GONIOMETRY LOWER LIMB

GONIOMETRY FOR THE LOWERLIMB DISCUSSES IN CONCISE THE DIFFERENT TYPES OF GONIOMETERS AVAILABLE FOR MEASURING VARIOUS JOINT ROM, PRINCIPLES OF GONIOMETRY, AND PLACEMENT OF GONIOMETER FOR MEASURING RANGE OF MOTION IN THE LOWER LIMB (HIP, KNEE, ANKLE).

1. Goniometry Lower limb ROM Dr. Peteti Sairam MPT(Neuro) Asst.Professor

2. PROCEDURE Position the patient in a relaxed manner and the joint to be measured should be free from obstructions like pillows, couch. Patient has to wear loose clothes, to allow smoot movement of the measuring joint. Measuring joint has to be in neural position or it has to be at 0⁰ position. Total procedure has to explain to the patient. Therapist has to stand near to the patient and facing the joint, which has to be measured. Axis or the fulcrum of the goniometer is placed over the axis of the joint to be measured. Stable arm is fixed to the proximal segment of the joint. Movable arm is fixed with the distal segment of the joint. Therapist has to move the distal segment of the joint with the movable arm of the goniometer to measure the joint range.

3. Selection of the goniometer An important factor for measuring ROM. Size of the joint -Bigger the joint = Size of goniometer is big, movable arm and stable arm bigger in length. -Smaller the joint = Size of goniometer is small, movable arm and stable arm smaller in length. An inclinometer also can be used for the measuring the joint ROM, specifically used for measuring pelvic movements

4. MOVEMENTS of lower limb HIP KNEE ANKLE FLEXION EXTENSION ABDUCTION ADDUCTION MEDIAL ROTATION LATEAL ROTATION FLEXION EXTENSION DORSIFLEXION PLANTAR FLEXION SUBTALAR JOINT INVERSION EVERSION

5. HIP movements FLEXION Position of patient: Supine lying Axis: Greater trochanter of femur Movable arm: Mid line of lateral aspect of thigh Stable arm: Mid line of lateral aspect of lower trunk Normal ROM: to 120 ⁰

6. HIP movements EXTENSION Position of patient: Prone lying Axis: Greater trochanter of femur Movable arm: Mid line of lateral aspect of thigh Stable arm: Mid line of lateral aspect of lower trunk Normal ROM: 0 to 30 ⁰

7. HIP movements ABDUCTION Position of patient: Supine lying Axis: 2 inch below the ASIS Movable arm: Mid line of anterior aspect of thigh Stable arm: P laced 90 ⁰ to the movable arm Normal ROM: 0 to 45 ⁰

8. HIP movements ADDUCTION Position of patient: Supine lying Axis: 2 inch below the ASIS Movable arm: Mid line of anterior aspect of thigh Stable arm: Placed 90 ⁰ to the movable arm Normal ROM: 0 to 30 ⁰

9. HIP movements MEDIAL ROTATION Position of patient: High sitting at the end of couch with legs kept hanging Axis: Mid point of patella Movable arm: midline of anterior aspect of leg Stable arm: straight line to the movable arm Normal ROM: 0 to 45 ⁰

10. HIP movements LATERAL ROTATION Position of patient: High sitting at the end of couch with legs kept hanging Axis: Mid point of patella Movable arm: midline of anterior aspect of leg Stable arm: straight line to the movable arm Normal ROM: 0 to 45 ⁰

11. knee movements FLEXION Position of patient: Prone lying Axis: Lateral epicondyle of femur Movable arm: Lateral aspect of midline of leg Stable arm: Lateral aspect of midline of thigh Normal ROM: 0 to 135 ⁰

12. Knee movements EXTENSION Position of patient: Prone lying Axis: Lateral epicondyle of femur Movable arm: Lateral aspect of midline of leg Stable arm: Lateral aspect of midline of thigh Normal ROM: 0 ⁰

13. ankle movements PLANTAR FLEXION Position of patient: High sitting at the end of couch with legs kept hanging Axis : Tip of medial malleolus Movable arm: L ateral aspect of foot Stable arm: Mid line of lateral aspect of leg Normal ROM: 0 to 50 ⁰

14. ankle movements DORSI FLEXION Position of patient: High sitting at the end of couch with legs kept hanging Axis: Tip of medial malleolus Movable arm: Lateral aspect of foot Stable arm: Mid line of lateral aspect of leg Normal ROM: 0 to 20 ⁰

15. OTHER METHODS FOR PLANTAR AND DORSI FLEXION PRONE LYING WITH KNEE 90 ⁰ FLEXION SUPINE LYING

16. SUB TALAR JOINT movements INVERSION Position of patient: High sitting, with legs kept hanging. Axis: Between two malleoli Movable arm: Over the mid line of foot Stable arm: Placed at the mid line of leg Normal ROM: to 35 ⁰

17. SUB TALAR JOINT movements E VERSION Position of patient: Prone lying, with foot kept hanging. Axis: Between two malleoli Movable arm: Over the mid line of calcaneum Stable arm: Aligned to the mid line of leg Normal ROM: 0 to 15 ⁰