Foot & Ankle Flashcards
What is the purpose of the anterior drawer test & is there good EBP to support it?
purpose - to test for ligamentous laxity of ATL (primarily) and anterior deltoid.
EBP - for acute testing,
What is the purpose of the medial taller tilt test & is there good EBP to support it?
purpose - test for ligamentous laxity of ATFL, CFL, and PTFL
EBP - spec 0.88 (respectable for ruling in)
What is the purpose of the impingement sign test & is there good EBP to support it?
purpose - test for anterior ankle impingement (causing impairment of tissue between talar dome and tip/fib
EBP - sens 0.95 & spec 0.88
What is the purpose of the syndesmosis squeeze test & is there good EBP to support it?
purpose - test for syndesmosis ankle sprains (high sprain) by causing separation of distal tib/fib interosseous membrane.
EBP - spec (good to rule in)
What is the purpose of the external rotation test & is there good EBP to support it?
purpose - test for syndesmsis ankle sprains by causing separation of distal tib/fib interosseous membrane.
EBP - spec 0.85 (good to rule in)
What is the purpose of the thompson test & is there good EBP to support it?
purpose - test for achilles tendon integrity by squeezing calf to shorten calf muscle, does not cause PF
EBP - sens 0.96 & spec 0.93
What is the purpose of the navicular drop test & is there good EBP to support it?
purpose - less than 3mm drop may indicate need for OTC orthotics (measurement change between loaded and unloaded)
EBP - sens 0.47 & spec 0.80
What is the talocrural impingement CPR?
purpose - test for anterior impingement EBP - (+) with 5/6 signs present 1. anterolateral ankle jt tenderness 2. anterolateral ankle jt swelling 3. pain with forced DF & eversion 4. pain with single leg squat 5. ankle instability
What is the Ottawa ankle rules CPR?
purpose - screens for need of radiograph with ankle or foot injuries.
refer for radio graphs if pain in the malleolar or mid foot area & anyone of the following.
- inability to bear weight both immediately after injury & in the emergency department for 4 steps.
- bone tenderness along any of following areas: distal 6cm posterior edge of tibia or tip of medial malleolus, distal 6cm of posterior edge of fibula or tip of lateral malleolus, base of 5th metatarsal or navicular bone
EBP - sens 0.98 (foot to rule out)
What manual therapy techniques can be used to improve your patients limited DF?
- talocrural AP mobilization
- distal tib-fib AP mobilization
- ankel DF mobilization with movement (improve tibial glide component)
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients limited PF?
- talocrural PA mobilization
- distal tib-fib PA mobilization
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients limited inversion and/or eversion?
- subtalar lateral glides
- subtalar medial glides
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients general mid-foot mobility?
- cuboid manipulation
- metatarsal AP/PA mobilization
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients general forefoot mobility?
- metatarsal AP/PA mobilization
What manual therapy techniques can be used to improve your patients 1st MTP mobility?
- 1st MTP mobilization (specific to 1st MTP)
- 1st MTP manipulation (is just general not specific)