Chapter 7 Functional Assessments Flashcards

Question

Shoulders: Torso/Shoulders Relative to Line of Gravity

Answer 1

Determine whether the torso and shoulders are symmetrical relative to the line of gravity.  A torso lean would shift the alignment of the sternum and spine away from the plumb line and create tightness on the flexed side of the trunk.  However, if the hips are level with the floor and the spine is aligned with the plumb line, but the shoulders are not level with the floor, this may represent muscle imbalance within the shoulder complex itself.  An elevated shoulder may present with an overdeveloped or tight upper trapezius muscle.  A depressed shoulder may present with more forward rounding of the scapula.  The shoulder on a person’s dominant side may hang lower than the non-dominant side.

Answer 2

Determine whether the scapulae and/or arms are internally rotated.  Anterior view – If the knuckles or the backs of the client’s hands are visible when the hands are positioned at the sides, this generally indicates internal rotation of the humerus or scapular protraction.  Posterior view – If the vertebral/inferior angles of the scapulae protrude outward, it indicates an inability of the scapulae stabilizers to hold the scapulae in place.

Answer 3

Determine whether the spine exhibits normal kyphosis.  With the client’s consent, the trainer can run one hand gently up the thoracic spine between the scapulae.  The spine should exhibit a smooth, small, outward curve.

Answer 4

With good posture, the earlobe should align approximately over the acromion process.  A forward-head position is very common.  This altered position does not tilt the head downward, but simply shifts it forward.  The earlobe appears significantly forward of the acromioclavicular (AC) joint.

Answer 5

Observing active movement is an effective method to identify movement compensations.  When compensations occur, it is indicative of altered neural action.  These compensations normally manifest due to muscle tightness or an imbalance between muscles acting at the joint.

Answer 6

Movement can essentially be broken down and described by five primary movements that people perform during many daily activities: Bending/raising and lifting/lowering movements (e.g., squatting) Single-leg movements Pushing movements Pulling movements Rotational movements ADL are essentially the integration of one or more of these primary movements.

Answer 7

Movement screens must be skill- and conditioning-level appropriate, and be specific to the client’s needs. Screens generally challenge clients with no recognized pathologies to perform basic movements. This can help the personal trainer evaluate a client’s stability and mobility throughout the entire kinetic chain.

Answer 8

 Prior to administering any movement screens, trainers should screen for pain by using basic clearing tests.  These tests may uncover issues that the individual did not know existed.  Trainers should select clearing tests according to the movements that require evaluation.  The objective when conducting clearing tests is to ensure that pain is not exacerbated by movement.  Any client who exhibits pain during a clearing test should:  Be referred to his or her physician  Not perform additional assessments for that part of the body

Answer 9

 The client performs the following movements in a seated position while the personal trainer monitors for any indication of pain:  Move the chin to touch the chest.  Tilt the head back until the face lies approximately parallel or near parallel to the floor.  Drop the chin left and right to rest on, or within 1 inch (2.5 cm) of, the shoulder or collarbone.

Answer 10

 The client performs the following movement in a seated position while the personal trainer monitors for any indication of pain:  Reach one arm across the chest to rest upon the opposite shoulder and slowly elevate the elbow as high as possible.

Answer 11

 The client performs the following movements from a prone position while the personal trainer monitors for any indication of pain:  Slowly move into a trunk-extension position, producing lumbar extension and compression in the vertebrae and shoulder joint.  Move into a quadruped position and slowly sit back on the heels with outstretched arms, producing lumbar and hip flexion.

Answer 12

 First repetition  Observe the stability of the foot.  Second repetition  Observe the alignment of the knees over the second toe.  Third repetition  Observe the overall symmetry of the entire body over the base of support.

Answer 13

First repetition  Observe whether the heels remain in contact with the floor. Second repetition  Determine whether the client exhibits “glute” or “knee” dominance. Third repetition  Observe whether the client achieves a parallel position between the tibia and torso in the lowered position, while controlling the descent phase. Fourth repetition  Observe the degree of lordosis in the lumbar/thoracic spine during lowering and in the lowered position. Fifth repetition  Observe any changes in head position.

Answer 14

To examine simultaneous mobility of one limb and stability of the contralateral limb while maintaining both hip and torso stabilization under a balance challenge of standing on one leg

Answer 15

First repetition  Observe the stability of the foot. Second repetition  Observe the alignment of the stance-leg knee over the foot. Third repetition  Watch for excessive hip adduction greater than 2 inches (5.1 cm) as measured by excessive stance-leg adduction or downward hip-tilting toward the opposite side. Fourth repetition  Observe the stability of the torso.  Fifth repetition  Observe the alignment of the moving leg.

Answer 16

First repetition  Observe the stability of the torso and stance leg. Second repetition  Observe the mobility of the hip.

Answer 17

 To examine stabilization of the scapulothoracic joint during closed-kinetic-chain pushing movements

Answer 18

 Observe any notable changes in the position of the scapulae relative to the ribcage at both end-ranges of motion.  Observe for lumbar hyperextension in the press position.

Answer 19

 To examine the client’s ability to stabilize the scapulothoracic joint during closed-kinetic-chain pulling movements

Answer 20

Observe any bilateral discrepancies between the pulls on each arm. Observe the ability to stabilize the trunk during the pull movement. That is, the ability of the core to stiffen and lift the hips with the shoulders and resist trunk rotation during the lift.

Answer 21

 To examine bilateral mobility of the thoracic spine  Lumbar spine rotation is considered insignificant, as it only offers approximately 15 degrees of rotation.

Answer 22

 Observe any bilateral discrepancies between the rotations in each direction.  Identify the origin(s) of movement limitation or compensation.  This screen evaluates trunk rotation in the transverse plane.  Evaluate the impact on the entire kinetic chain.  The lumbar spine generally exhibits limited rotation of approximately 15 degrees, with the balance of trunk rotation occurring through the thoracic spine.  If thoracic spine mobility is limited, the body strives to gain movement in alternative planes within the lumbar spine.

Answer 23

A personal trainer may opt to assess the flexibility of specific muscle groups. Specific muscle groups that frequently demonstrate tightness or limitations to movement are discussed in this section. The table on the following slide provides normal ranges of motion for healthy adults at each joint.

Answer 24

 To assess the length of the muscles involved in hip flexion  This test should not be conducted on clients suffering from low- back pain, unless cleared by their physician.

Answer 25

Observe whether the back of the lowered thigh touches the table (hips positioned in 10 degrees of extension). Observe whether the knee of the lowered leg achieves 80 degrees of flexion. Observe whether the knee remains aligned straight or falls into internal or external rotation.

Answer 26

To assess the length of the hamstrings

Answer 27

Note the degree of movement attained from the table or mat that is achieved before the spine compresses the hand under the low back or the opposite leg begins to show visible signs of lifting off the table or mat. The mat or table represents 0 degrees. The leg perpendicular to the mat or table represents 90 degrees.

Answer 28

Apley’s scratch test involves multiple and simultaneous movements of the scapulothoracic and glenohumeral joints in all three planes. To identify the source of the limitation, trainers can first perform various isolated movements in single planes to locate potentially problematic movements. Consequently, the scratch test is completed in conjunction with: The shoulder flexion-extension test An internal-external rotation test of the humerus

Answer 29

 To assess simultaneous movements of the shoulder girdle (primarily the scapulothoracic and glenohumeral joints)  Movements include:  Shoulder extension and flexion  Internal and external rotation of the humerus at the shoulder  Scapular abduction and adduction

Answer 30

Note the client’s ability to touch the medial border of the contralateral scapula or how far down the spine he or she can reach with shoulder flexion and external rotation. Note the client’s ability to touch the opposite inferior angle of the scapula or how far up the spine he or she can reach with shoulder extension and internal rotation. Observe any bilateral differences between the left and right arms in performing both movements.

Answer 31

 To assess the degree of shoulder flexion  This test should be performed in conjunction with Apley’s scratch test to determine if the limitation occurs with shoulder flexion or extension.

Answer 32

 To assess the degree of shoulder extension  This test should be performed in conjunction with Apley’s scratch test to determine if the limitation occurs with shoulder flexion or extension.

Answer 33

Measure the degree of movement in each direction. Note any bilateral differences between the left and right arms in performing both movements.

Answer 34

 To assess external rotation of the humerus at the shoulder joint to evaluate medial rotators  This test should be performed in conjunction with Apley’s scratch test to determine if the limitation occurs with internal or external rotation of the humerus.

Answer 35

 To assess internal rotation of the humerus at the shoulder joint to evaluate lateral rotators  This test should be performed in conjunction with Apley’s scratch test to determine if the limitation occurs with internal or external rotation of the humerus.

Answer 36

Measure the degree of movement in each direction. Note any bilateral differences between the left and right arms in performing both movements.

Answer 37

Balance and core baseline assessments evaluate the need for comprehensive balance training and core conditioning. Dynamic balance tests are generally movement- specific and quite complex. Trainers should aim to first evaluate the basic level of static balance that a client exhibits by using the sharpened Romberg test or the stork- stand test.

Answer 38

 To assess static balance by standing with a reduced base of support while removing visual sensory information

Answer 39

Continue to time the client’s performance until one of the following occurs: The client loses postural control and balance The client’s feet move on the floor The client’s eyes open The client’s arms move from the folded position The client exceeds 60 seconds with good postural control

Answer 40

The client needs to maintain his or her balance with good postural control (without excessive swaying) and not exhibit any of the test-termination criteria for 30 or more seconds. The inability to reach 30 seconds is indicative of inadequate static balance and postural control.

Answer 41

To assess static balance by standing on one foot in a modified stork-stand position

Answer 42

Timing stops when any of the following occurs: The hand(s) come off the hips The stance or supporting foot inverts, everts, or moves in any direction Any part of the elevated foot loses contact with the stance leg The heel of the stance leg touches the floor The client loses balance

Answer 43

 To evaluate balanced core strength and stability it is important to assess all sides of the torso.  Poor endurance capacity of the torso muscles or an imbalance between these three muscle groups can contribute to low-back dysfunction and core instability  The McGill’s torso test battery includes:  Trunk flexor endurance  Trunk lateral endurance  Trunk extensor endurance

Answer 44

 The flexor endurance test is the first of the three  It assesses muscular endurance of the deep core muscles  It is a times test involving a static, isometric contraction of the anterior muscles, stabilizing the spine until the individual exhibits fatigue and can no longer hold the assumed position.  This test may NOT be suitable for individuals who:  Suffer from low-back pain  Have had recent back surgery  Are in the midst of an acute low-back flare up

Answer 45

 Trainer starts the stopwatch as they move the board about 4 inches back while client maintains 60-degree suspended position  Terminate test when there is a noticeable change in the trunk position.  Terminate also if:  Watch for deviation from the neutral spine or an increase in the low-back arch  No part of the back should touch the back rest  Record time

Answer 46

 The trunk lateral endurance test assesses the muscular endurance of the lateral core muscles  This test may not be suitable for individuals:  With shoulder pain or weakness  Who suffer from low-back pain, have had recent back surgery or are in the midst of an acute low-back flare up

Answer 47

 Trainer starts stopwatch as the client moves into the side bridge position  Terminate the test when there is a noticeable change in the trunk position  Terminate also if:  A deviation from neutral spine occurs  The hips shift forward or backward in an effort to maintain balance and stability  Record time  Repeat for the opposite side and record the value

Answer 48

 Generally used to assess muscular endurance of the torso extensor muscles  This is a timed test involving a static, isometric contraction of the trunk that stabilize the spine  This test may not be suitable for:  A client with major strength deficiencies  A client with high body mass  A client who suffers from low-back pain, have had recent back surgery or are in the midst of an acute low-back flare up

Answer 49

 When ready the client lifts/extends the torso until it is parallel to the floor with their arms crossed over the chest  Start the stopwatch as soon as the client assumes this position  Terminate test when client can no longer maintain the position  Record the time