Evidence-Based Examination of the Hip Presented by Alexis Wright, PT, PhD, DPT, FAAOMPT Practice Sessions/Skill Check-offs

Transcription

1 Evidence-Based Examination of the Hip Presented by Alexis Wright, PT, PhD, DPT, FAAOMPT Practice Sessions/Skill Check-offs Module Five: Movement Assessment of the Hip (1 hour CEU time) Skilled Process Physiological Flexion Review in Chapter 7 3:54 Photo Description Check Off The patient lies supine bringing their knee to their chest abduction 8 5:15 The patient lies in a sidelying position and is instructed to bring their leg toward the ceiling adduction 9 5:51 The patient remains in sidelying and is instructed to bring the lower or table-side leg into hip adduction toward the ceiling extension 10 6:28 The patient lies in a prone position and is instructed to bring the lower extremity into hip extension or toward the ceiling the knee straight 1

2 internal rotation 11 6:58 The patient assumes a seated position and is instructed to rotate the leg internally so that the foot moves away from midline external rotation 12 7:41 The patient assumes a seated position and is instructed to rotate the leg externally so that the foot moves toward the midline flexion abduction adduction 14 8: : :19 supine. The clinician ly moves the hip into flexion toward the first point of pain and then toward end range. If no pain is reported, the clinician applies an to rule out the specific movement of the The patient lies supine. The clinician ly moves the hip into abduction toward the first point of pain and then toward end range. If no pain is reported, the clinician applies an to rule out the specific movement of the The patient lies supine. The clinician ly pulls the opposite hip into adduction toward the first point of pain and then toward end range. If no pain is reported, the clinician applies an to rule out the specific movement of the 2

3 internal rotation external rotation extension anterior to posterior 17 10: : : :19 supine. The clinician ly cradles the lower leg below the knee and slowly internally rotates the hip to the first point of pain and then toward end range. If no pain is reported, the clinician applies an to rule out the specific supine. The clinician ly cradles the lower leg below the knee and slowly externally rotates the hip to the first point of pain and then toward end range. If no pain is reported, the clinician applies an to rule out the specific the prone position. The clinician ly lifts the hip into extension to the first point of pain and then toward end range. One hand blocks just cephalically to the hip joint to reduce the amount of lumbar extension that occurs this procedure. If no pain is reported, the clinician applies an to rule out the specific The technique is performed the patient in supine the leg in a neutral position or flexion/adduction. The clinician assesses the resting symptoms then applies a of the hip joint using the heel of the hand. The clinician ly moves toward a posterior direction. Any reproduction of 3

4 indirect distraction direct distraction lateral 23 14: : :20 pain that is concordant implicates this assessment method as a possible treatment technique. If performed in the flexion/adduction position, the clinician uses their body weight to perform the through the shaft of the femur isolating the posterolateral capsule of the hip position. The clinician cradles the ankle of the patient into both of his or her hands or cradles the foot and ankle. The clinician then takes up the slack to preposition the hip into targeted motion. Generally, resting position of the hip includes a moderate degree of hip flexion, abduction, and slight external rotation. The clinician then provides an inferior force by leaning backward while holding the ankle. position. The clinician places the lower extremity over his or her shoulder and places his or her hands (ulnar border) near the hip joint for an appropriate contact. Using the shoulder as a fulcrum, the clinician pulls inferiorly the hands at the hip and pushes cephalically the shoulder for an inferior distraction. position. The clinician places the lower extremity in a position of hip flexion and places his or her hands medial to the hip The clinician then places his or her shoulder against the knee of the patient to create a counterforce. The clinician then pulls laterally 4

5 hip quadrant posterior to anterior Notes: 26 17: :27 the hands at the hip and pushes medially the shoulder for a lateral distraction The technique is performed in the supine position after assessment of resting symptoms. At 90 degrees of hip flexion, the clinician ly moves the hip into full flexion toward the ipsilateral shoulder. The clinician continues to assess patient symptoms by moving the hip into varying degrees of hip flexion and adduction to assess for reproduction of patient symptoms. The technique is performed the patient in prone the leg in a neutral position and slight extension. The clinician assesses the resting symptoms then applies a of the hip joint using the heel of the hand. The clinician ly moves toward an anterior direction. Any reproduction of pain that is concordant implicates this assessment method as a possible treatment technique. 5