Physical Assessment Form Page 4
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8E: LOWER EXTREMITIES IN LYING
Hip Flexion / Extension with knee bent/relaxed
RHS
LHS
130
0
10
130
0
10
Observations: Fixed/Flexible/Corrects with effort, tone/Spasm that may impact on seating
0
Knee Flexion / Extension with Hip Flexed at 90
, or until
Pelvis rolls
RHS
LHS
120-150
0
0
120-150
0
0
Observations: Fixed/Flexible/Corrects with effort, tone/Spasm that may impact on seating
Hip Abduction / Adduction (Hip & Knee Flexed as above)
RHS
LHS
50-80
0
20-30
50-80
0
20-30
Observations: Fixed/Flexible/Corrects with effort, tone/Spasm that may impact on seating
Hip Medially / Laterally Rotated (Hip & Knee Flexed)
RHS
LHS
40-50
0
30-40
40-50
0
30-40
Observations: Fixed/Flexible/Corrects with effort, tone/Spasm that may impact on seating
Ankle Dorsiflexion / Plantarflexion (Hip & Knee Flexed)
RHS
LHS
20-30
0
40-50
20-30
0
40-50
Observations: Fixed/Flexible/Corrects with effort, tone/Spasm that may impact on seating
Foot Inversion/Eversion (Hip & Knee Flexed as above)
Assessment of Hamstrings with legs together:
RHS
LHS
When Hips flexed to ______ ⁰,
Observations: Fixed/Flexible/Corrects with effort, tone/Spasm that may impact on seating
Knees extend to ______ ⁰
Don’t forget your
!
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Parent category: Medical