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Thanks for watching and we agree that patient safety and comfort is a priority. Based on the reference text used for goniometry, their protocol is to check passive range of motion prior to measuring active. Different resources may choose to follow different protocols.

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Thank you for the kind words and for supporting our channel. Your observation would be correct. At midstance the hip is transitioning from internal rotation to lateral rotation as the opposite side of the pelvis moves past neutral and backwards. As the foot approaches midstance it transitions to a pronated position to unlock and adapt to the ground. As we near terminal stance the foot returns to a supinated position to create a rigid lever to propel with.

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Thank you for your questions. We provide the videos for educational purposes, however it is not possible to comment on any specific treatment protocol because each individual person has different circumstances that would affect any clinical decisions.

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It is common in a clinical situation to assess range of motion before strength. So as a general rule we have already observed if a patient can move through full active range of motion which would mean at least a 3/5. So it is appropriate to move on to grades 4 and 5 testing. For the purposes of the video, we demonstrated only the actual muscle test starting at grade 5 and working backwards, not necessarily how things would proceed during an actual patient evaluation. We hope that is helpful and thank you for watching.

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As with any physical therapy procedure, there is a constant assessment as to the effectiveness of treatment. In general if the patient hasn't responded within 3-4 treatments it is probably time to re-assess and consider other alternatives.

There are no general rules that apply to a broad group of patients. The clinical goal for treating a particular diagnosis should be established and then you identify if US or electrotherapy can help the patient achieve that goal.

A thorough patient interview and objective evaluation for the cardinal signs of inflammation should help guide you.

The early stages of adhesive capsulitis are associated with some acute inflammation, but the frozen and thawing stages generally do not.

Generally you don't use thermal and pulsed ultrasound during the same treatment. As far as acute inflammation, you would want to identify certain parameters consistent with acute inflammation such as pain, redness, heat, swelling and loss of function. In the case of an injury that just occurred there will always be an initial period of acute inflammation. With osteoarthritis, it could be either acute or chronic. That is when you use your clinical judgement and patient history to determine which one is more likely.

@@physicaltherapyeducationso4585 which mode ultrasound do you use when you have chronic knee osteoarthritis? How many sessions do you do?

There are different electrotherapy protocols depending on what your clinical goal is. Some are for pain control, some for edema and some for neuromuscular reeducation. Which you choose will vary quite a bit based on the specifics of particular person and diagnosis. Generally acute inflammation is not necessarily a contraindication for certain electrotherapy protocols. We hope that is helpful.

@@physicaltherapyeducationso4585 Thanks. which tissue damage do we get if we apply more current? Which diseases can we treat by making tissue healing using electrotherapy? does electrotherapy has side effect of edema? can we apply electrotherapy for pain management or as you said for healing on partial or full thickness tendon tears? can we apply electrotherapy on damaged or torn knee meniscus? can the electrotherapy itself cause tendon /meniscus /ligament tears? Thanks

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Our main UA-cam page has the list of all the videos in our library. Thanks for supporting our channel.

Thermal ultrasound is contraindicated with acute inflammation because increased temperatures will lead to a greater inflammatory response which in turn leads to more swelling and pain. Therefore we only do non-thermal ultrasound in acute situations. We hope that is helpful.

@@physicaltherapyeducationso4585 Thanks a lot. But all other modalities like electrotherapy, laser therapy, magnetic therapy, shock wave, ect they also basically increase the blood circulation, so why they are not contraindicated in acute inflamation?

@@physicaltherapyeducationso4585 How to know if the knee osteoarthritis pain is considered acute inflammation or not? Or if we have back pain due to spinal disc herniation, how to know wheter it is acute inflamation? In cervical spondylosis neck pain, how to know if there is acute inflamation?

We are glad you found it helpful, thanks for watching.

Comprehensive Wound Management by Glenn L. Irion. Published by Slack Incorporated. Thanks for supporting our channel and we hope that is helpful.

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Yes it is, the term was used to stay consistent with the reference textbook that we used. Thanks for watching our videos.

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From the video it's hard to tell, however that's where skill and experience come in to play. The therapist would modify how much pressure they use based on the patient. You wouldn't use the same force for an 80 year old patient as you would for a 20 year old athlete. As a general rule force is applied gradually up to maximal if the patient is holding, instead of starting with maximal force. We hope that is helpful and thanks for watching our videos.

Joshua, thanks for supporting our channel. We are glad you found the video helpful and appreciate you watching.

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When evaluating end feel for the spine, it is more typically done on a spinal segment by spinal segment basis, because the motion is made up of multiple joints at each spinal level. As a general rule however the end feel for lumbar extension would be a firm end feel that results from capsular tightening at each facet joint. We hope that is helpful and thanks for supporting our channel.

Thanks for watching. At the beginning of every goniometer video we list the normal ranges for an uninjured joint before we show how to measure. For this particular joint the normal range is 90-100 degrees. We typically do not include numbers in our range of motion videos so the focus is on the technique, not the result. However, In this video the subject has a measurement of about 108 degrees.