Knee & ankle goiometry

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Knee & ankle goiometry

  1. 1. Knee & Ankle Goniometry By: Dr. Gehan Shaalan Physical Therapy Lecturer BMC
  2. 2. 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
  3. 3. 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.
  4. 4. 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.
  5. 5. Knee ExtensionPrecaution Prevent hip rotation and flexion.Factors limiting motion Tension of knee flexor muscles. Tension of cruciate ligament. Tension collateral ligament
  6. 6. 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.
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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.
  12. 12. 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
  13. 13. 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.

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