Osteokinematics refers to the movement of bone surfaces, while
arthrokinematics refers to the movement of bones in space.
B. Osteokinematics is measured by a goniometer, while arthrokinematics involves
rolls, spins, and slides that cannot be measured with a standard goniometer.
C. Arthrokinematics is under voluntary control, whereas osteokinematics is the
involuntary movement of joint surfaces.
D. Osteokinematics focuses on muscle length, while arthrokinematics focuses
solely on joint capsule integrity.
Answer: B
Rationale: Osteokinematics describes the gross movement of bones in relation
to the three cardinal planes (flexion, extension, etc.), which is what a goniometer
records. Arthrokinematics describes the internal movement of the joint surfaces
(roll, slide, spin) which are essential for normal osteokinematic motion but are
assessed via joint play/manual mobilization rather than goniometry.
Key words: Osteokinematics, Arthrokinematics, Goniometry.
2. A clinician observes that a patient's passive range of motion (PROM) is
significantly greater than their active range of motion (AROM). This clinical
finding most likely indicates:
A. Joint capsule fibrosis or capsular tightness.
, B. Bony obstruction within the joint space.
C. Muscle weakness, pain, or neuromuscular inhibition.
D. Systemic hypermobility syndrome.
Answer: C
Rationale: A gap where PROM exceeds AROM usually suggests that the joint
itself is mobile, but the "motor" (muscles/nerves) is unable to move the segment
through the available space due to weakness, pain, or lack of innervation. If the
capsule were tight (Option A), both AROM and PROM would be similarly limited.
Key words: AROM, PROM, Differential Diagnosis.
3. When assessing a patient with suspected "hypermobility," which of the following
must be considered to distinguish it from normal variation?
A. Comparing the values to the mean ROM of the general population.
B. Assessing the end-feel and comparing findings to the contralateral, uninvolved
limb.
C. Determining if the motion is limited by muscle length or joint capsule.
D. Using a digital inclinometer instead of a universal goniometer.
Answer: B
Rationale: Hypermobility is often specific to the individual. To determine if a
range is "excessive" for a specific patient, the clinician must compare it to the
uninvolved side and assess the quality of the end-feel (e.g., lack of standard firm
resistance) to ensure stability is not compromised.
Key words: Hypermobility, End-feel, Comparison.
,4. Which factor is generally cited in the text as having the most significant influence
on "normal" ROM values across the lifespan?
A. Biological sex.
B. Daily physical activity levels.
C. Age.
D. Body Mass Index (BMI).
Answer: C
Rationale: Research consistently shows that ROM decreases with age due to
changes in connective tissue elasticity, joint surface changes, and decreased
activity. While sex and BMI influence ROM, age remains the most pervasive
variable for establishing "normal" ranges.
Key words: Age, Normative values, Factors affecting motion.
5. A "soft" end-feel is considered normal for which of the following joint motions?
A. Elbow extension.
B. Knee flexion.
C. Hip internal rotation.
D. Wrist flexion.
Answer: B
Rationale: A soft end-feel is typically caused by soft tissue approximation
(muscle bulk meeting muscle bulk). During knee flexion, the posterior calf meets
the posterior thigh, creating a soft, yielding sensation.
, Key words: Soft end-feel, Tissue approximation, Knee flexion.
6. If a clinician fails to properly stabilize the proximal bone during goniometric
measurement, what is the most likely impact on the data?
A. The validity of the measurement will increase.
B. The measurement will likely overestimate the actual joint ROM.
C. The measurement will capture muscle length instead of joint motion.
D. The alignment of the fulcrum will become easier to maintain.
Answer: B
Rationale: Stabilization is required to isolate motion to a single joint. Without it,
compensatory movements from adjacent joints or segments (substitutions) often
occur, leading to a measurement that falsely suggests more motion exists at the
target joint than is actually present.
Key words: Stabilization, Compensation, Validity.
7. A patient presents with a "hard" end-feel during elbow extension before
reaching 0 degrees. This is an example of:
A. A normal physiological stop.
B. An abnormal end-feel due to bony fragments or osteoarthritis.
C. A capsular pattern of restriction.
D. Protective muscle guarding.
Answer: B
, Rationale: While elbow extension normally has a hard end-feel (olecranon
process in the fossa), a hard end-feel occurring before the expected end of range
is pathological, suggesting a bony block, fracture, or severe degenerative
change.
Key words: Hard end-feel, Bony block, Pathology.
8. Which plane of motion and axis of rotation are associated with shoulder
abduction?
A. Sagittal plane / Medial-lateral axis.
B. Transverse plane / Vertical axis.
C. Frontal plane / Anterior-posterior axis.
D. Frontal plane / Medial-lateral axis.
Answer: C
Rationale: Abduction occurs in the frontal plane (dividing the body into front
and back). Movement in the frontal plane always occurs around an axis that runs
from front to back (Anterior-Posterior).
Key words: Frontal plane, AP axis, Shoulder abduction.
9. In the context of the 0-to-180 degree notation system, what does the "0"
represent?
A. The start of the movement from a fully flexed position.
B. The anatomical position for most joints.
C. The point of maximum muscle tension.
Chapter 1: Basic Concepts
Chapter 2: Procedures
Chapter 3: Validity and Reliability of Goniometric Measurement
Chapter 4: The Shoulder
Chapter 5: The Elbow and Forearm
Chapter 6: The Wrist
Chapter 7: The Hand
Chapter 8: The Hip
Chapter 9: The Knee
Chapter 10: The Ankle and Foot
Chapter 11: The Cervical Spine
Chapter 12: The Thoracic and Lumbar Spine
Chapter 13: The Temporomandibular Joint
, Chapter 1: Basic Concepts of Measurement of Joint
Motion: A Guide to Goniometry.
1. Which of the following best describes the difference between osteokinematics
and arthrokinematics in the context of joint measurement?
A. Osteokinematics refers to the movement of bone surfaces, while
arthrokinematics refers to the movement of bones in space.
B. Osteokinematics is measured by a goniometer, while arthrokinematics involves
rolls, spins, and slides that cannot be measured with a standard goniometer.
C. Arthrokinematics is under voluntary control, whereas osteokinematics is the
involuntary movement of joint surfaces.
D. Osteokinematics focuses on muscle length, while arthrokinematics focuses
solely on joint capsule integrity.
Answer: B
Rationale: Osteokinematics describes the gross movement of bones in relation
to the three cardinal planes (flexion, extension, etc.), which is what a goniometer
records. Arthrokinematics describes the internal movement of the joint surfaces
(roll, slide, spin) which are essential for normal osteokinematic motion but are
assessed via joint play/manual mobilization rather than goniometry.
Key words: Osteokinematics, Arthrokinematics, Goniometry.
2. A clinician observes that a patient's passive range of motion (PROM) is
significantly greater than their active range of motion (AROM). This clinical
finding most likely indicates:
A. Joint capsule fibrosis or capsular tightness.
, B. Bony obstruction within the joint space.
C. Muscle weakness, pain, or neuromuscular inhibition.
D. Systemic hypermobility syndrome.
Answer: C
Rationale: A gap where PROM exceeds AROM usually suggests that the joint
itself is mobile, but the "motor" (muscles/nerves) is unable to move the segment
through the available space due to weakness, pain, or lack of innervation. If the
capsule were tight (Option A), both AROM and PROM would be similarly limited.
Key words: AROM, PROM, Differential Diagnosis.
3. When assessing a patient with suspected "hypermobility," which of the following
must be considered to distinguish it from normal variation?
A. Comparing the values to the mean ROM of the general population.
B. Assessing the end-feel and comparing findings to the contralateral, uninvolved
limb.
C. Determining if the motion is limited by muscle length or joint capsule.
D. Using a digital inclinometer instead of a universal goniometer.
Answer: B
Rationale: Hypermobility is often specific to the individual. To determine if a
range is "excessive" for a specific patient, the clinician must compare it to the
uninvolved side and assess the quality of the end-feel (e.g., lack of standard firm
resistance) to ensure stability is not compromised.
Key words: Hypermobility, End-feel, Comparison.
,4. Which factor is generally cited in the text as having the most significant influence
on "normal" ROM values across the lifespan?
A. Biological sex.
B. Daily physical activity levels.
C. Age.
D. Body Mass Index (BMI).
Answer: C
Rationale: Research consistently shows that ROM decreases with age due to
changes in connective tissue elasticity, joint surface changes, and decreased
activity. While sex and BMI influence ROM, age remains the most pervasive
variable for establishing "normal" ranges.
Key words: Age, Normative values, Factors affecting motion.
5. A "soft" end-feel is considered normal for which of the following joint motions?
A. Elbow extension.
B. Knee flexion.
C. Hip internal rotation.
D. Wrist flexion.
Answer: B
Rationale: A soft end-feel is typically caused by soft tissue approximation
(muscle bulk meeting muscle bulk). During knee flexion, the posterior calf meets
the posterior thigh, creating a soft, yielding sensation.
, Key words: Soft end-feel, Tissue approximation, Knee flexion.
6. If a clinician fails to properly stabilize the proximal bone during goniometric
measurement, what is the most likely impact on the data?
A. The validity of the measurement will increase.
B. The measurement will likely overestimate the actual joint ROM.
C. The measurement will capture muscle length instead of joint motion.
D. The alignment of the fulcrum will become easier to maintain.
Answer: B
Rationale: Stabilization is required to isolate motion to a single joint. Without it,
compensatory movements from adjacent joints or segments (substitutions) often
occur, leading to a measurement that falsely suggests more motion exists at the
target joint than is actually present.
Key words: Stabilization, Compensation, Validity.
7. A patient presents with a "hard" end-feel during elbow extension before
reaching 0 degrees. This is an example of:
A. A normal physiological stop.
B. An abnormal end-feel due to bony fragments or osteoarthritis.
C. A capsular pattern of restriction.
D. Protective muscle guarding.
Answer: B
, Rationale: While elbow extension normally has a hard end-feel (olecranon
process in the fossa), a hard end-feel occurring before the expected end of range
is pathological, suggesting a bony block, fracture, or severe degenerative
change.
Key words: Hard end-feel, Bony block, Pathology.
8. Which plane of motion and axis of rotation are associated with shoulder
abduction?
A. Sagittal plane / Medial-lateral axis.
B. Transverse plane / Vertical axis.
C. Frontal plane / Anterior-posterior axis.
D. Frontal plane / Medial-lateral axis.
Answer: C
Rationale: Abduction occurs in the frontal plane (dividing the body into front
and back). Movement in the frontal plane always occurs around an axis that runs
from front to back (Anterior-Posterior).
Key words: Frontal plane, AP axis, Shoulder abduction.
9. In the context of the 0-to-180 degree notation system, what does the "0"
represent?
A. The start of the movement from a fully flexed position.
B. The anatomical position for most joints.
C. The point of maximum muscle tension.
