Measurement of the active range of movement of the elbows, wrist and thumb saddle joint are carried out using a goniometer. To assess the range of movement of the finger joints, measurements are taken of the fingernail-table distance (total extension of the finger) and the fingertip-to-palm distance (total flexion of the finger).
Neutral Zero Method
Required material: Goniometer
The active range of movement of the elbows, wrist and thumb saddle joint are measured using a goniometer according to the neutral zero method, whereby the neutral joint position is defined the zero position. The pivot of the goniometer is placed on the pivot of the joint, the two arms of the goniometer on each side of the joint. In the case of the thumb saddle joint, the abduction and adduction is measured in the palmar plane.
Procedure: The goniometer measures the patient’s maximum possible joint movement away from the body, then the patient moves the joint the maximal possible distance towards the body, again the goniometer measures this value. First the healthy side is assessed and then the afflicted side. The values are rounded up or down to the nearest 5˚.
Total extension of the finger
Required material: Tape-measure (for instance on the goniometer)
Procedure: Laying both hands on the table, palms up, the patient is asked to stretch their fingers as far as possible towards the table. Alternatively, if the patient cannot lay the backs of their hands on th table (for instance due to weak supination), the backs of the hands are placed on a flat object in extension to the metacarpal bones.
The distance between the fingernail and the table (or the flat object on the back of the hand) is measured in cm for each finger.
Total flexion of the finger
Required material: Tape-measure (for instance on the goniometer or special fingertip-palm measuring gauge)
Procedure: The back of the hand is laid supine on the table or with the ulnar hand edge on the table. The patient is asked to bend their fingers as far as possible. The cm distance between the fingertip and palm (distal palmar crease) is measured for each finger.
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