iRat#4 Study Guide

Question 1

Placement of which of the following is the least important for producing a valid meausre of ROM?

A. Stationary arm
B. Fulcrum
C. Moveable arm

Answer 1

B. Fulcrum (natuarlly disects at both joints-arms make the angle)

Question 2

If performed in a typical fashion, which of the following would require the MOST elbow ROM?

A) Combing hair
B) Drinking from a cup
C) Using a landline telephone

Answer 2

A) Combing hair

Question 3

If AROM of a joint in the hand is PROM, and the motion is the same as regardless of the position of proximal joints, and there is a limitation in ROM, the limitation is due to:

A) Tendon adhesion
B) Joint stiffness
C) Muscle length
D) Muscle weakness

Answer 3

B. Joint stiffness (shortening & contracting of the joint structure)

Question 4

If performed in a typical fashion, which of the following would require MOST wrist ROM?

A) Rising from a chair with armrests
B) Cutting with a knife
C) Toilet hygeine/perineal care

Answer 4

C) Toilet hygeine/perineal care

Question 5

This type of test is useful for observing areas of strength/weakness and determining which areas require MMT.

Answer 5

Screening tests

Question 6

True/False: Screening tests help the therapist avoid unnecessary testing.

Answer 6

True

Question 7

Not as precise as MMT, and their purpose is to make a general evaluation of muscle strength.

Answer 7

Screening Tests

Question 8

Screening may be accomplished by the following means:
1. Examine medical
2. ____
3. Obsserve functional activities
4. ____
5. Gross check of bilateral muscle

Answer 8

• Observe clients movements
• Occupational-based assessment

Question 9

What does a gross check of bilateral muscle groups consist of:
1. The client is comfortably ____ in a sturdy chair or wheelchair and the OT practitioner asks the client to move both ____ through ____
2. OT applies pressure to both extremities at ____ of selected motions to obtain a gross estimation of ____

Answer 9

1. seated> Upper extremities> AROM
2. Midrange> Strength

Question 10

This test measures the maximal contraction of a specific muscle or muscle group

Question 11

MMT is used to determine?

Answer 11

the amount of muscle power and record gains and loses of strength

Question 12

What is the criteria for MMT:
1. ____
2. Amount of ROM through which the joint passes when the muscle contracts
3. ____

Answer 12

• Evidence of muscle contraction
• Amount of external pressure the muscle or muscle group can resist during contraction

Question 13

What is the purpose of MMT:

1. To determine the amount of ____ available, to discern how ____ limits performance in meaningful occupations.
2. To prevent ____ that can result from imbalances of ____
3. To determine the need for assistive devices as compensatory measures
4. To aid in the selection of occupations with the ____
5. To establish a **baseline **and guide intervention
6. To evaluate the effectiveness of ____ strategies and ____.

Answer 13

1. Muscle Power; Muscle weakness
2. Deformities; strength
3. N/A
4. Capabilities
5. N/A
6. Intervention; modalities

Question 14

The limitations of MMT

Which of the following are NOT directly measured during MMT?
A) Quality of movements
B) Muscle tone
C) Motor performance
D) All the above

Answer 14

D) All the above

Question 15

The limitations of MMT

True/False: Assessment of muscle strength involves assessment of ability to repetitively contract and resist fatigue, which are NOT measured in MMT.

Answer 15

FALSE: Muscle endurance (Process of development of tension in muscle tissue)

Muscle strength-the amount of forcegenerated by muscle contraction.

Question 16

THe limitations of MMT

True/False: Therapist should LIMIT number of times muscle is maximally contracted during MMT to ensure that strength is being measured.

Answer 16

TRUE

Question 17

Be able to identify contraindications and precautions

Contraindications:
1. Inflammation or pain in the regin being tested
2. ____
3. Recent surgery, particularly of musculoskeletal structures.
4. ____
5. ____
6. Weak muscles fatigue easily (MMT should not be performed when client is tired or especially fatigued).

Contraindications do not receive treatment.

Answer 17

• Dislocation or unhealed fracture
• Myositis ossifications
• Bone carcinoma or any fragile bone condition

Question 18

Be able to identify contraindications and precautions

Special Precautions:
* Osteoporosis
* Subluxation or hypermobility of a joint
* ____
* Abdominal surgery or an abdominal hernia
* ____

Must be taken when resistant movement could aggravate clients condition.

Special precautions can still recieve treatment but must be careful.

Answer 18

• Hemophilia or any type of cardovascular risk or disease
• Fatigue that exacerbates the clients condition

Question 19

Be able to identify contraindications and precautions

Weak muscles fatigue easily (MMT should not be performed when client is tired or especially fatigued) for two reasons which are?

1. The results will not ____ reflect ____
2. Negative ramifications can result when excessive ____ is applied to muscles that are ____.

Answer 19

1. Accurately; strength
2. Force; compromised

Question 20

True/False: MMT does not require the clients complete involvement in the testing procedure.

Answer 20

False: MMT does require complete involvement

Question 21

Be able to perform the steps of the MMT procedure in correct order

Place the steps of the MMT procedure in the correct order:
1. Test position: The joint position midway through the available range of motion.
2. Stabilize: The OT practitioner stabilizes the body part, just as proximal to the joint that is moving while simultaneously observing the motion.
3. Body position: the client is placed in a stable position that allows the muscle group to perform the action against gravity.
4. Action: after being shown the motion to be tested, the client actively performs, the action against gravity through the maximal available range of motion
5. Pressure: The OT practitioner applies pressure opposite to the direction of the muscle contraction and movement.

Answer 21

1. Body posistion
2. Action
3. Test position
4. Stabilize
5. Pressure

Question 22

Match the correct muscle grade to the correct discription:
* Complete ROM against gravity with full resistance
* Complete ROM against gravity with some resistance
* Complete ROM against gravity
* Complete ROM with gravity eliminated
* Evidence of slight contracility-no joint motion
* no evidence of contractility

1. Grade 5-Normal (N)
2. Grade 4-Good (G)
3. Grade 3-Fair (F)
4. Grade 2-Poor (P)
5. Grade 1-Trace (T)
6. Grade 0- Zero (0)

Answer 22

• Grade 5-Normal (N)- Complete ROM against gravity with full resistance
• Grade 4-Good (G)- Complete ROM against gravity with some resistance
• Grade 3-Fair (F)- Complete ROM against gravity
• Grade 2-Poor (P)- Complete ROM with gravity eliminated
• Grade 1-Trace (T)- Evidence of slight contracility-no joint motion
• Grade 0- Zero (0)- no evidence of contractility

Question 23

Place the steps for assessing grip in order:

• Dynamometer recommended for assessing grip strength
• Three trials are performed on each hand, with dynamometer set at second position
• A mean of three trials should be reported
• Client should be seated with the shoulder adducted and neutrally rotated, the elbow flexed at 90 degrees, the forearm in the neutral position, and the wrist between 0 and 30 degrees of extension and 0 to 15 degrees of ulnar deviation
• The uninjured hand is used for comparison
• The examiner should hold the dynamometer lightly to prevent accidental dropping of the instrument

Answer 23

1. Client should be seated with the shoulder adducted and neutrally rotated, the elbow flexed at 90 degrees, the
   forearm in the neutral position, and the wrist between 0 and 30 degrees of extension and 0 to 15 degrees of ulnar deviation
2. Three trials are performed on each hand, with the dynamometer handle set at the second position
3. The examiner should hold the dynamometer lightly to prevent accidental dropping of the instrument
4. A mean of three trials should be reported
5. The uninjured hand is used for comparison

Question 24

Used to test pinch strength and is most accurate

Answer 24

Pinch gauge

Question 25

What three pinches are performed in three trials?

Answer 25

* **Two-Point Pinch** (thumb tip to index fingertip) * **Lateral or Key Pinch** (thumb pulp to lateral aspect of the middle phalanx of the index finger) * **Three-Point Pinch or Three Jaw Chuck** (thumb tip to tips of index and middle fingers)