LE goniometer Flashcards
(28 cards)
Hip Flexion
pt post= Supine, knee extended stabilizing pelvis so post. hip rotation does not occur
M= flex hip while knee is flexed
F= Center fulcrum over greater troch.
S= Align with lateral midline of pelvis
M= Align with lateral midline of the femur
range: 120 end feel capsular
Hip extension
ROM : 20
Prone, knees extended, 0 deg abd/add/rot.Hold pelvis to prevent pelvic tilt, neutral, no ant. Or post. Pelvic tilt.
Motion= Raise hip w/ knee ext., active and then PAssive
F= Center fulcrum over greater troch. S= Align with lateral midline of pelvis M= Align with lateral midline of the femur
Hip Abduction
ROM: 45
Supine, knees extended, hips neutral Hand on pelvis to prevent abduction Slide
motion: LE laterally, active then PASSIVe
Fulcrum = ASIS,
Prox. arm: ASIS to ASIS,
Distal arm: with anterior midline of femur using midline of patella for reference
Hip external rotation,
ROM:45 Seated TOWEL under knee motion: active then passive Fulcrum: anterior aspect of patella Prox Arm: Perpendicular to floor Dist Arm: crest of tibia, and midway between malleoli End-Feel firm:
Hip internal rotation
ROM:45 Seated TOWEL under knee Fulcrum: anterior aspect of patella Prox Arm: Perpendicular to floor Dist Arm: crest of tibia, and midway between malleoli End-Feel firm:
knee extension
ROM:
Supine, knee in extension. position hip in 0 degrees. place towel under knee
Motion: push knee down, active then passive
Fulcrum: Lat epi
Prox Arm: Greater Troch
Dist Arm: Lat malleolus, head of fib
End-Feel: Firm
when knee extension excee5 degress in adults it is hyperextension
knee flexion
ROM: 135 TKA normal goal is 120
Supine, sitting, hold the subjects ankle in one hand and move post. thigh with other
motion: knee flexion active, passive
Fulcrum: Lat epicond
Prox Arm: greater troch
Dist Arm: lat malleolus and fibular head
end range of knee flexion occurs with resistance is felt and attempts to over come the reistance cause by additional hip flexion
End-Feel: soft
Ankle Dorsiflexion
ROM: 20
Seated, knee flexed at 90. foot at 0 in/eversion. subtalar neural
motion: toes up to the sky, active then passive
Fulcrum: lat maleolus
Prox Arm: lateral midline of fibula head of fib
Dist Arm: parrallel 5th MT
End-Feel:firm
ankle plantarflexion
ROM:50
seated, knee flexed at 90. foot at 0 in/eversion. subtalar neural
motion: toes to the floor, active then passive Fulcrum: lat maleolus Prox Arm: head of fib Dist Arm: 5th MT End-Feel: firm
Ankle inversion
ROM :35
seated flexed to 90, hip at 0 of rotat, add, abduction
motion: plantarflex, add, supinatio. active then PAssive
Fulcrum : midway b/w mallaeli
prox: midline of lower leg, tibial tuberosity
distal: anterior midline of the second metatarsal
subtalar inversion
ROM :5
prone, hip 0, knee at 0, foot over edge of table . bisection line is drawn down the posterior aspect of calcaneous
Motion: ONLY PASSIVE movment. Pull the subject calcaneous medially into adduction and supination
F: over post. aspect of ankle midway b/w malleoli
prximal: post. midline of the lower leg
distal: align the distal arm with the posterior midline of calcaneous
subtalar eversion
ROM :5
prone, hip 0, knee at 0, foot over edge of table . bisection line is drawn down the posterior aspect of calcaneous
Motion: ONLY PASSIVE movement. Pull the subject calcaneous laterally into abduction and pronation
F: over post. aspect of ankle midway b/w malleoli
prximal: post. midline of the lower leg
distal: align the distal arm with the posterior midline of calcaneous
Thomas test
thomas test ( hip flexors) Muscles involved? Iliopsoas ( 1 joint) , rectus femoris ( 2 joint). Purpose of this test: Tells us which muscle is tightness
patient: seated, lower legs off table
PT: assist into supine while flexing knees, flexs hip to bring knee to chest. make sure sacrum on table
Goal: one leg hanging over leg, other is bent to chest. Looking at thigh position and knee postion
if thigh rests on table and knee is flexed 80, no tightness is present
if thigh is not touch table Iliospoas tight
If leg is less than 80, rectus femorais is tight; confirm with ely test
Straight leg test ( hamstrings)
Positioning : Pt. supine, knee extended. Keeping leg straight, hip in NEUTRAL for ABD/ADD, flex hip. Maintain knee extension up to point where PT feel tension and communicates with the pt. Observe or palpate for pelvic or lumbar motion
Need another to hold so PT to measure
Normal length of hamstrings: hip is passively flexed 70-80 degrees
Abnormal length of hamstring: hip is passively flexed less than 70 degrees
Distal Hamstring Test
Positioning: Pt. supine, contralateral hip neutral, test hip flexed 90 degrees, Stabilize femur of test extremity, Straighten knee until tension is felt and further knee extension causes the hip to move toward extension
Fulcrum- center of knee joint.
Distal end- lined up with lateral malleolus
Proximal end- lines up with the greater trochanter.
•Mean value: 31 degrees of knee from full extension
Important notes: Hamstring tightness is really going to come into play with pt. with backpain. Instead of doing all the math when doing the hamstring leg test, instead of doing 180 minus whatever. You set the goniometer at 90 degrees up. When PT brings it up then PT would see right then at pt. ability for full extension what the pt. is lacking. e.i. the patient would be lacking 50 degrees. Again, so if you set at 90 then the difference if what you are lacking.
Ober Test (TFL)
Starting Positioning: Subject Sidelying, near edge of tableStarting in neutral, subject flexes lower hip and knee (stabilizes trunk)
Stabilization: PT task: Place a stabilizing hand on iliac crest prevent from lateral tilting during test.
Testing Motion: Hold medial aspect of knee and lower leg. Flex hip and knee to 90 degrees. Keep knee flexed, move hip into abduction and extension. Lower leg into adduction. Do not allow hip to flex or pelvis to tilt, or medially rotate
Observation: is the leg just droping or is there resistance. If thigh drops slightly below horizontal (approx 10 degrees), test is negative. The knee dropping down indicates a normal length of TFL/ITB; The knee remaining where it is indicates a tight TFL/IT
Positive test: The knee remaining where it is indicates a tight TFL/IT.Shortening of this structure has been cited as a contributing cause of low-back pain, iliotibial band friction syndrome, patellofemoral pain due to lateral tracking and tilting of patella.
Normal end-feel: firm owning to TFL
Goals for positive: stretch it, deep muscle massage, using PT knuckles, ice massage
• Measuring: Central fulcrum over the ASIS of the extremity. Proximal arm with a line extending from one ASIS to other. Distal arm- anterior midline of the femur, using the midline of the patella for reference.
Modified Ober test
Starting Position: same as for the ober test except the the knee is held in extension through the test
Stabilization: Place a stabilizing hand on iliac crest prevent from lateral tilting during test. Other hand is one leg extend.
Testing: same as for ober test, but medial rotation may be more of a concern and must be prevented. The need of the test occurs when pelvis begins to tilt laterally or the leg stops dropping.
Measure: same as ober test.
Ely test rectus femoris
Ely Test (Rectus Femoris)
• Starting Position: Subject prone, feet off of end of table, knees extended, hips neutral
• Stabilization: hip to maintain the neutral positon. Do not allow the hip to flex.
• Goal: If knee flexes at least 90 degrees, length is normal. It is a passive position NOT active.
• End of ROM: occurs when resistance is felt from tension in the anterior thigh and further keen flexion cause the hip to flex.
• Goal not meet: If PT feels resistance and if its below 90 rectus is tight. knee flexion is limited when hip is in flexion position the limitation is not due to a short rectus femoris muscle but to abnormalities of joint structure or short one-joint knee extensor muscles.
ankle eversion
ROM: 15
seated knee flexed 90, hip 0 of rotat. add, abd
motion: pull forefoot laterally, abd, and dorsiflexion, active then passive
F: midway between malleoli
proximal: anterior midline of lower leg, tibial tuberosity
distal: anterior midline of second metatarsal
MTP Flexion
ROM: 45
Supine or sitting
stabilize the metatarsal to prevent plantarflexion of the ankle and inversion or eversion of foot
F: dorsal aspect of MTP joint
P: dorsal midline of the metatarsal
D: dorsal midline of proximal phalanx
MTP Extension
ROM: 70
Supine or sitting
stabilize metatarsal to prevent plantar flexion ankle inversion or eversion of foot
F: dorsal aspect of MTP joint
dorsal midline of the metatarsal
D: dorsal midline of proximal phalanx
Muscle length testing : gastro/soleus Complex
supine with knee extended and foot in 0 of inversion and eversion
Dorsiflexion to end range by pushing upward across the plantar surface of the metatarsal head. Do NOT allow the foot to rotate and move into inversion or eversion
ROM value vary with age;
20-24: 25 degrees
40-59: 22 degrees
60-84: 15 degrees
Thoracolumbar Flexion : Tape Measure Method
- Mark C7 and S2
- S2 is on the horizontal level with the PSIS
- Measure starting before ROM and then after flexion
- Record the difference in measurement of their standing position and flexed position
- 4 inches or 10 cm is average
Tape Measure Method: Thoracolumbar extension
Tape
• Mark C7 to S2
• Keep the tape measure aligned during motion and record the measurement at the end of the ROM
• Record the difference in measurement of their standing position and extended position
4 to 5 cm average
