Lower Leg Exam Flashcards
describe the outcome measure: FAAM
Foot and Ankle Ability Measure
- 29-item questionnaire designed to reflect change across a range of functional ability
- 21 item ADL subscale
- 8 item sport scale
- MDC = 5.7
- MCID = 8 for ADL subscale
Special tests: Elimination tests for Lower Leg
- Anterior Ankle Impingement
- forced dorsiflexion test
- CPR of impingement
Impingement CPR
5/6 of the following:
- anteriolateral ankle joint tenderness
- anteriolateral ankle joint swelling
- pain with forced dorsiflexion
- pain with single-leg squat
- pain with activities
- absence of ankle instability
research properties and clinical implications of Ankle Impingement CPR
- Research properties
- +LR 3.8
- -LR 0.08
- Clinical Implications
- requires valdiation
- QUADAS score = 7
- Use with caution
Structural Stress Tests at the Lower Leg
- Talocrural
- Plantarflexion
- Dorsiflexion
- Subtalar/midtarsal
- Supination
- Pronation
- MTP, IP
- Plantarflexion
- Dorsiflexion
Resistive Testing for the Lower Leg
- Ankle plantarflexion
- Foot dorsiflexion and inversion
- Foot inversion
- Foot eversion with plantarflexion
- Hallux and toe MP flexion
- Hallux and toe DIP and PIP flexion
- Hallux and toe MP and IP extension
Bone and Joint structures for palpation in the Lower Leg
- Fibular head
- Medial malleolus
- Lateral malleolus
- Cuboid
- Calcaneus
- Navicular
- Cuneiforms
- Talus
- Sustentaculum Tali
- Phalanges
Palpation of Soft tissue structures
- Achilles Tendon
- Posterior Tibialis Tendon
- ATFL
- Deltoid Ligament
- Fibularis Longus and Brevis
- Dorsalis Pedis Pulse
- Posterior Tibial Pulse
Proximal Tibiofibular Assessment
- Pt position
- hook lying
- Stabilization
- proximal tibia
- Palpation finger
- tib-fib joint line
- Mobilizing Force
- with pinch grip on; fibular head;
- A → anteriolateral
- P → posteriomedial
Distal Tibiofibular Assessment
- Pt Position
- side-lying
- Stabilization
- distal tiba (thenar grip)
- Palpation Finger
- tib-fib joint line
- Mobilizing force
- distal fibula (thenar grip)
- A → anterior force
- P → posterior force
Talocrural Joint Assessment
- Pt Position
- A → prone
- P → supine
- Stabilization
- foot overhangs table (+/- distal lower leg)
- Palpation finger
- b/w sustentaculum tali and medial malleolus
- Mobilizing force
- A → anterior force with hand wrapped around post calcaneus
- P → hand gripping dorsum of foot
Subtalar Joint Assessent
- Pt Position
- SL (tested direction contacting table)
- Palpation finger
- M → lateral joint line
- L → medial joint line
- Stabilization
- lower leg on table
- Mobilizing force
- medial or lateral around axis of rotation for STJ
Talonavicular Joint Assessment
- Pt position
- supine foot off edge of table
- Palpation finger
- joint line
- Stabilization
- table vs wedge vs talus (pinch)
- Mobilizing force
- navicular (dorsal vs plantar)
- grasping with 1st and 2nd digit
Calcaneocuboid Assessment
- Pt position
- SL
- Palpation finger
- joint line
- Stabilization
- table vs wedge vs calcaneus (pinch)
- Mobilizing force
- cuboid (dorsal vs plantar)
- grasping with 1st and 2nd digit
Tarsometatarsal Joint Assessment
- Pt position
- SL
- Stabilization
- tarsal between 1st and 2nd digit
- Mobilizing force
- plantar or dorsal, MT base between 1st and 2nd digit
MTP/IP joint assessment
- Pt position
- SL/hooklying/wedge
- Stabilization
- proximal segment’s head between 1st and 2n digit
- Mobilizing force
- distal segment’s base between 1st and 2nd digit
confirmation tests for syndesmotic ankle sprain
- fibular translation test
- external rotation test
- syndesmosis squeze test
confirmation tests for ATFL integrity
- anterior drawer test
- reverse anteriolateral drawer test
lateral talar tilt stress test if a confirmation test for what condition?
- medial ankle ligament integrity
medial talar tilt stress test is a confirmation test for what condition?
- lateral ankle ligament integrity
confirmation test for achilles tendon integrity
- Thompson Test
Confirmation tests for interdigital neuroma
- foot squeeze test
