Hip Goniometry

Flexion

Patient Instructions:

Ask the patient to bend their knee and bend their leg and bring it as close to their chest as is comfortable for them.

Starting and Ending Position:

·        The patient should be lying supine in the anatomical position.

·        The fulcrum is aligned with the greater trochanter of the femur.

·        The stationary arm is positioned along the lateral midline of the abdomen, using the pelvis for reference, the moving arm along the lateral midline of the femur.

Normal ROM is between 115 and 125 degrees.  The patient is in 115 degrees of knee flexion.

Extension

Patient Instructions:

            Have the patient lift their leg off the table as far as they can.

Starting and Ending Position:

·        Patient is lying prone with legs together and arms at sides.

·        Goniometer positioning is the same as for hip flexion.

Normal ROM for hip extension is 10 to 30 degrees, patient has 25 degrees of hip extension.

Abduction

Patient Instructions:

            The patient should be asked to move their leg out to the side as far as they can.

Starting Position:

·        Patient is supine in anatomical position.

·        Fulcrum is placed in line with the anterior superior iliac spine.

·        The moving arm of the goniometer is aligned with the midline of the patella, the stationary arm with the ASIS of the opposite side.

·        Note:  This places the goniometer reading at 90 degrees, to determine the actual reading make sure to read 90 as 0 and determine the measurement in that manner.

Ending Position:

·        Same as above

Normal ROM for hip abduction is 40 to 50 degrees; the patient has 48 degrees of hip abduction.

Adduction

Patient Instructions:

            Ask the patient to move their leg to the inside toward their opposite leg.

Starting Position:

·        Patient is supine the leg not being measured is abducted to allow full adduction of the opposite leg.

·        The goniometer positioning is the same as for abduction, fulcrum at the ASIS, moving arm aligned with the midline of the patella, and the stationary arm with the ASIS of the opposite side.  Also, remember to adjust due to the goniometer starting at a reading of 90 degrees.

Ending Position:

·        Same as above

The normal ROM is 15 to 25 degrees.  The patient has 18 degrees of hip adduction.

Medial (Internal) Rotation

Patient Instructions:

            Have the patient bring their leg out to the side.

Starting Position:

·        The patient will be sitting off of the edge of the table, knees against the table, with their legs dangling down off the table.

·        The fulcrum is aligned with the patella and both arms of the goniometer with the midline of the tibia.

Ending Position:

·        The fulcrum and moving arm remain in the same position as above.

·        The stationary arm should now be hanging freely but should be perpendicular to the floor.

The normal ROM for internal rotation is 35 to 50 degrees.  Patient has 49 degrees of internal rotation at the hip.

Lateral (External) Rotation

Patient Instructions:

            Ask the patient to move their leg in toward the opposite leg.

Starting Position:

·        Patient is sitting on the edge of the table as was done for internal rotation.  The leg not being measured can either remain off the table or can be on the table depending on the ability of the patient.  The patient in the picture has her leg on the table to her side.

·        The goniometer positioning is the same as for lateral rotation.  The fulcrum is aligned with the patella, and both arms with the midline of the tibia.

Ending Position:

·        The fulcrum and moving arm are still in the same position.

·        The stationary arm should be hanging freely and perpendicular to the floor.

Normal ROM is between 25 to 40 degrees, the patient in the picture is at 26 degrees.

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