Extremity Functional Assessments Flashcards
Subtalar Neutral
Palpate the medial and lateral aspect of the talus and find where it articulates with the navicular bone
Navicular Drop Test
Patient is standing
Have the patients foot in neutral position
Mark the navicular tuberosity and measure distance to floor
Have patient relax and compare the new distance
Do bilaterally
Findings: normal drop is 6-10 mm
Weight Bearing Wall Lunge Test
Patient stands with toe 5 inches from the wall
Patient attempts to touch knee to wall without lifting up their heel
Interpretation: Normal is >10cm or >40 degrees
Findings: Restriction = lack of dorsiflexion
Knee Extended Ankle Dorsiflexion
Patient stands upright and tries to step as far as possible with the non-testing foot while keeping the heel of the testing foot on the ground
Knee must be straight and foot should be in sagittal plane
Angle is measured over tibial tuberosity
Interpretation: Angle should be around 22 degrees
Restriction = tightness in gastrocnemius and/or ankle joint
Functional Heel Raise Test (Hubscher maneuver or Jack’s test)
Have patient stand on their toes
Look at presence of arch
Interpretation: If arch appears = functional flat foot
Arch remains flat = structural flat foot and could indicate joint restriction or ruptured tibialis posterior
Non-Weight Bearing Toe Extension Test
Press the first metatarsal dorsal
Press the phalanx of the first toe into extension and observe at what angle
Interpretation: Normal 70-90 degrees
Restriction = Hallux Rigidus
Tibial Torsion (Supine Assessment)
Patient is supine and places knee on the table so both femoral condyles rest on the table
Goniometer is aligned parallel to the table
The other arm goes along the transmalleolar line
Interpretation:
>20 degrees = external tibial torsion
<15 = internal tibial torsion
Prone Knee Flexion ROM
Patient is prone
Inclinometer placed at posterior mid-calf
Pelvis is stabilized and doctor approximates heel to glute
Interpretation
Angle should be 147.9 degrees
Functional angle should be one fist size between heel and glute
Trendelenburg Test
Patient stands on one foot and raises the other (usually the affected side first) to 90 degrees at the hip
Look for pelvic drop on raised foot side
Ask WWRRs the pain
Interpretation
Iliac crest drop = weak contralateral hip abductors (on side of standing leg)
Prone Passive Hip Internal Rotation
Patient prone with knees flexed
Move patient’s foot laterally to internally rotate the hip
Take measurement with goniometer or inclinometer and compare sides
Interpretation
Less that 30 degrees of motion = restricted
Prone Passive Hip External Rotation (ER)
Patient prone with test side knee flexed Move patients foot medially to externally rotate the hip Take measurement and compare sides Interpretation Less than 40 degrees = restricted
Craig’s Test (Femoral Torsion)
Patient prone
Palpate greater trochanter most prominent laterally between 10-15 degrees of internal rotation
Interpretation
Anteversion if >15 degrees of internal rotation
Retroversion if <10 degrees of internal rotation
Shoulder Flexion Test
Have patient raise their hands above their head from posterior and lateral views
Ask the following questions
1. Does the inferior angle of the scapula reach the posterior border of the mid axillary line
2. Does the scapula tilt posterior
3. Does the cervicothoracic junction extend when palpating the spinous process
Interpretations
Reduced ROM due to glenohumoral joint if it passes questions 1 and 2
Reduced ROM due to scapulothoracic joint if it fails either 1 or 2
Total Rotation
Should be 150 degrees for medial and lateral rotation of the shoulder
Passive Lateral Rotation
Patient supine
Flex elbow and shoulder to 90 degrees
Move the patients forearm into lateral rotation
Interpretations
Limited motion due to pecs, larissimus dorsi, subscapularis
