Goniometry: Hip Flexion
Introduction
The hip joint's range of motion (ROM) is an important clinical parameter used in hip assessment.[1]Hip flexion is one of the hip motions that can be measured with a goniometer. The goniometer can simply measure the joint angles. It has some limitations not allowing the clinician to analyse the ROM and track the hip joint during eg walking or maximum squat. Motion capture devices are mainly used to analyse the patient's gait and assess the condition of the joints and bones.[1]
Image 1: Goniometer
Anatomical Movement
Hip Flexion
Axis and Plane For Motion
Sagittal Plane
Frontal Axis
Testing Position
Client lying supine.
Stabilization
Ensure that the pelvis and spine are in neutral:
- Obliterate lumbar curve by flexing other hip and holding.
- Flex hip with hand under lumbar area to check no pelvic movement occurs.
- Motions of the pelvis on the lumbar spine during measurement of hip flexion or extension can artificially inflate the range of motion measurement obtained.
- 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.
Hip flexion range of motion is dependent on the position of the knee during movement.
- Full hip flexion is obtained only with the knee flexed.
- If the hip is flexed with the knee extended, tension in the hamstring muscles limits the motion
Image 2: Hip flexion ROM
Goniometer Placement
| AXIS LOCATION | STATIONARY ARM | MOVEMENT ARM |
|---|---|---|
| Greater trochanter of the Femur | Parallel to the trunk | Parallel with longitudinal axis of the femur in line with the lateral femoral condyle |
Technique
Passive ROM: Therapist holds the ankle and flexes the hip joint keeping the knee in flexion.
Active ROM: The therapist instructs the patient to bend the hip keeping the knee flexed and foot raised off the plinth.The patient is guided to take the knee towards the chest as much as possible.
Expected Findings
Expected range of motion is 0- 120 degrees[2]
Most of the motions at the hip are limited by the ligaments (iliofemoral, ischiofemoral, and pubofemoral) and muscles that surround the joint, and the hip joint capsule. Hip flexion range is frequently limited by approximation of the soft tissue between the anterior thigh and the abdomen when the knee is flexed.
Image 3: Ligaments of the hip joint posterior aspect
Functional Range Of Motion
- For walking it is 9.9 to 49.3 degrees.
- For stair climbing it is 19.6 degrees to 67.8 degrees.
- For stairs descent it is 26.2 to 52.4 degrees.
- Getting on and off from toilet it is 112.6 degrees.
- Tying shoes it is 126.1 degrees.
- Sit to stand it is 103 degrees
- Squatting 120 degrees.ׁׁׁׁ[3]
References
- ↑ 1.0 1.1 Yazdifar M, Yazdifar MR, Mahmud J, Esat I, Chizari M. Evaluating the hip range of motion using the goniometer and video tracking methods. Procedia Engineering. 2013 Jan 1;68:77-82. Available: https://www.sciencedirect.com/science/article/pii/S1877705813020043(accessed 15.1.2022)
- ↑ Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry. FA Davis; 2016 Nov 18.
- ↑ Sah AP. How much hip motion is used in real-life activities? Assessment of hip flexion by a wearable sensor and implications after total hip arthroplasty. The Journal of arthroplasty. 2022 Aug 1;37(8):S871-5.