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7 knee assessment examination

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Examination of knee joint

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7 knee assessment examination

  1. 1. Saurab Sharma, MPT Knee Joint Assessment Range of Motion Muscle Length MMT Reflex testing
  2. 2. Objectives of session: At the end of the class, students will be able to:  Measure ROM of knee joint  Assess muscle length  Assess muscle strength  Perform knee jerk 2
  3. 3. ROM examination 3  Active ROM  Active ROM with over pressure  Passive ROM  End feel
  4. 4. ROM examination Active movement: 4  First in sitting and later in lying position  Look if the patella is tracking freely  Pain?  ROM? full or partial ?  Most painful movement should be done last
  5. 5. ROM examination Passive movement: 5  Passive patellar movement  Tibiofemoral movement  Record ROM  End feel
  6. 6. Measurement of Knee ROM  Measure ROM of at least one proximal and one distal joint i.e. Hip joint and Knee joint  Movements possible:  Flexion  Extension (Note: Be aware of TRICK MOVEMENTs) 6
  7. 7. Knee flexion • Patient position: Prone with hip in neutral position • Stabilization: on femur to prevent movement at hip • Axis: Lateral epicondyle of femur • Stationary arm: Lateral midline of femur with greater trochanter as reference • Movable arm: Lateral midline of fibula with lateral malleolus as reference 7
  8. 8. Knee flexion: measurement Starting position End position 8
  9. 9. Knee flexion: Alternative position • Patient position: Supine with hip in neutral position • Stabilization: on femur to prevent movement at hip • Axis: Lateral epicondyle of femur • Stationary arm: Lateral midline of femur with greater trochanter as reference • Movable arm: Lateral midline of fibula with lateral malleolus as reference 9
  10. 10. Knee flexion: Alternative position Starting position 10
  11. 11. Knee flexion: Alternative position ROM measurement Starting position End position 11
  12. 12. Knee extension  Patient position: Supine with knee extended as much as possible with towel roll under ipsilateral ankle  Stabilization: not needed  Axis: Lateral epicondyle of femur  Stationary arm: Lateral midline of femur with greater trochanter as reference  Movable arm: Lateral midline of fibula with lateral malleolus as reference  Examiner action: Determine if knee is fully extended by applying passive overpressure to knee extension12
  13. 13. Knee extension: Starting position 13
  14. 14. Knee extension: measurement Starting position End position 14
  15. 15. End feel: 15 Normal end feel:  Bone to bone  Soft tissue approximation  Tissue stretch Abnormal end feel  Bone to bone  Tissue stretch  Early/ late muscle spasm  Hard/soft capsular  Empty  Springy
  16. 16. Muscle length: 16  Iliospoas  Rectus femoris  Quadriceps  Hamstring
  17. 17. Muscle strength: 17  Dynamometer  MMT  Hamstring: medial and lateral  Rectus femoris
  18. 18. Reflex: 18
  19. 19. Summary 19
  20. 20. Objectives of knee assessment At the end of the class, students will be able to:  Understand the need of taking consent for assessment  Identify and ask relevant history question in knee injuries/ pain  Observe a patient with knee problem  Palpate important structures around knee joint  Measure ROM of knee joint  Assess muscle strength  Perform knee jerk 20

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