Lower Limb Measurements in Physical Therapy

Lower Limb Measurements

• Hip Flexion (115° to 125°): Patient position: supine, other leg straight. Fulcrum: greater trochanter. Stationary arm: greater trochanter and lateral superior crest of ilium. Movable arm: lateral midline of femur toward the condyle.

• Hip Extension (0-10°-15°): Patient position: prone, opposite lower extremity over the table to stabilize the pelvis. Anterior superior spines must be in contact with the table. Stationary and Movable arm positions are the same as those for hip flexion.

• Hip Abduction (0-45°): Patient position: supine. Fulcrum: inferior to anterior superior spine. Stationary arm: on a line between the anterior superior spines. Movable arm: dorsal midline of thigh toward the patella.

• Hip Adduction to Midline (45°-0°): Patient position: same as above, other leg passively or actively abducted out of the way. Fulcrum: same as abduction. Stationary arm: same as abduction. Movable arm: same as abduction

• Hip Internal and External Rotation (0-45°): Patient position: sitting, knee flexed to 90 degrees. Fulcrum: patella. Stationary arm: perpendicular or parallel to table. Movable arm: tibial crest to mid-malleoli.

• Knee Flexion and Extension (0-120°-130°): Patient position: sitting or prone, thigh supported knee free over edge or prone. Fulcrum: lateral condyle. Stationary arm: femoral lateral midline trochanter & condyle. Movable arm: lateral mid fibula toward malleolus.

• Ankle Dorsiflexion (0-20°) and Plantarflexion (0-40°-45°): Patient position: supine lying position. Fulcrum: posterior to base of fifth metatarsal. Stationary arm: on a line between fibular head and malleolus. Movable arm: lateral mid-line of 5th metatarsal.

• Subtalar Inversion (0-35°) and Eversion (0-35°): Patient position: sitting, knee in flexion foot in neutral position. Fulcrum: between both malleoli. Stationary arm: parallel to leg. Movable arm: along heads of metatarsals pivot.

• Cervical ROM: Describes different types of neck movement and their corresponding normal ranges, like flexion, extension, and rotation. Also lists the specific cervical joints involved.

• Neck Flexion: Starting and ending position: sitting with trunk well supported, neck in the anatomical position, hand placed on the lap, and shoulder joints relaxed. Axis: external auditory meatus. Stationary arm: vertical. Moving arm: aligned with nostrils.

• Neck Extension: Starting and ending position: Just as for flexion. Axis: external auditory meatus. Stationary arm: vertical. Moving arm: aligned with nostrils.

• Cervical Rotation: Starting and ending position: Just as for flexion & extension. Axis: placed over the center of the top of the head. Stationary arm: placed in the line with the acromion process of the side being measured. Moving arm: placed in the line with the tip of the nose.

• Cervical Side Bending (Lateral Flexion): Starting and ending position: sitting with trunk well supported, neck in the anatomical position, hand placed on the lap, and shoulder joints relaxed. Axis: placed over the spinous process of C7. Stationary arm: placed along the thoracic spinous processes. Moving arm: placed over the external occipital protuberance of the occipital bone. ROM: 0 - 45-60 degrees in each direction.

• Trunk ROM: Extension 20°-30°, Lateral flexion 30°, Flexion 75-90° average(80°), Rotation 45°.

• Trunk Flexion: Starting position: the tape is placed proximally on the spinous process of C7 and S1 distally. Ending position: following flexion of the vertebrae using the same landmark. Calculated difference between start and ending positions. ROM: approximately 4 inches. Difference between starting and ending positions.

• Trunk Hyperextension: Tape alignment is the same as for trunk flexion. ROM: 2 inches.

• Thoracic and Lumbar Lateral Flexion: Position: standing erect. Axis: S1 spinous process. Stationary arm: vertical. Moving arm: C7 spinous process. Stabilization: the pelvis is stabilized.

• Knee Joint as a Fixed Point: The knee joint can be used as a fixed point for measuring lateral bending

• Longitudinal Measurements: Measurement from umbilicus or xiphisternal juncture to the medial malleolus of the ankle. Use supine position with legs relaxed.

• True Leg Length Discrepancy: Determining true leg length involves placing the patient's legs in comparable positions and measuring the distance from the anterior superior iliac spines to the medial malleoli of both ankles. Unequal distances indicate a discrepancy.

• Apparent Leg Length Discrepancy: Establishing no true leg length discrepancy before testing. Apparent shortening may stem from pelvic obliquity or flexion deformity. During inspection, pelvic obliquity manifests as uneven anterior or posterior superior iliac spines.

• B-segmental Leg Length Measurements: Goal is to determine the site of shortening. Measurements from the highest point of the iliac crest to greater trochanter, greater trochanter to lateral knee joint line and medial knee joint line to medial malleolus to determine the tibial length.

• Circular Measurements: The purpose is to evaluate muscle wasting or edema. Materials needed include skin marker and measuring tape. Measurements are taken at the same place to ensure clear comparison. The "skin marker" is used to mark a precise area for consistent measurement. Ex. Quadriceps wasting measured 15 cm over superior border of the patella and for edema, a precise area must be determined and measured from a bony prominence near the area.. These measurements must include the exact distance from which they were taken.

This quiz covers the essential lower limb measurements relevant to physical therapy, focusing on hip flexion, extension, abduction, and adduction. Each measurement includes patient positioning and fulcrum placements to ensure accurate assessments. Test your knowledge on these key measurements and improve your clinical practice.