Goni hip, knee, and ankle Flashcards
Hip flexion
End feel
Norms
soft
0-120 degrees
client supine with legs straight, then moves testing extremity into max hip flexion with knee also flexed
fulcrum: lateral aspect of the greater trochanter
stable arm: parallel to mid-axillary line of the trunk
movable arm: parallel to the lateral aspect of the femur
PROM: stabilize at lower leg
Hip extension
End feel
Norms
firm
0-30 degrees
client prone with legs straight and feet off testing surface, then moves testing extremity into max hip extension with knee still extended
Fulcrum: lateral aspect of the greater trochanter
stable arm: parallel to mid-axillary line of the trunk
movable arm: parallel to the lateral aspect of the femur
PROM: stabilize right above pelvis, put other hand on distal femur
Hip abduction
End feel
Norms
firm
0-45 degrees
client is supine with legs straight, then moves testing extremity into max hip abduction
fulcrum: over ASIS
Stable arm: horizontally between both ASIS
Movable arm: parallel to the anterior midline of the femur
toe stay pointed toward ceiling
PROM: stabilize at ASIS and put other hand on calf when bringing leg to abduction
Hip adduction
End feel
Norms
firm
0-30 degrees
client supine with legs straight nontest extremity in abduction and testing extremity in neutral, then moves testing extremity into max hip adduction
fulcrum: over ASIS
stable arm: horizontally between both ASIS
movable arm: parallel to the anterior midline of the femur
PROM: have client abduct nontest leg and I bring test leg into max adduction
Stabilize at ASIS and put other hand on calf when bringing leg to adduction
Hip external rotation
End feel
Norms
firm
0-45 degrees
Client sitting with testing extremity in 0 degrees of hip abduction/adduction and rotation and 90 degrees of hip and knee flexion, then client moves testing extremity into maximum hip external rotation
fulcrum: over midpoint of patella
stable arm: perpendicular to the floor
movable arm: parallel to the anterior midline of the tibia midway between the two malleoli
Hip internal rotation
End feel
Norms
firm
0-45 degrees
Client sitting with testing extremity in 0 degrees of hip abduction/adduction and rotation and 90 degrees of hip and knee flexion, then moves testing extremity into max internal rotation
fulcrum: over midpoint of patella
stable arm: perpendicular to the floor
movable arm: parallel to the anterior midline of the tibia midway between the two malleoli
Knee flexion
End feel
Norm
soft
0-135 degrees
client supine with legs straight and neutral hip, then moves testing extremity into max knee flexion (hip will also flex)
fulcrum: over lateral epicondyle of femur
stable arm: parallel to lateral midline of femur
movable arm: parallel to the lateral midline of the fibula
have them flex as far as they can go bringing their heel to their butt (encourage it), flex hip as well for max active knee flexion
Knee extension
End feel
Norm
firm
135-0 degrees
client supine with testing hip and knee flexed, then moves testing extremity into max knee extension (hip will also extend)
Fulcrum: over lateral epicondyle of femur
Stable arm: parallel to lateral midline of femur
movable arm: parallel to the lateral midline of the fibula
Ankle dorsiflexion
End feel
Norm
firm
0-20 degrees
client sitting with testing extremity in hip and knee extension and ankle in neutral over end of table, then moves testing extremity into max ankle dorsiflexion
fulcrum: lateral aspect of lateral malleolus
stable arm: parallel to lateral midline of fibula
movable arm: parallel to the lateral midline of the 5th metatarsal
Ankle plantar flexion
End feel
Norm
firm
0-50 degrees
client sitting with testing extremity in hip and knee extension and ankle in neutral over end of table, then moves testing extremity into max ankle plantar flexion
fulcrum: lateral aspect of lateral malleolus
stable arm: parallel to lateral midline of fibula
movable arm: parallel to the lateral midline of the 5th metatarsal
Ankle eversion (forefoot)
End feel
Norm
hard
0-15 degrees
client sitting with testing extremity in hip and knee extension and ankle in neutral over end of table, then moves testing extremity into max ankle eversion
fulcrum: over anterior aspect of ankle midway between malleoli
stable arm: parallel to the anterior midline of lower leg
movable arm: parallel to the anterior midline of the 2nd metatarsal
Ankle inversion (forefoot)
End feel
Norm
firm
0-35 degrees
client sitting with testing extremity in hip and knee extension and ankle in neutral over end of table, then moves testing extremity into max ankle inversion
fulcrum: over anterior aspect of ankle midway between the two malleoli
stable arm: parallel to the anterior midline of lower leg
movable arm: parallel to the anterior midline of the 2nd metatarsal
Foot metatarsophalangeal (MTP) flexion
End feel
Norm
(tell patient to bend toes)
firm
measuring great toe 0-45 degrees
Client supine with testing hip, knee, ankle, foot, and toes in neutral with foot over edge of testing surface, then moves testing extremity into max MTP flexion
fulcrum: over dorsum of MTP
Stable arm: parallel to dorsal midline of metatarsal
movable arm: parallel to dorsal midline of proximal phalanx
Foot metatarsophalangeal (MTP)extension
End feel
Norm
(tell patient to extend toes)
firm
measuring great toe 45-0 degrees
Client supine with testing hip, knee, ankle, foot, and toes in neutral with foot over edge of testing surface, then moves testing extremity into max MTP extension
fulcrum: over dorsum of MTP (do it on the medial side of the foot instead)
Stable arm: parallel to dorsal midline of metatarsal
movable arm: parallel to dorsal midline of proximal phalanx
Functional tasks
put these in more cards
Hip Flexion: Climbing stairs or attempting to don socks
Hip Extension: Sit-to-stand activities including transferring from bed to chair and toilet
Hip abduction: Getting onto a bicycle or sidestepping in/out of the bath tub
Hip adduction: Sitting with ankles crossed or bracing an object between the legs
Hip external rotation: Sitting “pretzel” style or observing the bottom of the foot
Hip internal rotation: Getting into a kneeling position or performing a quadriceps stretch in standing
Knee flexion: Stand-to-sit movements or positioning to bathe feet
Knee extension: Kicking a ball or hiking pants
Ankle dorsiflexion: Pressing the gas pedal while driving or dancing
Ankle Plantar flexion: Walking on the beach or donning shoes
Foot inversion/eversion: Activities which require foot stabilization such as walking on rough ground
Toe MTP flexion: Any functional mobility activity such as ambulating to the bathroom with an assistive device or climbing stairs
Toe MTP extension: Any functional mobility activity such as making a bed or climbing stairs. Weakness may also be noted when trimming toe nails
