Chapter 7 - Functional Assessments Flashcards by Cameron Bennington

The alignment and balance of the musculoskeletal system. Allows for joints, muscles, and nerves to function efficiently together.

Functional Integrity

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What are the 4 Postural Deviations

Kyphosis
Lordosis
Flat Back
Sway Back

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What is Kyphosis?

Increased posterior thoracic curve from neutral.

Excessive posterior curvature of the spine typically in the thoracic region.

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What is Lordosis?

Increased anterior lumbar curve from neutral.

Excessive anterior curvature of the spine that typically occurs at the low back.

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What is Flat Back Posture?

decreased anterior lumbar curve

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What is Sway Back ?

decreased anterior lumbar curve and increased posterior thoracic curve from neutral.

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Tightened/Shortened muscles in Kyphosis/Lordosis?

Hip Flexors
Lumbar Extensors
Anterior Ches/Shoulders
Latissimus Dorsi
Neck Entenstors

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Weak/Lengthened muscles in Kyphosis/Lordosis?

Hip Extensors 
External Obliques
Upper Back extensors
Scapular Stabilizers
Neck Flexors

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Tightened/Shortened muscles in Flat Back Posture?

Rectus abdominus
Upper Back Extensors
Neck Extensors
Ankle Plantar Flexors

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Tightened/Shortened muscles in Sway Back Posture?

Hamstrings
Upper Fibers of Posterior Obliques
Lumbar Extensors
Neck Extensors

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Weak/Lengthened muscles in Flat Back Posture?

Iliacus/psoas major
Internal Oblique
Lumbar Exensors
Neck Flexors

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Weak/Lengthened muscles in Sway Back Posture?

Illiacus/Psoas major
Rectus Femoris
External Oblique
Uppber Back extensors 
Neck flexors

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Correctable Muscle Imbalances?

Repetitive Movements
habitually poor posture
side dominance
lack of joint stability/mobility
imbalanced strength programs

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Non-Correctable Muscle Imbalance?

Scoliosis
Rheumatoid Arthritis
Structural Deviations
Surgeries/Amputations

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What are the 5 deviations?

Ankle Pronation/Supination
Hip Adduction
Pelvic Tilting
Shoulder Position/Thoracic Spine
Head Position

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What is ankle pronation?

Arch Flattening
Foot - Eversion
Tibia(Knee) - Internal Rotation
Femoral - Internal
Plane of View - Front

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What is ankle supination?

High Arches
Foot - Inversion
Tibia(Knee) - External Rotation
Femoral - External Rotation
Plane of View - Front

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What is Hip Adduction deviation?

Lateral tilt of pelvis that elevates one hip
Lengthened(Weakened) Leg Hip Abductors
View from back

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Deviation: Anterior Pelvic Tilt?

Pelvis Tilted down and forward
Associated with Tight Hip flexors, sedentary lifestyle and lots of time sitting
Plane of View - Saggital

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Deviation: Posterior Pelvic Tilt?

Pelvis tilted down and backwards
Associated with Tight rectus abdominus and hamstrings
Plane of View Saggital View

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Shoulder Deviation: Shoulders not level

Upper trapezius
levator scapula
rhomboids
Plane of View: Frontal

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Shoulder Deviation: Asymmetry to midline

Lateral trunk flexors

Plane of View: Frontal

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Shoulder Deviation: Protracted (forward, rounded)

Serratus anterior
anterior scapulo-humeral muscles
upper trapezius
Plane of View: Sagittal

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Shoulder Deviation: Medially Rotated humerus

Pectoralis major and latissimus dorsi (Shoulder adductors)
internal obliques
Plane of View: Frontal

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Shoulder Deviation: Kyphosis and depressed chest

``` Shoulder Adductors Pectoralis minor rectus abdominus internal oblique Plane of View: Sagittal ```

bend and lift screen: lack of foot stability: ankles collapse inward/feet turn outward: tight muscles

soleus lateral gastrocemius peroneals

bend and lift screen: knees move inward: tight & underactive

tight: hip adductors tensor fascia latae underactive: gluteus medius and maximus

bend and lift screen: unable to keep heels in contact with floor: tight

plantarflexors

bend and lift screen: hip and knee initiation of movement:

movement initiated at knees may indicate quadriceps and hip flexor dominance, as well as insufficient activation in glutes

bend and lift screen: unable to achieve parallel between tibia and torso

poor mechanics; lack of dorsiflexion due to tight plantarflexors (which normally allow the tibia to move forward)

bend and lift screen: hamstrings contact back of calves

muscle weakness and poor mechanics; inability to stabilize and control the lowering phase

bend and lift screen: back excessively arches: tight & undercactive

tight: hip flexors back extensors latissimus dorsi ``` underactive: core rectus abdominus glutes hamstrings ```

bend and lift screen: back rounds forward: tight & underactive

tight: lat dorsi teres major pec major and minor underactive: upper back extensors

Bend and lift screen: Head Upward

compression and tightness in the cervical extensor region

bend and lift screen: head downward

increased hip and trunk flexion

hurdle step screen: lateral tilt, forward lean, rotation:

lack of core stability

hurdle step screen: anterior tilt with forward torso lean: tight & overactive

tight: stance leg hip flexors overactive: rectus abdominis and hip extensors

Shoulder Push Stabilization Screen: "Winging" during push-up movement

Inability of parascapular muscles to stabilize the scapulae against the rib cage Can also be due to a flat thoracic spine.

Shoulder Push Stabilization Screen: Hyperextension (collapsing) of the low back

Lack of core, abdominal, and low back strength

Thoracic Spine Mobility Screen: how far should the trunk rotate in each direction?

45 degrees

Thoracic Spine Mobility Screen: bilateral discrepancy

Side Dominance

lack of thoracic mobility will negatively impact...

glenohumeral joint mobility

What are the 5 primary movements?

1) Bending/raising and lifting/lowering movements (squatting) 2) Single-Leg Movements 3) Pushing Movements 4) Pulling Movements 5) Rotational Movements

Thomas Test: Objective

To assess the length of the muscles involved in hip flexion. (Do not use on clients with low back pain)

Thomas Test: with the back and sacrum flat, the back of the lowered thigh does not touch the table and the knee does not flex to 80 degrees: muscle tightness?

primary hip flexor muscles

Thomas Test: with the back and sacrum flat, the back of the lowered thigh does not touch the table but the knee does flex to 80 degrees: muscle tightness?

iliopsoas, which is preventing the hip from rotating posteriorly and inhibiting the thigh from being able to touch the table

Thomas Test: with the back and sacrum flat, the back of the lowered thigh does touch the table but the knee does not flex to 80 degrees. muscle tightness?

the rectus femoris, which does not allow the knee to bend

passive straight leg raise (PSL) test: purpose

to assess the length of the hamstrings

passive straight leg raise tes: the raised leg achieves >/ 80 degrees of movement before the pelvis rotates posteriorly

normal hamstring length

passive straight leg raise: the raises leg achives <80 degrees of movement before the pelvis rotates posteriorly or there are any visible signs in the opposite leg lifting off the mat or table

tight hamstrings

Shoulder Flexion: Range of Motion?

170-180 degrees

Shoulder Flexion: How to test?

lay supine on floor with back flat and bent knee position. hold neutral spine raise both arms at once, moving them overhead, keeping them close to the head, and bringing them down to touch the floor or as close as possible

shoulder flexion test: inability to flex the shoulders to 170 degrees or discrepancies between the limbs

potential tightness in the pectoralis major/minor, latissimus dorsi, teres major, rhomboids, subscapularis

shoulder flexion test: tightness in the latissimus dorsi will force...

the low back to arch

shoulder flexion test: tightness in the pectoralis minor

may tilt scapulae forward (anterior tilt) and prevent arms from touching floor

shoulder extension test: how to test?

lie prone, extending both legs and arms at sides. | raise both arms simultaneously into extension, lifting them off the mat

shoulder extension: Range Of Motion

50-60 degrees

shoulder extension test: inability to extend the shoulders to 50 degrees or discrepancies between the limbs

potential tightness in pectoralis major, abdominals, subscapularis, biceps brachii

external/lateral rotation test: ability to externally rotate the forearms 90 degrees to touch the mat

good mobility in the internal (medial) rotators, allowing the joint to move through the full range of motion

external/lateral rotation test: inability to reach the floor or discrepancies between the limbs

potential tightness in internal rotators of the arm (subscapularis)

internal/medial rotation test: ability to internally rotate the forearms 70 degrees toward the mat (forearms are 20 degrees of the mat)

good mobility in the external rotators, allowing the joint to move through full range

internal/medial rotation test: inability to rotate the forearms 70 degrees, or discrepancies between the limbs

potential tightness in the external rotators of the arm (infraspinatus and teres minor)

where is the arm/shoulder positioned when it is doing shoulder flexion, external rotation, and scapular abduction

overhead and behind the head reaching for opposite superior scapula

where is the arm/shoulder positioned when it is doing shoulder extension, internal rotation, and scapular adduction

under and behind the back reaching up to touch opposite scapula

trunk flexor endurance test

Assesses muscular endurance of the deep core muscles

trunk lateral endurance test

assesses muscular endurance of the lateral core muscles | side-bridge test

trunk extensor endurance test

assesses muscular endurance of the torso extensor muscles (erector spinae, logissimus, and multifidi)

flexion:extension ratio should be....

less than 1.0

right side bridge:left side bridge scores should be...

no greater than 0.05 from a balanced score of 1.0

side bridge (either side): extension ratio should be...

less than 0.75

Sharpened Romberg Test: continue to time clients performance until one of the following occurs...

``` Loss of postural control or balance Client's feet move on the floor Client's eyes open Client's arms move from the folded position Client exceeds 60 seconds ```

Sharpened Romberg Test: The client needs to maintain his or her balance with good postural control for how long?

30 or more seconds

Stork-Stand Balance Test: Males

``` Excellent: >50 seconds Good: 41-50 seconds Average: 31-40 seconds Fair: 20-30 seconds Poor: <20 seconds ```

Stork Stand Balance Test: Females

``` Excellent: >30 seconds Good: 25-30 seconds Average: 16-24 seconds Fair: 10-15 seconds Poor: <10 seconds ```

Chapter 7 - Functional Assessments Flashcards

(74 cards)