Functional Assessments Of The Extremities

Question 1

Subtalar Neutral

Answer 1

-Palpate medial/lateral aspects of the Talar head
-Palpate both sides of the subtalar joint/locate the sulcus on the medial and lateral sides near the neck of the talus
-Pronate/Supinate the foot so the sulci are relatively the same depth

Question 2

Navicular Drop Test

Answer 2

-Find subtalar neutral, mark location of navicular Tuberosity then re-measure the distance in relaxed
-Normal:6-10mm/Excessive:11-15mm/Abnormal:>15mm

Question 3

Weight Bearing Wall Lunge Test

Answer 3

-Toes 5 inches (1 hand-width from the wall)
-Try to touch front knee to the wall w/ heel on ground
Results
-Measuring Tape: Normal>10cm/Restricted<10cm
-Inclinometer: <40 degrees is restricted

Question 4

Knee Extended Ankle Dorsiflexion

Answer 4

-Patient attempts to stand as far forward as possible with non-testing foot while maintaining heel contact with the floor of the rear leg
-Inclometer should be over the tibial Tuberosity
-Normative Data: 22.5 degrees

Question 5

Functional Heel Raise Test (Hubscher Maneuver or Jacks Test)

Answer 5

-If arch is present during the heel raise, this is considered a “functional flat foot” (able to supinate/stabilize foot)
-If arch does not appear during heel raise, the patient has a true flat foot or a collapsed arch (+)
-Positives: Joint restriction, ruptured posterior tibialis, or structural difference

Question 6

Non-Weight Bearing Toe Extension Test

Answer 6

-Place thumb under the 1st metatarsal just proximal to the sesamoid bones/Press the first metatarsal dorsal
-Press first toe into extension
-Normal: 70-90 degrees
-40-60 Degrees is mild “hallux rigidus”

Question 7

Tibial Torsion (Supine Assessment)

Answer 7

-Position knee so posterior femoral condyles rest parallel to the exam table
-Measure transmalleolar line (between medial/lateral Malleolus)
-Normal: 15-20 degrees of external torsion
->20 degrees (External Tibial Torsion)
<15 degrees (Internal Tibial Torsion)

Question 8

Prone Knee Flexion ROM

Answer 8

-Normal angle equals 147.9 degrees
-Functional assessment: Heel within one fist width of the buttocks

Question 9

Trendelenburg Test

Answer 9

-Patient stands on one foot, typically raising the affected side foot first (looking for a drop of the pelvis on the side of the foot that is elevated)
-If iliac crest drops on the raised leg side, its indicative of weak hip abductors on the CL side (weak gluteus medius of stance leg)

Question 10

Prone Passive Hip Internal Rotation

Answer 10

-Minimum normal value = 30 degrees of internal rotation

Question 11

Prone Passive Hip External Rotation

Answer 11

Minimum Normal Value=40 degrees of external rotation

Question 12

Craig’s Test: Femoral Torsion

Answer 12

-Normal: 10-15 degrees of internal rotation
-Anteversion: >15 degrees internal rotation
-Retroversion: <10 degrees of internal rotation