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Knee & ankle goiometry
 

Knee & ankle goiometry

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    Knee & ankle goiometry Knee & ankle goiometry Presentation Transcript

    • Knee & Ankle Goniometry By: Dr. Gehan Shaalan Physical Therapy Lecturer BMC
    • Knee Flexion Starting Position: Patient should be supine with both legs flat on the table. The fulcrum is aligned with the lateral epicondyle of the femur. The stationary arm is in line with the greater trochanter and midline of the femur, the moving arm with the lateral malleolus and midline of the fibula. Ending Position: Goniometer positioning is same as above. Normal ROM is 135
    • Knee FlexionPrecaution 1-Prevent hip rotation, adduction and abduction. 2-Hip flexed to 90 degrees only to prevent stretching of the rectus femoris muscle.Factors limiting motion Tension of muscles of knee extension ( quadriceps muscles) Contact of bulk of calf muscles of posterior leg with posterior thigh.
    • Knee Extension Starting and Ending Position: The patient should be lying prone with both legs flat on the table. The goniometer positioning for knee extension is the same as it is for knee flexion. Normal ROM for knee extension is between 0 and –10 degrees. The patient has –3 degrees of knee extension.
    • Knee ExtensionPrecaution Prevent hip rotation and flexion.Factors limiting motion Tension of knee flexor muscles. Tension of cruciate ligament. Tension collateral ligament
    • Ankle Dorsi FlexionStarting Position Patient is supine with legs off the table. The fulcrum is aligned with the lateral malleolus. The stationary arm is in line with the midline of the lower leg; use the head of the fibula for reference. The moving arm is parallel to the fifth metatarsal. Note: Once again remember that the goniometer will be at 90 degrees and to adjust for that when recording the angles.Ending Position: Same as above Normal ROM for dorsiflexion is between 0 and 20 degrees.
    • Ankle Dorsi FlexionPrecaution Avoid eversion and inversion. Avoid motion of hip and knee.Factors limiting motion Tension of peroneus muscles. Contact of lateral bones medially. Tension of the lateral tarsal ligaments
    • Ankle Plantar Flexion Starting Position and Ending Position: Patient is sitting with legs off table. Goniometer alignment is the same as for dorsiflexion. Normal ROM is 45 degrees
    • Ankle Plantar FlexionPrecaution Prevent hip rotation Avoid forefoot flexion. Prevent inversion and eversion of the foot.Factors limiting motion Tension of the dorsiflexor muscles of ankle. Contact of posterior portion of talus with tibia. Tension of ligaments:a) anterior talofibular.b) Anterior fiber of deltoid ligament
    • Subtalar InversionStarting and Ending Position: The patient should be lying prone with foot hanging off the table. The fulcrum is placed between the two malleoli. The stationary arm is aligned with the midline of the leg and the moving arm with the midline of the calcaneus The ROM is from 0 - 30 degrees
    • Subtalar InversionPrecaution Prevent medial rotation of the knee. Prevent lateral rotation and abduction of the hip. Allow ankle joint plantar flexion.Factors Limiting ROM Contact of tarsal bones medially. Tension of eversion muscles ( peroneal group) Tension of lateral tarsal ligament.
    • Subtalar EversionStarting and Ending Position: The patient should be lying prone with foot hanging off the table. The fulcrum is placed between the two malleoli. The stationary arm is aligned with the midline of the leg and the moving arm with the midline of the calcaneus. The ROM is from 0 - 25 degrees
    • Subtalar EversionPrecautions Prevent lateral rotation of knee. Prevent medial rotation and abduction of the hip. Allow dorsiflexion at the ankle.Factors Limiting ROM Contact of tarsal bones laterally. Tension of muscles of inversion tibialis posterior. Tension of medial tarsal ligaments.