No abstract

This study determined the intratester and intertester variability and reliability of goniometric measurements taken by four physical therapists on upper and lower extremity motions of normal male subjects. The same subjects were measured once weekly for four weeks by testers with varied experience in goniometry. Data were analyzed by analyses of variance with repeated measures. Intratester variation for all measurements was less than intertester variation. Further, intertester variation was less for the three upper extremity motions than for those of the lower extremity. These findings indicate the necessity for using the same tester when effects of treatment are evaluated. When the same tester measures the same movement, increases in joint motion of at least three to four degrees determine improvement for either the upper or lower extremity. When more than one tester, however, measures the same movement, increases in joint motion should exceed five degrees for the upper extremity and six degrees for the lower extremity to determine improvement.

Many diseases and injuries can impair joint mobility. Normal reference values are needed to determine extent of impairment to assess and monitor joint motion. There is very little published data describing normal joint range of motion (ROM) for healthy men and women across a wide span of ages. We enrolled male and female subjects aged between 2 and 69 years who were free from conditions that could potentially limit joint mobility for the study. Nine licensed physical therapists used universal goniometers to determine passive joint motion bilaterally of elbow flexion, extension, supination and pronation, shoulder flexion, hip flexion and extension, knee flexion and extension, and ankle dorsiflexion and plantarflexion. Descriptive statistics were calculated for male and female subjects in four age groups: 2-8, 9-19, 20-44 and 45-69 years. Joint ROM measurements were obtained on a total of 674 (53.6% female) healthy, normal subjects aged 2-69 years. Female subjects had greater joint mobility in all age groups in nearly all joints and the gender difference was most obvious in measures of ankle plantarflexion, elbow pronation and supination. Range of motion average values for all joints decreased with advancing age for both men and women and, in most cases, were significantly different than most commonly used normative values. Our study of ROM measurements taken by trained physical therapists on a large sample of healthy individuals revealed significant gender- and age-related variation that may be an important consideration in patient assessment.

No abstract