Practical assessment

Question 1

STJ ROM

Answer 1

• Identify the motion of eversion and inversion
• Calculate ideal using total ROM divide by 3
• not a reliable measure

Question 2

Hamstrings ROM

Answer 2

• Normal is 70-90 deg
• differentiate b/w semien/mem and biceps fem for in toe and out toeing Pt
• Medial compartment tight = in toeing
• Lateral hamstrings tight = out toeing
• Stretches (hold 30 sec):

1. Supine, stretching leg two body from thigh flexed 90° position, preferably by 2nd person.
2. Edge of table/coffee table, leg out straight, lean twd foot
3. Foot on object (stool, chair) lean fwd to touch toes or with hands on hips

-If Pt presents with LBP advise to see physio as stretches may cause strain to lower back

Question 3

SP, FP and Patella assessment

Answer 3

Q: why would there be arthritis under patella?
A: patella has a triangle. base & corresponding
triangle groove, when it moves outside of this,
cartilage is worn away

• Is there genu varum or valgum
• Tight posterior musculature Y/N
• Hyperextension Y/N

Question 4

FF to RF assessment

Answer 4

• identify a varus or valgus forefoot position

- review signs an symptoms

Question 5

NCSP and RCSP

Answer 5

-identify position of calcaneus in neutral and resting

Question 6

HIP ROM

Answer 6

• 45 deg internal and external rotation
• External limited, internal tight (gluteus Medius, Minimus, adductors and TFL)
• Internal limited, external tight (gluteus maximus, piriformis, sartorius)
• If more motion medially than lateral cause for concern

Question 7

1st Ray Position/ROM

Answer 7

• 1st ray PF/DF
• If thumbs line neutral
• Thumb width each way for normal ROM

-Know etiologies for 1st ray PF and DF

Question 8

FPI

Answer 8

-foot posture pronated/supinated or neutral

Consideration of clinic exam

• easy to conduct
• time efficient
• cost value
• simple to understand
• quantifiable data

Reliability
-Moderate to good reliability, some studies found low reliability (politics?)
Validity
-Poor due to validation against measures that are un validates
-studies have shown good validity when foot is excessively pronated or supinated, but not when small differences exist (EMT and Radiographic tools)

Question 9

STJ neutral measured

Answer 9

• Reference point for STJ ROM and other LL measurements

- used for orthotics manufacturing and casting

Question 10

Ankle Joint Dorsiflexion

Answer 10

• Flex knee to remove gastroc, insert above the knee wont function at 90 deg
• Tightness Knee extended is gastroc, knee flexed is soleus
• Three stretches:
• wall lunge, stair stretch and soleus stretch

Question 11

MTJ OA

Answer 11

• looking for 2:1 ratio of motion FP:TP
• Increase in FP motion, low OA
• increase in TP motion, high OA (harder to control with orthoses), advise Pt of getting a sturdy shoe build orthotics with lateral lip to keep foot in position

Question 12

1st MPJ ROM

Answer 12

• normal is >65 deg

- Measurement WB: Roukis goniometer but cannot lock MTJ

Question 13

Malleolar Torsion

Answer 13

• 13 to 18 deg normal
• quantifies TP torsion of malleoli relative to proximal shaft of tibia
• good for paediatrics to identify potential cause of in toeing or out toeing

Question 14

LLD assessment

Answer 14

• If LLD present in RCSP and NCSP structural, difficult to treat
• If LLD fix when NCSP function can treat with orthoses

Question 15

Navicular Drop

Answer 15

• Greater 1cm cause for concern

- Reliability poor as STA and foot size may impact normalize values of navicular height

Question 16

Why do we measure from STJ neutral?

Answer 16

-Motion we measure occur from mid stance which is when the STJ is neutral, therefore we mimic this position