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11-10). This tells me, and more importantly the pt, that we are making mechanical improvements. Using the pelvis for alignment of the stationary arm of the goniometer eliminates the possibility of including motion of the lumbar spine in goniometric measurements of hip flexion and extension. Bony landmarks for goniometer alignment (lateral midline of pelvis/trunk, greater trochanter, lateral femoral epicondyle) indicated by red line and dots. Fig. 11-12 End of hip flexion ROM, showing proper hand placement for stabilizing pelvis and detecting pelvic motion. CDC collected range of motion (ROM) measurements of the elbow, shoulder, hip, knee and ankle from a sample of individuals without known medical or physical conditions affecting the joint mobility. Other techniques recommended for measuring hip flexion and extension use landmarks on the trunk or the examining table for alignment of the stationary arm of the goniometer.1,10,24 The danger in using these landmarks is the possibility that lumbar motion may be included in measurements of hip motion, thus creating unreliable goniometric measurements. Haley, Additionally, the amount of motion measured at the hip may differ depending on the measurement tool used. Performing passive movement yields an estimate of the ROM and demonstrates to patient exact motion desired (see Fig. You can perform reverse hyperextensions -- also called reverse hypers -- using a high exercise bench, a specialized reverse hyper bench or machine, or a stability ball. Fig. ANATOMY Examiner action: Using the pelvis for alignment of the stationary arm of the goniometer eliminates the possibility of including motion of the lumbar spine in goniometric measurements of hip flexion and extension. Measurements have been taken with the patient in the supine position with the contralateral hip flexed or extended (Figs. These include physical factors such as a reduced range of motion (ROM) of the joints [2]. CAPSULAR PATTERN 11-10). Essentials of the study populations and instrumentation used are included in the table. Normal end-feels for hip extension, abduction, adduction, medial rotation, and lateral rotation are firm, as a result of capsular and ligamentous limitations of motion. 11-10 Pelvifemoral angle technique for measuring hip motion. If the hip is flexed with the knee extended, tension in the hamstring muscles limits the motion. Special tests Thomas’s test. Hip external rotation (lateral): 40 to 60 degrees. When our hip flexors are shortened or tight, it inhibits our hip extension, which is the opposite movement (moving the upper leg away from the toros which allows the legs to move behind us when we run). A fibrocartilaginous rim, the acetabular labrum, attaches to the margin of the acetabulum, further increasing its depth.4,25 Thus the hip, unlike the glenohumeral joint, has a great deal of inherent bony stability and is less dependent on muscular and ligamentous structures for support. Several studies investigating motion of the hip joint during functional activities are described in the literature. To control for this phenomenon, one should use landmarks on the pelvis to eliminate the possibility of including lumbar spine motion in the measurement, or one should manually ensure that the pelvis remains in a neutral position at the beginning and end of the range of motion measurement. Motions of the pelvis on the lumbar spine during measurement of hip flexion or extension can artificially inflate the range of motion measurement obtained. Hip flexion: 110 to 120 degrees; Hip abduction: 30 to 50 degrees; Hip adduction: 20-30 degrees; Patient in lateral decubitus position. Goniometer alignment: Hip flexion and extension range of motion are dependent on the position of the knee during movement. Bony landmarks for goniometer alignment (lateral midline of pelvis/trunk, greater trochanter, lateral femoral epicondyle) indicated by red line and dots. A number of other factors have been proposed as possible explanations for the level of disability in these patients [2, 6]. A fibrocartilaginous rim, the acetabular labrum, attaches to the margin of the acetabulum, further increasing its depth. The use of such a reference is advantageous because it allows the patient to be placed in a supine (flexion) or a prone (extension) position during the measurement, thus providing greater stability of the pelvis. Upon re-testing after performing manual therapy to the reference list at the hip movement... 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