Clin. Int. 4

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teatea2
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114017
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Clin. Int. 4
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2011-11-18 12:12:20
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Clinical Int Hip
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Clinical Int. 4 Hip
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  1. AROM for hip flexion?
    120° (straight knee 70-90°)
  2. AROM for hip extension?
    30°
  3. AROM for hip medial (internal) rotation?
    45°
  4. AROM for hip lateral (external) rotation?
    45°
  5. AROM for hip ABduction?
    45°
  6. AROM for hip ADduction?
    30°
  7. PROM hip flexion (What is the end feel?)
    Tissue stretch
  8. PROM hip extension (What is the end feel?)
    Tissue stretch
  9. PROM hip medial rotation (What is the end feel?)
    Tissue stretch
  10. PROM hip lateral rotation (What is the end feel?)
    Tissue stretch
  11. PROM hip abduction (What is the end feel?)
    Tissue stretch (soft)
  12. PROM hip adduction (What is the end feel?)
    Soft tissue approximation /tissue stretch
  13. Mrt for hip flexion, position and muscles being tested:
    • Ct. seated, hips and knees flexed to 90. Th. applies tableward pressure.
    • MS Group: Hip Flexors
    • Iliopsoas
    • Rectus femoris
    • Sartorius
    • Pectineus
    • Add. Longus & Magnus
    • TFL
    • Glut. Med. (ant fibers)
  14. MRT for hip extension, position and muscles being tested:
    • Ct. prone on table, knees flexed to 90, use gravity to test.
    • MS Group: Hip Extensors
    • Glut. Max
    • Hamstrings
    • Glut. Med (posterior fibers)
  15. MRT for hip medial rotation, position and muscles being tested:
    • Ct. prone on table w/ knee flexed to 90. Th. places hand on lateral aspect of the ct's distal leg near the ankle. Ct. holds this position while Th. attemps to push the leg in a medial direction.
    • MS Group: Hip Medial Rotators
    • Glut. Med (Ant fibers)
    • Glut. Min.
    • TFL
    • Semimembranosus
    • Semitendinosus
    • Add. Mag. & Long
  16. MRT for hip lateral rotation, position and muscles being tested:
    • Ct. prone on table w/ knee flexed to 90. Th. places hand on medial aspect of the ct's distal leg near the ankle. Ct. holds this position while Th. attemps to push the leg in a lateral direction.
    • MS Group: Hip Lateral Rotators
    • Glut. Max
    • Piriformus
    • Sartorius
    • Biceps Femoris (long head)
    • Glut. Med. (post. fibers)
    • Iliopsoas
    • Hovi said: QF, obter.., and infir... also)
  17. MRT for hip Abduction, position and muscles being tested:
    • Ct. is supine with the thigh partially abducted. Have client spread legs apart to a combined 45 degrees. Th. places fists on table just proximal to the ct's lateral ankles. Ct. attempts to slowly push their legs apart.
    • MS Group: Hip Abductors
    • Glut. Med
    • Glut. Min
    • TFL
    • Sartorius
    • Hovi said: piriformus and upper glut. max
  18. MRT for hip Adduction, position and muscles being tested:
    • Ct. is supine with the thighs partially abducted. Have client spread legs apart to a combined 45 degrees. Th. places fists on table just proximal to the ct's medial ankles. Ct. attempts to slowly bring their legs together.
    • MS Group: Hip Adductors
    • Adductor Mag.
    • Adductor Long.
    • Adductor Brevis
    • Pectineus
    • Gracilis
  19. What test would you perform if you suspected hypermobility/hypomobility in the SI joint? Ct. complains of low back pain, pointing to the SI region, possibly walking with a limp, or showing limited active lumbar flexion and extension?
    Gillet's Test (Stork Test)
  20. How is Gillet's Test (Stork Test) performed?
    Ct. stands with feet 6" apart, th. stands behind them and places one thumb on the inferior aspect of the test side PSIS and the other thumb on the sacral base. Ct. then flexes hip and knee to 90.
  21. What is a positive for Gillet's Test (Storks Test)?
    If the thumb on the test side PSIS moves superiorly as the Ct's knee lifts, indicating hypomobility (lack of movement or like it is glued in one place) of the SI joint.
  22. Why would you run a Pace Abduction Test?
    Ct. complains of P in the posterior leg/butt region.
  23. What does the Pace Abduction Test test for?
    • Piriformus pressing on the siatica nerve
    • Piriformus Sndrome
    • Trigger points in the piriformus
  24. How is the Pace Abduction test performed?
    Ct. seated at edge of table with hips partially abducted. Th. places each hand on the lateral sides of ct's knees. Ct. is instructed to hold this position (for a minimum of 10 seconds) as the Th. attemps to press their knees together.
  25. What is a positive sign for the Pace Abduction test?
    Ct. experiences radiating pain in the gluteal region or down the posterior leg (could go to foot), or dull achiness, weakness.
  26. Why would you run FABER (Patrick's Test)?
    Ct. complains of hip P or SI P (can be on the back or front side of the body).
  27. How is the FABER (Patrick's Test) performed?
    Ct. Supine on the table. Affected side leg is put into flexion, abduction, and external rotation, with the knee flexed and the foot resting on the opposuite distal thigh (figure 4). Th. places one hand on the opposite side ASIS and the other hand on the test side knee. Slow pressure is applied away from the ASIS.
  28. Pain in the SI region indicating SI joint pathology or P in the hip joint inidcating hip pathology is a positive for which test?
    FABER (Patrick's Test)
  29. What test is run if you suspect hip joint and/or SI joint pathology?
    FABERS (Patrick's Test)
  30. What test do you run if you suspect short/tight hip flexors? Hypertonicity of the iliospoas and rectus femoris?
    Modified Thomas Test
  31. Why would you run a Modified Thomas Test?
    For anterior pelvic tilt, lower back P
  32. How is the Modified Thomas Test performed?
    Ct. seated on edge of table, brings both knees to chest, Th. helps client roll slowly onto back, then slides ct. so ischial tuberosities are closer to edge of table (braces unaffected leg on th. body) then ct. is instructed to slowly lower affected leg into extension (toward the table). Th. observes the extended thigh: does the thigh drop to the level of the table? Does the knee flex to 90? Does the thigh abduct too much?
  33. What is a positive for Modified Thoma's Test?
    • Ct.'s thigh is too high = hip flexors may be tight (hypertonicity in the iliopsoas)
    • Ct.'s thigh is too low (knee is not flexed to 90) = possible hypertonicity in the rectus femoris (tightness)
    • Thigh is abducted too much = TFL/ITB may be tight
  34. What tests for the strength of the gluteus medius muscle?
    "Model's Walk"
    Trendelenburg's Sign (test)
  35. How do you perform Trendelenburg's Test?
    Ct. standing. Th. instructs them to stand on the affected leg while flexing the knee and hip of the unaffected side. Th. stands behind the ct. observing the relative heights of the client's PSIS's and iliac crests (hips).
  36. If the non-weight bearing hip falls then the weight bearing hip has weak abductors (glut. medius). What test is this a positive sign for?
    Trendelenberg's Sign (test)
  37. Why would you run a Modified Ober's Test?
    If you suspect muscle tightness in the muscles associated with the ITBand. Ct. complains of lateral hip P or lateral knee P. (Often seen in runners)
  38. How is the Modified Ober's Test performed?
    Ct. sidelying on table, close to therapist. Th. flexes ct.'s affected knee to 90. Then stabalizes hip, and grasps ct.'s knee and supports lower leg with forearm. Flexes ct.'s hip slightly, abducts hip, extends hip past neutral. Then moves thigh into adduction without rotating the lower extremity. (off edge of table)
  39. What is a positive sign for Modified Ober's Test?
    If the leg cannot drop to the level of the table = indicates excess tension (tightness) of the ITB (abductors) (gluteus maximum and TFL.
  40. Why/how do you perform Apley Distraction Test?
    • Tests for ligamentous damage
    • Test if client reports a sudden movement or activity that caused sharp pain in the knee, generally near the knee joint.
    • The therapist places a knee on the client's posterior thigh to stabilize it against the table, then use both hands to pull the client's leg so it is distracted (lifted) from the femoral condyles. Gently rotate the tibia through its full range of motion both medially and laterally. Make sure the rotational force is directed to the knee and not the foot/ankle.
    • Positive is knee pain on the lateral or medial sides of the knee.
  41. Knee- end-feel for extension (PROM)
    Tissue stretch (firm)
  42. Knee- end-feel for flexion (PROM)
    Tissue stretch approximation
  43. AROM Knee- degrees of flexion
    135
  44. Valgus Stress Test
    • Tests for MCL sprain
    • Test if client reports a sudden injury that involves a valgus or rotary stress to the knee.
    • Therapist stabilizes the distal medial tibia with one hand, while applying valgus force to the lateral knee with the other hand.
    • Positive is pain, or a mushy end feel indicates damage to the MCL.
  45. What muscles are being tested with MRT knee flexion (5)?
    • Hamstrings
    • Gracilis
    • Sartorius
    • Gastrocnemius
    • Plantaris
  46. What do you suspect if pain is felt during Apley's compression test but not distraction test...
    There is probably a meniscal problem.
  47. What muscles are being tested with MRT knee extension?
    Quads
  48. If pain is felt during both Apley's compression test and distraction test...
    It is probably a ligament issue if the pain is the same during both tests.
  49. Knee ligament that is usually injured
    ACL
  50. Posterior Drawer Test- what does it test for and why would you test?
    • PCL sprain
    • Client describes a sudden motion or activity performed which immediately causes pain. The client may describe hearing a loud pop or snap at the onset of injury. Ask the client about weakness in the knee after the injury.
  51. How do you perform the Anterior Drawer Test?
    • Stabilize the client's foot by anchoring the toes beneath their thigh. Place both hands around the posterior side of the proximal tibia and gives a firm anterior pull on the tibia.
    • A positive is a mushy end feel and/or anterior movement of the tibia
  52. What does the Varus Stress Test test for? How is it performed?
    • Tests for LCL sprain
    • Test if client reports a sudden injury that involves a varus or rotary stress to the knee.
    • Therapist stabilizes the distal lateral tibia with one hand, while applying varus force to the medial knee with the other hand.
    • Positive is pain, or a mushy end feel indicates damage to the LCL.
  53. What special test would you use for a possible ACL sprain?
    Anterior Drawer Test
  54. AROM for knee extension (degrees)
    10

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