Lab Class 8

Learning Objectives

At the end of the lab class:

  •  You will be able to conduct basic assessment of the knee joint.

  • You will be able to assess swelling in the knee joint.

Basic Assessment of the Knee

Welcome to Lab Class 8!

In this lab class you will learn how AROM and PROM is performed for all possible movements of the knee joint.
Keep in mind that AROM is performed by the patient himself, so you will have to instruct your patient properly.
Besides judging the range of motion, you are looking for pain during a movement as well as compensations in other joints.


After AROM, you want to passively assess the range of motion of the knee, meaning without muscle activation of your patient.
It is crucial to check for compensations during the movements and that you prevent them from occuring using fixations.
By doing so, you will receive exact information on how far your patient can move in the knee joint into a certain direction and you will be able to get the correct end-feel.

In this video you will learn how PROM is performed for all possible movements of the knee joint:

When a joint is inflamed, range of motion is usually limited following a specific pattern for each joint.
The capsular pattern for the knee joint is flexion before extension.

The normal values for knee range of motion are:


After your AROM and PROM assessment you would like to know more about the muscles that are affecting the knee joint.
This is how you perform Resisted Isometric Testing for the knee joint:

Lastly, make sure to check out these two special tests to assess for knee swelling:

Note: In these videos, Andreas places the patient's leg in full extension. Be aware that the tests are done on a healthy individual. In practice, you might encounter excessive swelling and the patient might not be able to extend the leg fully to 0°, as the knee joint will adopt the Maximally Loose Packed Position (MLPP) of 15 - 25° of flexion. By doing so, it allows for equal distribution of the synovial fluid within then joint capsule.
Take home: Conduct the tests in extension, which might mean to do it in 25° of knee flexion if further extension is not possible!

Tasks:

1) Practice the tests for swelling! Also research what kind of swelling you may encounter and how you can differentiate between them.

2) Compare ROM assessment in a male and female student. Note down differences you see.

Preparation for next week:

1) Brush up on knee anatomy! Practice palpation of bony landmarks!