Clinical measurement of range of motion is a fundamental evaluation procedure with ubiquitous application in physical therapy. Objective measurements of ROM and correct interpretation of the measurement results can have a substantial impact on the development of the scientific basis of therapeutic interventions. The purpose of this article is to review the related literature on the reliability and validity of goniometric measurements of the extremities. Special emphasis is placed on how the reliability of goniometry is influenced by instrumentation and procedures, differences among joint actions and body regions, passive versus active measurements, intratester versus intertester measurements, and different patient types. Our discussion of validity encourages objective interpretation of the meaning of ROM measurements in light of the purposes and the limitations of goniometry. We conclude that clinicians should adopt standardized methods of testing and should interpret and report goniometric results as ROM measurements only, not as measurements of factors that may affect ROM.
T he quadriceps femoral angle ( Q angle) has been associated with general patellofemoral disorders (7.1 1 ), patella subluxation (I), and chondromalacia (1,6,8). T h e Q angle is usually measured as the angle between a line connecting the anterior superior iliac spine (ASIS) and the midpoint of the patella, and a line between the midpoint of the patella and the tibia1 tubercle (4.1 3). Although the landmarks for measuring the Q angle have been standardized, the procedures have not. A review of the literature revealed various methods, particularly with reference to quadriceps contraction and the position of the subject. Aglietti et al (1) recommended measuring the Q angle with the subject supine with the knee fully extended, but quadriceps contraction o r relaxation was not addressed. Hughston et al (5) advocated measuring the Q angle with the subject supine and the quadriceps contracted. Magee (1 1) advocated measuring the Q angle in sitting with the quadriceps relaxed. Merchant (1 3) also recommended measuring the Q angle with the quadriceps relaxed but with the knee in full extension. Lyon et al (10) recommended the supine position but did not address quadriceps contraction o r relaxation. Horton and Hall (4) measured the Q angle with the subject standing with the knees in full extension, but they also did notThe quadriceps femoral angle (Q angle) has been linked with several knee disorders, but Qangle measurement procedures have not been standardized. The purpose of this study was to examine the effects of isometric quadriceps contraction in the standing and supine positions on the Q angle. The Q angles of the right knees of 30 men and 30 women were measured goniometn'cally during four test conditions: I) quadriceps relaxed in standing, 2) quadriceps contracted in standing, 3) quadriceps relaxed in supine, and 4) quadriceps contracted in supine. The pelvic widths were also measured as the distance between the anterior superior iliac spines in standing and supine. A twoway multivariate analysis of variance showed a significant difference between genders (p < 0.001) and among the four test conditions (p < 0.001) (N = 60). Separate one-way analyses of variance (ANOVAs) with two grouping factors (contraction and position) showed significant effects of contraction (p < 0.001) for both men and women, but no significant effect of positions. A dependent t-test showed that the pelvic width differed between standing and supine for both men and women (p < 0.001). The results showed that isometric quadriceps contraction affects the Q angle with the subjects standing or supine, even though the pelvic width differed significantly between the two positions. Clinicians and researchers should consider the results of this study in order to standardize procedures for measuring the Q angle. address quadriceps contraction o r relaxation. Other reports did not describe Q-angle measurement procedures (6-8).T h e lack of standard Q-angle measurement procedures led us to investigate the influence of isometric quadriceps contraction i...
. Mitrnan, BS, P?linical observations have suggested that the length of the hamstring muscles may be associated with specific pelvic and trunk postures. If hamstring length influences pelvic and trunk postures, then knowledge about the influence of hamstring length is important for understanding normal postures in nondisabled people and abnormal postures in patients. As a result, therapeutic interventions could be designed to address muscle length abnormalities in an effort to promote postures that decrease abnormal stresses that may lead to injury o r disease.Several published studies have reported attempts to examine the relationship between tests of hamstring length and the pelvic inclination angle and the lumbar angle. One study found no significant relationship between straight-leg raising (SLR) and the pelvic inclination angle in standing (1 3). T h e authors also reported a significant negative relationship between SLR and the lumbar angle, indicating that short hamstrings may be associated with an increased lumbar angle. However, in a follow-up study, the same researchers reported
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