Lecture 8 Flashcards
Who initiates contraction?
The client, the examiner resists the movement.
What position is the muscle placed in?
Mid-contracted
How long is force applied for in muscle testing?
2-3 seconds
What is the grading of muscle testing?
0 – No evidence of contractility
1 – Evidence of slight contractility. No joint motion
2 – Complete range of motion with gravity eliminated
3 – Complete range of motion against gravity but no resistance
4 – Complete range of motion against gravity with some resistance
5 – Complete range of motion against gravity and with full resistance
Muscle Fields Tests
Tests that use body weight as resistance and time or repetitions as the primary means of quantifying performance.
- Sit-to-stand
- Heel-raise
Sit-to-stand Test (STS)
- Characterise strength of the lower limb
- Time required to complete a given number of repetitions (usually 5) or counting the number of repetitions completed in a period of time (usually 30 seconds)
- Patients should be sitting forward on the chair with their feet flat on floor, upper limbs are folded across there chests.
Heel-raise test (HR)
- Characterise the strength of the ankle plantarflexor muscles
- Stand facing wall with hands lightly resting on wall
- First do max bilateral HR to establish test range
- Then perform unilateral HRs at a rate of 1 every other second
- Knee must stay fully extended.
Heel-Raise Scoring
0 = no evidence of contraction
1 = evidence of contraction but no movement
2 = partial range of motion
3 = full range of motion (1-9 times)
4 = full range of motion (10-19) times
5 = full range of motion (20 or more times.)
What can grip strength test diagnose?
- Sarcopenia
- Proxy for overall muscle strength
Grip strength Test
- Client is seated with shoulder adducted, elbow flexed to 90 degrees and forearm and wrist neutral
- Dynamometer in the clients hand, and ask to squeeze
- 3 trials
Muscle Testing Scalenes and Superficial Neck Flexors
Patient Position:
- Supine or seated with arms at their side, neck flexed without tucking the chin
Examiners Force:
- Finger, thumb & palm pushing down on forehead
Stabilization:
- Over superior sternum or shoulder
Muscle Testing - Deep Neck Flexors
Same as for scalenes except chin should remain tucked
Patient Position:
- Supine or seated with arms at their side, neck flexed WITH tucking the chin
Examiners Force:
- Finger, thumb & palm pushing down on forehead
Stabilization:
- Over superior sternum or shoulder
Muscle Testing - Sternocleidomastoid (SCM)
Patient Position:
- Patient seated or supine with neck flexed & rotated to contralateral side
Examiners Force:
- Hand on lateral frontal bone, force is posterior and slightly lateral, in a curve following anatomical arc of muscle action
Stabilization:
-Sternum (have patient cover chest with free hand)
Muscle Testing - Upper Trapezius
Patient Position:
- Seated, head laterally flexed, rotated away & slightly extended from side being tested
Examiners Force:
- 75% toward opposite lateral flexion, 25% down on shoulder
Stabilization:
- Ipsilateral Shoulder
Muscle Testing - Levator Scapula
Patient Position:
- Seated, head laterally flexed, rotated and slightly extended toward same side
Examiners Force:
- 75% toward opposite lateral flexion & 25% pressure down on scapula
Stabilization:
- Ipsilateral shoulder
Muscle Testing - Middle and Lower Trapezius
Patient position:
- Prone
- Middle = Shoulder abducted 90 & externally rotated
- Lower = Shoulder abducted 120 & externally rotated
Examiners Force:
- Toward floor
Stabilization:
- Contralateral Scapula
Muscle Testing - Rhomboids?????
Patient Position:
- Prone
Muscle Testing - Pectoralis Minor
Patient Position:
- Supine, shoulder adducted across body & lifted off examination table
Examiners Force:
- Diagonal toward retraction of the scapula
Stabilization:
- Patient may grip table with opposite arm if the feel unstable
Muscle Testing - Pectoralis Major Clavicular
Patient Position:
- Supine client flexes shoulder to 90 and internally rotates arm 45, with elbow in full extension.
Stabilization:
- Opposite shoulder
Muscle Testing - Pectoralis Major Sternal
Patient Position:
- Supine, shoulder flexed to 110-120 and internally rotate arm so thumb points towards feet, with elbow in full extension
Stabilization:
- Opposite shoulder
Muscle Testing - Serratus Anterior
Muscle Testing - Erector Spinae
Patient Position:
- Prone, back extended
Examiners Force:
- Toward flexion of spine
Stabilization:
-Posterior thigh
Muscle Testing - Quadratus Lumborum
Muscle Testing - Latissimus Dorsi
Patient Position:
- Supine or seated, arm internally rotated
Examiners Force:
- Diagonal toward abduction & flexion of shoulder
Stabilization:
- Over the patients shouler or upper arm
