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Hip / Knee ROM & MMT Flashcards

1
Q

what is the official name of the hip joint?

A

iliofemoral joint

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2
Q

how many degrees of freedom does the iliofemoral joint have? what motions

A

3 - frontal, transverse, and sagittal
ab/add, IR/ER, flex/ext

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3
Q

what motion does positioning have a significant effect on when testing the hip?

A

ER
better to do it sitting than laying down. Sitting locks the pelvis

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4
Q

what directly effects hip flexion?

A

BMI / Pregnancy
“belly size”
limits sagittal plane motion

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5
Q

mean hip range of flexion is

A

120°

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6
Q

what is the position of hip flexion ROM

A

supine with knees extended
hips in neutral ab/add and rotation

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7
Q

what is the testing motion of hip flexion ROM?

A

lift thigh off table directing patient’s knee toward their head
passive knee flexion is allowed
maintain neutral rotation/abduction

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8
Q

normal end feel of hip flexion?

A

soft

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9
Q

goniometer positions for hip flexion

A

axis - greater trochanter
SA - lateral midline of pelvis
MA - femur aimed at lateral epicondyle

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10
Q

how is the pelvis stabilized during hip flexion/extension rom

A

keep other leg flat on the table to prevent posterior pelvic tilting

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11
Q

what is the mean hip extension ROM

A

20°

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12
Q

what is the testing position for hip extension

A

patient is prone
knees extended with hip in neutral ab/add and IR/ER
no pillow under head, can be under abdomen if preferred by patient

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13
Q

testing motion of hip extension ROM

A

keeping knee in full extension, thigh is raised off of the table

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14
Q

normal end feel of hip extension

A

firm

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15
Q

goniometer placement during hip extension ROM

A

axis - greater trochanter
SA - lateral midline of pelvis
MA - midline of lateral femur toward lateral epicondyle

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16
Q

what is the mean ROM for hip abduction

A

40°

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17
Q

what is the testing position for hip abduction

A

patient is supine with knee extended, everything in neutral

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18
Q

what is the testing motion for hip abduction

A

hip is abducted by sliding LE laterally
ensure lack of rotation during abduction

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19
Q

what is the normal end feel for hip abduction

A

firm

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20
Q

what is the positioning of the goniometer during abduction ROM

A

axis - over the ASIS of testing side
SA - along line extending from ASIS to ASIS
MA - anterior line of femur toward patella

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21
Q

what is a way someone could cheat during abduction ROM

A

hip hiking

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22
Q

what is the normative range of hip adduction ROM

A

20°

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23
Q

what is the testing position for hip adduction

A

patient is supine with knees extended
hip being tested should be in neutral with opposite hip in abduction (moved out of the way)

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24
Q

what is the testing motion for hip adduction

A

hip is adducted by sliding the slower extremity medially toward contralateral lower extremity

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25
what is the normal end feel for hip adduction
FIRM
26
goniometer position for hip adduction
axis - over the ASIS of testing leg SA - from one ASIS to the other ASIS MA - anterior femur in line with the patella
27
what is the normative range of motion for hip IR?
45
28
what is the testing position for hip IR
patient seated with knees flexed to 90° and leg hanging off of table
29
what is the testing motion for hip IR
medially rotate hip by moving ankle/leg lateral while stabilizing distal femur.
30
what is the normal end feel of hip IR
Firm
31
goniometer alignment for hip IR/ER
axis - over anterior aspect of patella SA - perpendicular to the floor / supporting surface MA - anterior midline of the lower leg, pointing midway between the lateral and medial malleoli
32
what are the two joints of the knee?
tibiofemoral patellofemoral
33
what are the degrees of freedom at the knee
flexion / extension rotation
34
where is the greatest range of voluntary knee rotation
at 90° flexion
35
at terminal knee extension __________ happens because _______
involuntary rotation due to asymmetric shape of femoral condyles
36
what is the locking or screw-home mechanism
at end range of knee extension, motion stops at shorter lateral condyle but continues at the longer medial condyle this must be undone in order to flex knee
37
at what age does one expect to see full knee extension? why?
around age 2 because the individuals have not been able to walk or bear weight on the legs
38
what age do flexion contractures tend to develop?
>50 can be developmental to assist with balance
39
how do male and female joints compare? how is this clinically important?
females may tend to have more laxity hyperextension or ability to hyperextend the knee is a possible factor in increased ACL injury in female athletes
40
how does BMI affect range of motion at the knee?
less BMI > ROM
41
what is the mean value for knee flexion? extension?
flex - 140-150 extension - 0
42
what is the testing position for knee flexion/extension
patient is supine with knees extended hip in neutral flex patients knee without hip flexing past 90°
43
what can be done to test for hyperextension at the knee?
towel roll or support under ankle
44
end feels for knee flexion/extension
flex - soft ext - firm
45
goniometer placement for knee flexion/extension
axis - lateral epicondyle SA - lateral midline of femur aimed toward greater trochanter MA - lateral midline of fibula aimed at lateral malleolus
46
what muscles may contribute to lack of knee ROM
muscle length of rectus femoris and/or hamstrings
47
what muscles assist in hip flexion
iliacus psoas major
48
gravity resisted position for flexion
seated with knees flexed over edge of table (allowed to hold on) taken through passive ROM lifted actively to highest point and pressure is applied over anterior aspect of distal thigh stabilize pelvis at iliac crest
49
gravity eliminated position for hip flexion
patient is sidelying on the testing side with hip extended and knee flexed taken through passive ROM asked to bring their knee to their chest with knee flexed
50
if the patient's hip abducts and externally rotates during active hip flexion, they are ________
substituting the sartorius
51
if the patient's knee extends as they attempt active knee flexion, they are ______
substituting rectus femoris
52
if the patient has a weak trunk, what is the best way to test hip flexion?
having them in supine position
53
what motions does the sartorius do?
flexion, abduction, and lateral rotation
54
what is the gravity resisted position for the sartorious
seated with knees bent off of table passively flexed, abducted and laterally rotated (sliding their ankle up the shin) and then actively completed, returning to their highest point resistance is applied over anterior lateral thigh toward extension and adduction while applying pressure to ankle toward hip IR and knee extension
55
gravity eliminated position for sartorious
patient is supine with heel of testing LE resting on anterior portion of the opposite ankle w/ legs extended taken through passive ROM by sliding testing leg up shin of opposite leg ask patient to reproduce motion
56
what muscles produce hip extension
glute max semitendinosus semimebranosus biceps femoris
57
gravity-resisted position for hip extension
prone with LE extended passively taken through ROM ask patient to lift leg off of table without bending the knee resistance applied over posterior aspect of distal femur toward hip flexion stabilize posteriosuperior aspect of pelvis if needed
58
gravity eliminated hip extension
side-lying with LE extended move / hold uppermost limb out of the way patient is to move leg back toward therapist while keeping the knee straight
59
what muscles assist in hip abduction
gluteus medius/minimus
60
what is the gravity resisted test for hip abduction
side lying with testing limb stacked upon other limb hip in line with trunk in a neutral position passively abducted, then actively resistance applied over distal thigh toward adduction
61
what could be a variation of hip abduction MMT?
a longer lever arm could be used by therapist with resistance at the ankle
62
what is the gravity eliminated position for hip abduction
supine with knees extended and hips in neutral patient passively abducted told to pull their leg out to the side with toes pointing the ceiling
63
what occurs if the pelvis posteriorly rotates during abduction mmt
tensor fascia lata may be used to substitute for weak hip abductors
64
what happens if the hip externally rotates during hip abduction mmt
hip flexors may be used instead of hip abductors
65
what muscle produces hip abduction with flexion
tensor fascia lata
66
MMT for tensor fascia lata
patient in sidelying with uppermost hip being tested hip placed in 45° flexion with neutral rotation testing procedure similar to hip abduction
67
gravity eliminated for TFL muscle
patient in long sitting position with hips flexed to 45 normal hip abduction
68
what muscles produce hip adduction
adductor: magnus longus brevis Pectineus Gracilis
69
gravity resisted position for hip adduction
patient in sidelying with lowermost hip being tested uppermost hip being supported passively taken through adduction then actively patient lifts up as high as they can, apply force at distal thigh
70
gravity eliminated test for hip adduction
supine with nontested hip in full abduction, pelvis in neutral with knees extended passively adducted, returned to start actively adduct with knee toward ceiling
71
if the hip posteriorly / anteriorly rotates, the ____ will be used to compensate for weak adductors
post - hip flexors ant - hip extensors
72
what muscles assist in hip internal rotation
tensor fascia lata gluteus minimus gluteus medius
73
gravity resisted hip IR/ER MMT
patient seated with legs hanging off table, towel roll under the knees patient can hold on to edge of table hip is passively IR, then actively resistance is applied over distal leg medially HIP ER same position passively ER then active resistance applied in a lateral direction instead
74
gravity eliminated hip IR/ER
patient is supine with legs extended with leg that is tested in full ER passively IR then returned patient is asked to roll leg toward the other opposite for ER in full IR told to roll externally
75
muscles that do ER at hip
piriformis gamellus twins obturator internus/externus quadratus femoris
76
how might a patient cheat during rotation testing
may lean toward testing limb to substitute for lateral hip rotation may hike the hip or shift weight on other side to substitute medial rotation
77
muscles that do knee extension
rectus femoris vastus - medialis, lateralis, intermedius
78
gravity resisted test for knee extension
seated with legs off of the table with a towel roll under tested leg thigh allowed to hold onto table passively then actively extended resistance applied over anterior leg toward knee flexion
79
gravity eliminated for knee extension / flexion
sidelying on side of tested limb knee is flexed with hip extended passively gone through extension asked to straighten the knee flexion hip and knee extension passively flexed asked to bend the knee
80
muscles that do hip flexion
biceps femoris semitendinosus semimembranosus
81
gravity resisted knee flexion mmt
patient is prone with LE extended knee passively then actively flexed resistance applied to posterior distal leg toward extension
82
how can semimembranosus/tendinosus be isolated?
medial rotation and flexion
83
how can biceps femoris be isolated
lateral rotation with flexion
84

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