end of semester prac

Question 1

grade 1 PAMs dosage and application of force

Answer 1

small amplitude movement at beginning of the available range
1-2 sets of 30 sec < 1 min dependent on pain
for pain

Question 2

grade 2 application of force and dosage

Answer 2

1-2 sets of 30 sec < 1 min dependent on pain
large amplitude movement within a resistance-free part of available range
for pain

Question 3

grade 3 application of force and dosage

Answer 3

large amplitude movement performed into resistance or up to the limit of available range
2-3 sets or > of 1 min or > dependent on changes in tissue resistance and/or pain
for pain and stiffness

Question 4

grade 5 application of force

Answer 4

stiffness and locked joint
small amplitude, high velocity movement at end of available range

Question 4

grade 4 application of force and dosage

Answer 4

2-3 sets or > of 1 min or > dependent on changes in tissue resistance and/or pain
small amplitude movement performed into resistance or up to limit of available range
for stiffness

Question 5

what type of conditions are grade 1 and 2 used for

Answer 5

acute conditions in which pain is the over-riding
feature and limitation to movement

Question 6

what type of conditions are grade 3 and 4 used for

Answer 6

chronic and overuse conditions where stiffness is the main feature.

Question 7

preform talocural joint AP glide

Answer 7

 Patient supine or prone with knee flexed and
ankle in plantar grade. May also be performed
in sitting or standing.
 If performing in supine, it is helpful to have the
foot off edge of bed to ensure clearance.
 In supine have patient’s foot resting against
therapist’s thigh. Stabilise distal tibia either
anterior or posterior against the bed. Apply an
anteroposterior force to the talocrural joint.

Question 8

preform talocural joint PA glide

Answer 8

 In prone with knee flexed
 Stabilise distal tibia with one hand and apply a
posteroanterior directed force to the talocrural
joint via the calcaneum using a cupped hand
position.

Question 9

Inferior Tibio-fibular Joint AP/PA glide

Answer 9

THIS IS A CLEARENCE TEST FOR THE ANKLE
 Patient supine with the ankle in 0 – 10 degrees
of plantarflexion and the foot over the end of
the bed
 Stabilise the tibia and hold the distal head of
fibula between thumb and index finger or you
can use the heel of the hand.
 Apply anteroposterior force to the fibula for the
AP glide and release to the resting position.
 Apply an upward pressure on the fibula to
produce a posteroanterior force to the fibula for
the PA glide.

Question 10

REARFOOT subtalar joint transverse glides

Answer 10

 Patient side lying with towel to stabilize tibia
and fibula.
 Foot off edge of bed to ensure clearance.
 Medial to lateral glide (affected limb
lowermost with hip and knee in some flexion)
(INVERSION)
 Lateral to medial glide (affected limb
uppermost) (EVERSION)
 For both glides, stabilize the tib/fib/talus
standing in front of patient, apply the calcaneal
glide along the oblique plane of the STJ

Question 10

PREFORM MODFOOT Talonavicular joint

Answer 10

 Patient supine with foot off end of plinth
 Therapist stands on lateral side of foot and
facing dorsal surface of foot.
 Fix talus (and calcaneum) with web space of
proximally positioned hand.
 Fix and glide navicular (big toe to 3rd toe) with thumb positioned
dorsally and fingers on plantar surface or use a
lumbrical grip.
 Navicular is moved in dorsal or plantar direction
in relation to the fixed talus.

Question 11

preform MIDFOOT Calcaneocuboid joint PAM

Answer 11

 Patient side lying with foot supported on plinth.
 Therapist stands in front of patient.
 Stabilize calcaneus and talus with one hand.
 Fix and glide cuboid between thumb and fingers
Assess:
 Plantar glide of cuboid
 Dorsal glide of cuboid

Question 12

FOREFOOT preform Tarsometatarsal joints (1st TMTJ only) NOT THE TOES

Answer 12

 Patient supine with foot off end of plinth
 Therapist stands on lateral side of foot and
facing dorsal surface of foot.
 Stabilise tarsal eg navicular with thumb and fingers of one hand and grip and glide the metatarsal (medial cuneiform) with the thumb and fingers of the other hand.
 Plantar & dorsal glide

Question 13

FOREFOOT Metatarsophalangeal joints (1st MTPJ only)

Answer 13

 Patient in supine
 Therapist stands on lateral side of patient’s foot.
 Stabilize metatarsal, fix and move the phalanx.
 Ensure you are close to the joint line which is
aligned with middle of the fat pad of foot.
 Distraction
 AP phalanx
 PA phalanx

Question 14

what is the anterior draw (SPECIAL ORTHOPAEDIC TESTS) used for

Answer 14

anterior talofibular ligament

Question 15

what are you feeling for in an ATFL test// any ligament test

Answer 15

range/laxity, quality and end feel of the
movement, reproduction of symptoms

Question 16

Positive Ligament stress tests grades 1,2,3

Answer 16

Grade 1: no laxity, definite end feel, reproduction of patient’s pain
Grade 2: some laxity with an end feel, reproduction of patient’s pain
Grade 3: laxity++, no end feel, may or may not reproduce patient’s pain.

Question 16

preform Anterior Draw Test (primarily tests integrity of ATFL) a special orthopaedic test.

Answer 16

 Supine with foot relaxed over edge of bed.
 Ankle 10-20 degrees plantar flexion
 Patient must have a flexed knee to prevent a false negative result that can come from a
tight Tendo-Achilles preventing the talus and
calcaneum from being brought forward.
 Therapist grasps firmly around the tibia &
fibula at the level of the malleoli and ensures
that this remains motionless. Index finger
palpates anteriorly to the fibula for talar
movement.
 Other hand holds firmly around the
calcaneum and draws the talus forward in the
ankle mortise.
 Laxity or rupture of the ATFL will result in a
positive test.
 A dimple or suction sign may appear over
ATFL and anterior joint line with palpable
anterior talar movement during a +ve test

Question 17

preform Talar Tilt Test (primarily Calcaneofibular ligament stress test) special orthopedic test

Answer 17

 Patient supine / long sitting.
 Foot is held in plantigrade.
 Therapist stands on side of bed facing foot of
patient.
 One hand cups calcaneus, other wraps over
dorsum so fingers positioned over lateral talar
dome, index finger palpates joint line below
lateral malleoli.
 Varus stress applied to calcaneus whilst other
hand feels for talar ROM.

Question 18

preform Medial collateral ligament stress test (deltoid ligament stress test) special orthopaedic test

Answer 18

 Patient supine / long sitting.
 Foot is held in plantigrade.
 One hand cups calcaneus, other hand wraps
around dorsum of foot from medial side with
index finger palpating the medial joint line.
 Valgus stress is applied to calcaneus to stress
the deltoid ligament, upper hand can also add
eversion in a degree of dorsiflexion.
 Watch/feel for gapping under the medial
malleoli.
 Positive test is pain over medial aspect of
ankle and/or laxity

Question 19

preform Calcaneocuboid Ligament stress test (Bifurcate ligament) special orthopaedic test

Answer 19

 Supine or side lying with foot relaxed over edge
of bed.
 Heel of hand on medial aspect of calcaneus
cups the heel.
 Lumbrical grip over cuboid and distal foot
applies a supination force (inversion,
plantarflexion, adduction)
 See above for criteria of positive ligament stress
tests and grading.

Question 19

preform External rotation stress test (inferior tibiofibular syndesmosis test) special orthopaedic test

Answer 19

 Sitting over edge of bed, knees flexed to 90
degrees.
 Stabilise over distal thigh and tibia.
 Other hand grasps the posterior calcaneus, rests foot along forearm & supports foot in plantigrade.
 A passive external rotation stress is applied to
the foot and ankle.
 A +ve test would be pain reproduced over
anterior inferior tibiofibular ligament and interosseous membrane.

Question 20

preform Dorsiflexion compression test (inferior tibiofibular syndesmosis) special orthopaedic test

Answer 20

 Patient in standing
 Patient asked to actively lunge and dorsiflex
ankle and report any pain (therapist notes ROM)
 Therapist uses both hands to squeeze the
malleoli together and test is repeated.
 It is a +ve test if pain is reduced and/or
dorsiflexion ROM increases when squeeze
added

Question 21

preform Thompson’s test (Achilles tendon integrity) special orthopaedic test

Answer 21

 Patient prone and relaxed with foot hanging off end of bed (note resting position of ankle in this position)  Therapist gently but firmly squeezes the muscle bellies of the gastro-soleus complex.  If the Tendo-Achilles is intact (partially or wholly) the ankle will passively plantar flex  +ve test = Lack of PF indicating a complete rupture

Question 22

preform Metatarsal squeeze test

Answer 22

 Supine / long sitting.  Therapist grasps medial and lateral aspects of forefoot with one hand.  Medial and lateral aspects are squeezed together & palpation of tender area performed with other hand.  Positive test indicated by provocation of pain

Question 23

preform AP glide of talocurual joint

Answer 23

 Supine over edge of bed, foot in neutral position (then progress towards DF)  Stabilise distal tibia & fibula.  Other hand web space over anterior talus (be careful not to cover the joint)  Glide the talus posteriorly

Question 24

variations of AP talocrural glide PAM and preform it

Answer 24

 MWM for DF o Sustain A-P glide. o Patient actively DF o Patient relaxes. o Therapist release glide

Question 25

why would you use AP talocrural glide

Answer 25

to increase DF ROM

Question 26

WB MWM for TaloCrural Joint DF and dosage

Answer 26

 Patient standing on stable surface with something to hold onto for balance.  Therapist one hand stabilises anterior talus, other hand around posterior tibia.  Glide the tibia anteriorly in treatment plane while patient actively DF. Dosage = 1 x 6-10 repetitions

Question 27

variation of WB MWM for TaloCrural Joint DF

Answer 27

Use seatbelt around posterior tibia and both hands can stabilise anterior talus

Question 28

why would you use a WB MWM for TaloCrural Joint DF

Answer 28

- to increase DF ROM

Question 29

TaloCrural or SubTalar joint distraction GI-IV

Answer 29

 Prone lying with knee flexed to 90 degrees.  Therapist stabilises patient’s thigh with knee.  Hands hook onto talus for TC joint distraction or onto calcaneus for ST joint distraction.  Distract the TC/ST joint by flexing elbows.  Effective for deloading joint

Question 30

why would you use TaloCrural or SubTalar joint distraction GI-IV

Answer 30

- Osteoarthritis of TCJ and STJ, hypomobility of TCJ and STJ e.g., post immobilisation

Question 31

preform SubTalus J transverse glides GI-IV

Answer 31

 Patient side lying with towel to stabilize tibia and fibula.  Foot off edge of bed to ensure clearance.  Medial to lateral glide (affected limb lowermost with hip and knee in some flexion)  Lateral to medial glide (affected limb uppermost)  For both glides, stabilize the tib/fib/talus standing in front of patient; apply the calcaneal glide along the oblique plane of the STJ

Question 32

why would you use STJ transverse glides GI-IV

Answer 32

- Lateral to Medial glide will facilitate eversion. - Medial to lateral glide will facilitate inversion

Question 33

preform Talonavicular joint GI-IV

Answer 33

 Patient supine with foot off end of plinth  Therapist stands on lateral side of foot and facing dorsal surface of foot.  Fix talus (and calcaneum) with web space of proximally positioned hand.  Fix and glide navicular with thumb positioned dorsally and fingers on plantar surface or use a lumbrical grip.  Navicular is moved in dorsal or plantar direction in relation to the fixed talus. The navicular is concave so plantar glide may go with plantar flexion and dorsal glide with dorsiflexion.

Question 34

perform Calcaneocuboid joint GI-IV

Answer 34

 Patient side lying with foot supported on plinth.  Therapist stands in front of patient.  Stabilize calcaneus and talus with one hand.  Fix and glide cuboid between thumb and fingers  Assess:  Plantar glide of cuboid  Dorsal glide of cuboid

Question 35

preform Tarsometatarsal joints (1st TMTJ only) GI-IV

Answer 35

 Patient supine with foot off end of plinth  Therapist stands on lateral side of foot and facing dorsal surface of foot.  Stabilise tarsal with thumb and fingers of one hand and grip and glide the metatarsal with the thumb and fingers of the other hand.  Plantar & dorsal glide

Question 36

preform Metatarsophalangeal joints (1st TMTJ only) GI-IV

Answer 36

 Patient in supine  Therapist stands on lateral side of patient’s foot.  Stabilize metatarsal, fix and move the phalanx.  Ensure you are close to the joint line which is aligned with middle of the fat pad of foot.  Distraction  AP phalanx  PA phalanx

Question 37

External physical devices for the footy

Answer 37

orthotics braces taping ankle foot orthosis- prevents foot drop

Question 38

what are Manual therapy treatment techniques to improve ankle dorsiflexion:

Answer 38

 PAM of talus AP in neutral Gr 1 or 2 if pain is the limitation to movement.  PAM of talus AP in dorsiflexion range close to the onset of symptoms, Gr 3 and 4  NWB or FWB MWMs for TC DF  Massage techniques for improving range of gastroc-soleus muscle group

Question 39

what are Manual therapy treatment techniques to improve ankle plantarflexion:

Answer 39

 PAM of talus PA in neutral, Gr 1 or 2 if pain is the limitation to movement.  PAM of talus PA in plantarflexion range close to the onset of symptoms, Gr 3 and 4  Massage techniques for improving range of tibialis anterior and toe extensor muscle groups.

Question 40

what are Manual therapy treatment techniques to improve inversion:

Answer 40

 PAM of lateral glide of STJ, Gr 1 & 2 if pain limited, Gr 3 if pain & stiffness, Gr 4 if stiffness only.

Question 41

what are Manual therapy treatment techniques to improve eversion:

Answer 41

PAM of medial glide of STJ, Gr 1 & 2 if pain limited, Gr 3 if pain & stiffness, Gr 4 if stiffness only.

Question 42

preform Open Basketweave Technique taping

Answer 42

1) Apply an anchor approx. 5cm above malleoli. 2) Apply a stirrup starting on the medio-posterior aspect of the anchor, directing the tensioned tape behind the medial malleolus, under the foot and finishing behind the lateral malleolus on the posterolateral aspect of the anchor 3) Apply a spur starting along the 5th MT, directing the tape posterior to the calcaneus, and finishing along the 1st MT 4) Repeat alternating between stirrups and spurs, overlapping each previous layer by up to ½ width of tape 5) lock off top but leave part in the middle

Question 43

preform Anti-inversion technique for lateral ankle sprains (prophylactic or late rehab)

Answer 43

1) Apply an anchor approx. 5cm above malleoli. 2) Apply a stirrup starting on the medio-posterior aspect of the anchor, directing the tensioned tape behind the medial malleolus, under the foot and finishing behind the lateral malleolus on the posterolateral aspect of the anchor (medial to lateral). Repeat with 2 more stirrups overlapping each stirrup by half of the width 3) Apply two 6’s overlapping each one by half the tape width of the previous. The 6’s start on the medial aspect of the anchor and work to the lateral side where it is directed over the dorsal aspect of the foot, locking at the medial malleolus. 4) Apply a full Heel lock: Start at the medial malleolus. Bring the tape anteriorly over the anterior ankle joint line to below the lateral malleolus. Continue the tape under the plantar surface of the foot from lateral to medial. Next cross the medial aspect of the calcaneus obliquely, continue across the posterior calcaneus then to the lateral malleolus and to the anterior ankle joint line. From here continue medially under the plantar aspect of the foot, medial to lateral and cross the lateral calcaneus obliquely. Continue around the posterior calcaneus and finish on the tape at the anterior ankle

Question 44

preform taping for Anteroposterior Cranial Glide on Inferior Fibula

Answer 44

1) Apply tape over inferior tibiofibular joint, tension tape with one hand and apply it in an oblique cranial direction while applying an anteroposterior cranial glide on the fibula with the other hand. 2) Direct the tape posteriorly above the Achilles tendon and finish the tape anteromedially. 3) Apply a second strip over first one if desired

Question 45

preform Anti-pronation Techniques (Low Dye Technique)

Answer 45

1) Apply spur starting from 1st MTP joint directing around the posterior calcaneus and finishing along the lateral aspect of the 5th MTP jt. 2) Apply a mini stirrup from the lateral aspect of the spur directing them under the plantar aspect of the foot and finishing on the medial aspect of the spur. Apply 3-4 of these, overlapping tape by 1/2 to cover the plantar aspect of the foot. Don’t go past the MTP joint lines. 3) Avoid creases of the skin underneath the foot 4) May plantarflex the first ray to enhance push off if required 5) Apply a second spur medial to lateral over the same direction as the first one to lock off the ends of the mini stirrups

Question 46

ORIF POST TIB-FIB # exercise

Answer 46

resisted plantar flexion with theroband- 2 sets 12 reps 3x a week calf stretch- 2 sets 3x a day for 30 sec toe curl with towel- 2 sets 8 reps 2 times a day single leg stance with finger on table- 2 sets 10-30seconds 2-3x a day

Question 46

lateral ankle sprain exercise prescription and dosage

Answer 46

single leg stance- 3 sets of 30 seconds 3 times a day calf flexibility- 2 sets 30 seconds 3 times a day passive ankle dorsiflexion- 2 sets of 10 reps 2 times a day spinning bike- 2-3 times a week for 20mins resisted eversion w theroband- 2 sets of 12 reps 2-3 times a week

Question 47

exercise related leg pain px of exercise

Answer 47

seated TP strengthening- 2 sets, 10 reps, 2x a week toe curl with towel- 2 sets 8 reps 2 times a day calf flexibility- 2 sets 30 seconds 3 times a day flexor hallicus stretch- knee to wall w block to bend toes- 2 sets 2 times daily of 30 seconds

Question 48

Achilles tendionopathy exercise prescription

Answer 48

isometric work- sustained calf raise- 5 sets 45 sec then progress to isotonic strength- calf raised- 4 sets 6-8 reps 2x a week then double leg skipping

Question 49

preform PAM Longitudinal Caudad

Answer 49

 Patient position: supine, pillow under knee of test leg.  Therapist position: stands beside plinth facing patient.  Handling: gripping around femoral condyles  Procedure: apply longitudinal distraction to the femur in a caudad direction  Used to assess joint play of the hip.  Positive test: symptom reproduction or relief

Question 50

preform PAM Hip (femoral head) AP and PA

Answer 50

 Patient position: supine, close to side of bed, pillow under knee of test leg, non-test leg slightly abducted.  Therapist position: stands to the side of patient.  Handling: Be sure to gain informed consent first.  AP: Place medial hand anteriorly over the hip joint, the other hand is over the greater trochanter. PA: Place one hand on medial thigh as close to hip joint line as possible. The other hand over the greater trochanter. This handling can also be used as an alternative for performing an AP.  Procedure: glide femoral head in the acetabulum in AP/PA direction  To assess the joint for bony or capsular restrictions or hypermobility  Positive test: less or more joint play +/- pain compared to unaffected side

Question 51

preform PAM assessment Lateral glide

Answer 51

 Patient supine with pillow under knee of test leg.  Therapist standing beside plinth facing the patient.  Handling: one hand on medial thigh as close to the hip joint as possible, the other hand over the greater trochanter  Lateral movement of the head of the femur in the acetabulum is produced by the therapist moving the femur laterally while ensuring that the angle of Ab/Ad does not alter.  To assess the joint for bony or capsular restrictions or hypermobility  Positive test: less or more joint play +/- pain compared to unaffected side

Question 52

special orthopaedic test for Gluteal tendinopathy/GTPS and a positive test

Answer 52

Standing Trendelenburg test - Positive test : the pelvis on the NWB side drops when the patient stands on the affected leg, and the WB/affected side of the pelvis may shift laterally Trendelenburg held for 30seconds - Positive test: Provocation of the patient’s pain for Gluteal tendinopathy or GTPS

Question 53

preform special orthopaedic test for Gluteal tendinopathy/GTPS and a positive test FADER-R test

Answer 53

 Patient supine  Take affected leg to 90°hip flexion, adduction, and full external rotation.  Ask the patient to internally rotate their hip as you resist them back to neutral hip rotation.  Positive test: reproduction of the patient’s lateral hip pain

Question 54

preform special orthopaedic test for Gluteal tendinopathy/GTPS and a positive test hip quadrant test

Answer 54

 Patient lies supine near edge of plinth with knee flexed.  Therapist stands by patient’s thigh, with fingers of both hands interlocked and lightly cupped over the top of the patient’s flexed knee towards shoulder, chin, contralateral shoulder, ribs, other asis

Question 55

preform special orthopaedic test for Gluteal tendinopathy/GTPS and a positive test ADD-R test

Answer 55

 Patient position: side-lying, affected side uppermost, unaffected side with hip and knee flexed to provide a stable base. Affected side, hip in neutral position.  Therapist: stand behind patient, proximal hand stabilises pelvis, distal hand on top of the knee  Ask the patient to push up into your hand as you resist them.  Positive test: reproduction of the patient’s lateral hip pain

Question 56

preform special orthopaedic test for Gluteal tendinopathy/GTPS and a positive test FADIR Test: Passive hip Flexion/ADduction/Internal Rotation.

Answer 56

 Used to detect a range of conditions e.g. FAI, labral tear, psoas bursitis, piriformis syndrome.  Patient supine  Therapist standing on the affected side.  Handling: support the hip and knee  Procedure: Move the hip flexion (allowing knee to bend), internal rotation and adduction  Positive test: reproduction of patient’s pain. Site of pain reproduction will vary depending on pathology.

Question 57

preform special orthopaedic test for Gluteal tendinopathy/GTPS and a positive test FABER Test: Passive hip Flexion/ABduction/External Rotation

Answer 57

 Used for diagnosis of non-specific intra- articular pathology.  If performed actively and ROM normal, but lateral hip pain reproduced, strong evidence of GTPS (Fearon et al 2013)  Patient lies supine, the examiner places patient’s test leg so that the foot of the test leg is just above the knee of the opposite leg.  The therapist lowers the knee of the test leg toward the examining table while stabilizing the pelvis on the unaffected side  Positive test: test leg’s knee remains above the opposite straight leg

Question 58

preform Muscle Tests Adductor Squeeze test short and long leaver

Answer 58

Used as a test of load tolerance and willingness to generate and subject the groin region to load Short Lever  Position: crook lying, with hips in 45° Flexion  Procedure: patient squeezes knees together as hard as possible (often using dynamometer or sphygmomanometer pre- inflated to 10mmHg between knees to measure force to pain onset)  Positive test: Pain +/- muscle weakness Long Lever  Position: supine, with hips in neutral flexion and abduction  Procedure: patient squeezes legs together as hard as possible (often using dynamometer or sphygmomanometer pre- inflated to 10mmHg between ankles just above the medial malleolus to measure force to pain onset)  Positive test: Pain +/- muscle weakness

Question 59

preform a Thomas test

Answer 59

 Patient position: patient perched on edge of bed with unaffected leg towards the chest.  Therapist: stand in front of the patient and support the position of the unaffected leg, ensure the lumbar lordosis is flat, assist the patient to lie back on the plinth  Procedure: Relax and lower the affected leg towards the floor keeping the lumbar lordosis flat  Thigh of affected leg should reach horizontal position and passively extend to 10-15 deg of hip extension, the thigh should remain in a neutral hip ad/ab position and passively adduct 10-15 deg, lower leg should hang vertically,  Positive test : 1) affected thigh stays in a degree of hip flexion indicating tight hip flexors, 2) thigh is in an abducted position indicating tight TFL+/- ITB, 3) lower leg is in <90 deg knee flexion indicating tight RF,

Question 60

I can use the Thomas test instead of

Answer 60

femoral nerve slump test

Question 61

preform Examination of hip abduction pattern

Answer 61

 Assess inner range gluteus medius strength prior to assessing muscle recruitment patterns.  With the patient in side-lying, palpate the trunk lateral flexors, gluteus medius and TFL. Progress to other positions relevant to patient function.  Correct recruitment sequence (in side lying): gluteus medius ipsilateral trunk side flexors  Faults/substitutions may include: o Backward pelvic rotation o Trunk lateral flexion o Hip flexion

Question 62

preform Examination of hip extension pattern

Answer 62

 Assess inner range gluteus maximus strength prior to assessing muscle recruitment patterns.  With the patient in prone, palpate trunk extensors, gluteus maximus, hamstrings. Progress to other positions relevant to patient function.  Use pillow under pelvis if restricted hip extension.  Correct recruitment sequence (prone) o Gluteals followed by hamstrings or hamstrings and gluteals simultaneously-> ipsilateral erector spinae

Question 63

what are faults of Examination of hip extension pattern

Answer 63

incorrect sequence excessive lumbar spine extension excessive pressure through contralateral leg

Question 64

preform hip internal/ external rotation PPM

Answer 64

 Patient position: supine with pillow or therapist knee supporting patient knee into slight flexion.  Therapist: stands beside plinth, facing across patient at level of knee  Handling: Hands grasp above and below the knee go from 90 degrees into IR or ER

Question 65

preform Lateral glide in Hip Neutral (Gr III & IV

Answer 65

 Patient supine with pillow under knee of test leg.  Therapist standing beside plinth facing the patient.  Handling: one hand on medial thigh as close to the hip joint as possible, the other hand over the greater trochanter  Lateral movement of the head of the femur in the acetabulum is produced by the therapist moving the femur laterally while ensuring that the angle of Ab/Ad does not alter USE BODY WEIGHT. ONLY APPLY FORCE TO MOVE SOFT TISSUE

Question 66

preform Lateral glide at 90° Hip Flexion

Answer 66

 Patient supine, hip flexed to 90 degrees.  Therapist standing beside plinth, at the level of the hip joint, facing across the patient’s body.  Handling: Both hands grasp around the patient’s medial thigh, therapist trunk & arms stabilise patient’s thigh position. You may use a pillow between you and the patient’s thigh.  Alternatively, can use a seatbelt around the patient’s thigh and therapist trunk.  Lateral movement of the head of the femur in the acetabulum is produced by the therapist’s body movement (transfer weight to back leg)

Question 67

preform Longitudinal caudad in neutral PAM

Answer 67

 Patient position: supine, pillow under knee of test leg  Therapist position: stands beside plinth facing patient.  Handling: gripping around femoral condyles. Alternatively: grasp around the distal tibia (at level of malleoli) +/- reinforcement with seatbelt  Procedure: apply longitudinal distraction to the femur in a caudad direction  Useful to provide distraction and unload joint

Question 68

what condition would Longitudinal caudad in neutral PAM feel good for

Answer 68

joint OA

Question 69

preform Longitudinal caudad glide at 90° Flexion

Answer 69

 Patient supine, hip flexed to 90 degrees.  Therapist standing beside plinth, facing towards patient’s head.  Handling: Both hands grasp around the patient’s anterior thigh, therapist upper body/trunk stabilises patient’s thigh position. Alternatively, can use a seatbelt around the patient’s thigh and therapist trunk.  Caudad movement of the head of the femur in the acetabulum is produced by the therapist’s body movement (transfer weight to back leg)

Question 70

preform Anteroposterior (AP) glide GIII-IV

Answer 70

 Patient position: supine, close to side of bed, pillow under knee of test leg, non-test leg abducted.  Therapist position: stands to the side of patient.  Handling: Be sure to inform patient first. AP: Place medial hand anteriorly over the hip joint, the other hand is over the greater trochanter.  Procedure: glide femoral head in the acetabulum in AP direction

Question 71

preform Posteroanterior (PA) glide GIII-IV

Answer 71

 Patient position: prone, pillow under shins.  Therapist position: stands to the side of patient.  Handling: Place one hand on posterior aspect of hip joint. The other hand is over the greater trochanter.  Procedure: glide femoral head in the acetabulum in PA direction by translation of therapist body weight downwards along arm

Question 72

Common soft tissue massage techniques used on the hip to improve range of motion. what muscles

Answer 72

psoas major, gluteals hip rotators adductors TFL rectus femoris

Question 73

GLUTEUS MEDIUS TENDINOPATHY exercise prescription

Answer 73

double leg hip abduction (preformed with weaker side into the wall isometric contraction)- 2 sets 10 seconds, 2-3x a week. single leg stance, finger on table- 2 sets 10 seconds 2-3x a week hip abduction with elastic- 2 sets 6-8 reps 2 mins rest in between

Question 74

ADDUCTOR RELATED GROIN PAIN (GRADE I ADDUCTOR LONGUS STRAIN)

Answer 74

0 degrees squeeze- 2 sets 10 reps 2x a week hold for 3sec lay supine, ball bw legs and squeeze using adductors , can be done on a machine at the gym stabilisation abd/ext rot- 2 sets 6 reps lay on back on ground hips at 90 degrees and open up to 20-30 degrees

Question 75

POST-OPERATIVE FEMORAL FRACTURE prescription exercise

Answer 75

seated single knee to chest- 2 sets 10 reps 2-3 times daily, hold 3 sec to progress add there band seated hip ER with pressure- 2 sets, 10 reps 2-3 times a day hold 3 sec standing hip extension- 2 sets 10 reps 3 second, 2-3 times daily, do not arch back seated hip abduction w resistance band- 2 sets, 15 reps 2x a week

Question 76

what are you looking for in PAMs

Answer 76

resistance, range, end feel, reproduction of symptoms