Knee Extension: Why Is The Suine Patient Position Essential?

The patient is supine for knee extension to allow for a full range of motion. This position is used to regain full knee function through treatment and is necessary for functional and sport-specific activities. Loss of full range of motion at the knee joint can be detrimental to the function of the lower extremity.

The supine position is used to attain knee extension to a maximum of zero degrees

During a basic active range of motion (AROM) assessment, the patient is asked to lie in the supine position with straight legs. They may be asked to contract their quads or push their knee into a bench, which will extend the lower leg and lift the heel off the bench. This position allows for the observation of the patella and whether it tracks smoothly along the femoral trochlea.

The supine position is also used for passive range of motion assessment, where the leg is flexed to 90 degrees at the hip and the tibia is manipulated to perform maximal flexion and extension. This position is important for observing internal and external rotation, which are minimal but crucial for full knee extension and flexion.

To improve knee extension range of motion, patients can perform self-stretches, low-load long-duration (LLLD) stretching, and use range-of-motion devices. LLLD stretching in the supine position is often preferred as it is more comfortable and beneficial. This involves placing a towel roll under the heel to allow full knee extension, followed by a comfortable weight over the distal thigh to hold the stretch for several minutes.

A knee extension device may be used to treat arthrofibrosis

To assess knee extension, the patient is positioned supine with the leg lying flat on the bench. This position allows for the "screw-home" mechanism to occur at terminal knee extension. The patient is asked to contract the quads or push the knee into the bench, which will extend the lower leg and cause the heel to lift off the bench.

Knee Extension Device for Arthrofibrosis

Arthrofibrosis is a frequent complication following anterior cruciate ligament (ACL) reconstruction, leading to loss of motion, pain, stiffness, muscle weakness, swelling, and limited activities of daily living. The use of a knee extension device may provide an effective rehabilitation intervention in the treatment of arthrofibrosis.

A case study involving an 18-year-old female patient who underwent ACL reconstruction and subsequently developed arthrofibrosis is presented. Despite traditional physical therapy, the patient continued to experience pain, stiffness, and limited activities. As part of her rehabilitation program, she used a knee extension device to obtain knee extension and flexion equal to her opposite normal knee. Upon completion of the program, the patient returned to full activities, including competitive sports.

The knee extension device used in this case was the Elite Seat by Kneebourne Therapeutics, which is patient-controlled and provides a low-load, long-duration stretch. The patient was instructed to use the device for 10 minutes, 3-4 times per day, followed by additional knee extension exercises.

The use of a knee extension device, in conjunction with physical therapy, can be an effective approach to treating arthrofibrosis and improving knee range of motion. This case study demonstrates the successful rehabilitation of a patient with arthrofibrosis using this method, allowing her to regain full function and return to competitive sports.

Prone hang exercises can help improve knee extension range of motion after injury or surgery

During a basic active range of motion (AROM) assessment, the patient is positioned supine to evaluate knee extension. This position allows for a controlled and stable environment to assess the patient's knee extension range of motion and to observe the patellar tracking.

Prone hang exercises are an effective method to improve knee extension range of motion after an injury or surgery. This exercise is typically recommended when an individual experiences a loss of knee extension range of motion, which is a common complication following knee procedures such as anterior cruciate ligament (ACL) surgery, total knee replacement, patella release surgery, or a tibial plateau fracture.

The prone hang exercise is performed by lying on your stomach on a bed, with your thigh supported on the bed while your lower leg hangs off the edge. A small rolled-up towel is placed above the kneecap to reduce pressure. This position is held for 30 to 60 seconds, allowing gravity to straighten the knee. The exercise can be repeated up to 10 times, and weights can be added to the lower leg or ankle to increase the stretch gently. It is important to consult with a healthcare provider or physical therapist before starting this exercise to ensure safety and proper form.

Prone hang exercises are beneficial for improving knee extension range of motion, which is crucial for performing basic functional tasks such as walking, sitting, and climbing stairs. Additionally, this exercise can help reduce soreness and improve overall knee mobility. It is a simple yet effective tool in the rehabilitation process after knee injuries or surgeries.

A knee flexion contracture may limit force production

To assess a patient's knee extension, they must lie in the supine position with their leg flat on the bench. This is done to evaluate the range of motion in degrees and, if limited, to evaluate the end-feel. A knee flexion contracture is the inability to fully straighten or extend the knee, resulting in a limited range of motion.

The treatment of a knee flexion contracture includes non-surgical and surgical methods. Conservative treatments such as physical therapy, home exercise programs, and mechanical therapy can be used to treat and minimise the occurrence of flexion contractures. Surgical treatments include soft-tissue release, osteotomies, femoral shortening, hamstring lengthening, and rectus transfer.

The goal of treating a knee flexion contracture is to improve the patient's range of motion and force production, allowing them to return to normal daily activities and improve their quality of life.

Manual therapy and splinting can increase knee range of motion and improve physical function

Manual therapy and splinting can effectively increase knee range of motion and improve physical function. Manual therapy is defined as the application of manual forces by a therapist to improve the quality and range of motion of joints and soft tissues. It is often used to treat osteoarthritis of the knee and can reduce soft-tissue inflammation, improve tissue repair, and increase tissue extensibility and stability.

One technique used in manual therapy is joint mobilisation, which involves applying repeated passive motion at low speed to replicate normal joint glides. Research has shown that tibiofemoral mobilisations can increase range of motion and function, although these effects are usually short-term. Manual therapy is often combined with exercise therapy to address pain and joint limitations and improve muscle activity.

Splinting, or dynamic splinting, is another effective method for increasing knee range of motion. It involves the use of a brace or device to apply a sustained force to the knee joint, providing a low-load, prolonged-duration stretch. This technique can be particularly useful for patients who have undergone total knee arthroplasty (TKA) and are experiencing knee flexion contracture. Dynamic splinting can be used as an adjunct to physical therapy, helping patients regain full knee extension and avoid more invasive procedures.

The supine position is often used during knee range of motion assessments and treatments. For knee extension, the patient lies supine with their leg flat on the bench, allowing the therapist to fixate the distal femur and grab the distal tibia to perform passive extension. This position enables the "screw-home" mechanism to occur at terminal knee extension.

Overall, manual therapy and splinting are valuable tools for increasing knee range of motion and improving physical function, particularly when combined with appropriate exercise therapy.

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