Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

3.2 The Lower ExtremityNote: For the purposes of impairment evaluation, ankylosis is defined aseither: (a) complete absence of motion, or (b) planar restriction of motionpreventing the subject from reaching the neutral position of motion in thatplane. Using an impairment rating of ankylosis excludes the simultaneoususe of the abnormal motion measurements from the same table. Forexample, an individual whose hip joint forward flexion ranges from 50° to90° is considered to have an ankylosis at 50°, which is 67% impairment ofthe lower extremity. An exception to this rule is the knee, for whichextension lag is taken into account (see Table 35).3.2a ToesInterphalangeal Joint of the Great Toe Flexion and ExtensionAbnormal MotionPlace the patient's foot in the neutral position (Figure 50). Note the 45°angle of the knee and the 90° angle of the ankle.Center the goniometer next to the interphalangeal joint (Figure 51).Record the goniometer reading.