MSK Objective Assessment

Question 1

What makes up a routine assessment?

Answer 1

Observation
Palpation
Effusion 
Active ROM
Passive ROM
Resisted testing 
Accessory movement 
Ligaments 
Functional tests

Question 2

What are you observing during the objective assessment?

Answer 2

Alignment
Atrophy
Colour
Deformity

Question 3

What are you feeling for during active ROM?

Answer 3

Quality 
Range 
Pain response (when and where)
Occurrence of muscle spasm 
Any resistance to movement

Question 4

What movements are you testing during active ROM?

Answer 4

Flexion 
Extension 
Abduction 
Adduction 
Medial rotation 
Lateral rotation

Question 5

What does AROM test for?

Answer 5

Muscle and tendon
Inert tissue
Load

Question 6

What is a passive ROM?

Answer 6

A test of inert and non-contractile structures

Question 7

What should you be looking for when performing PROM?

Answer 7

Limit to movement
Pain response
ROM achieved
Any other symptoms produced

Question 8

What is normal end feel?

Answer 8

Soft - soft tissue approximation
Hard - bony approximation
Spongey - inflamed or effusive joint
Soft with a hard end feel - capsular, ligament or muscle stretch

Question 9

What are abnormal end feels?

Answer 9

Bone to bone 
Muscle spasm
Capsular/elastic 
Empty (can’t get an end feel)
Springy block

Question 10

What is effusion testing?

Answer 10

Tap test - tap the patella and find soft end feel, indicative of swelling
Sweep test - sweep fro, inferior medial to superior and then laterally, observe medial aspect of knee or palpate to for fluid

Question 11

What does resisted muscle testing test for?

Answer 11

Contractile tissues

Question 12

What does a strong and painful resisted muscle test result mean?

Answer 12

Tendinitis

Question 13

What does a strong and painless resisted muscle test result mean?

Answer 13

Normal

Question 14

What does a weak and painless muscle test result show?

Answer 14

Muscle rupture

Question 15

What does a weak and painful resisted muscle test show?

Answer 15

Fracture

Question 16

What does it show when a resisted muscle test is painful on repetition?

Answer 16

Intermittent claudication

Question 17

What does it mean when all movements are painful in a muscle resisted test?

Answer 17

Affective disorder

Question 18

What are special tests used for during an objective assessment?

Answer 18

To determine which disease, condition or injury is present

Question 19

What procedure do you use for a soft tissue injury?

Answer 19

POLICE

Question 20

What does POLICE stand for?

Answer 20

Protection 
Optimal Loading 
Ice 
Compression 
Elevation

Question 21

What is the process of mechanotherapy?

Answer 21

Loading of tissue 
Stimulated cellular response 
Tissue adapts 
Tissues improves structure 
Tissue able to maintain homeostasis = less pain

Question 22

How can you assess ligaments?

Answer 22

Accessory tests

Question 23

What are the soft tissue treatment techniques?

Answer 23

Specific soft tissue mobilisations (SSTM)
Deep transverse frictions 
Muscle lengthening 
Trigger point 
Exercise

Question 24

How can SSTM help injuries?

Answer 24

Pain relief
Collagen remodelling and ground substances
Affects visco-elastic properties

Question 25

What is physiological SSTM?

Answer 25

Self stretch Therapist stretch Engage barrier Oscillate using maitland grading or static holds

Question 26

What are accessory SSTM techniques?

Answer 26

Direct pressure Bowing Transverse mobilisations

Question 27

What are combined SSTM techniques?

Answer 27

Deep transverse friction massage

Question 28

How does deep transverse friction massage work (DTFM)?

Answer 28

Breaks down adhesions Increases blood supply Activates cells in the area Helps re-orientate fibres

Question 29

What are the contra-indications and precautions for DTFM’s?

Answer 29

``` Open wounds Clotting disorders DVT Acute inflammation Skin infections Acute inflammation Growth plates Skin disorders Possible cancer Rheumatoid arthritis Bursitis ```

Question 30

What are graded mobilisations determined by?

Answer 30

SIN factor Position in the range Amplitude Relationship to resistance and pain

Question 31

What are the grades for mobilisations>

Answer 31

``` Grade I - small and fast Grade II - large sand slow RESISTANCE Grade III - large and slow Grade IV - small and fast ```

Question 32

What are the effects of immobilisation?

Answer 32

``` Loss of function Decreased ROM Muscle atrophy Soft tissue length changes Cartilage changes Bony changes Pain states ```

Question 33

What are the types of joint motion?

Answer 33

Osteokinematic | Arthrokinematic

Question 34

What is Osteokinematic joint motion?

Answer 34

Movement of the bones

Question 35

What is arthrokinematic joint motion?

Answer 35

Motion between joint surfaces

Question 36

What is closed pack position?

Answer 36

Position in which the joint ligaments and capsule are maximally taught

Question 37

What are the benefits for joint mobilisations?

Answer 37

Restoration of movement to a joint | Specific to joint

Question 38

What are the effects of joint mobilisations?

Answer 38

Improving ranges of active, passive and accessory joint movements Increasing length of joint joint soft tissue structures Increasing length of joint surrounding soft tissue structures Relief of pain Decrease muscle spasm Placebo effect

Question 39

What are the benefits of exercise?

Answer 39

``` Reduced stress Increased balance and coordination Decreased body fat Decreased osteoporosis Relaxation Increase muscle tone, flexibly and posture Increased cardiorespiratory function Increased well-being and confidence ```

Question 40

What are the principles of strength training?

Answer 40

``` Overload Specificity Motivation Learning Reversibility Diminishing returns Age Gender ```

Question 41

What are some of the goals for active assisted exercise?

Answer 41

Maintain physiological elasticity and contractility of the participating muscles Provide sensory feedback for the contracting muscles Increase circulation Develop coordination and motor skills for functions activities

Question 42

What are the principles of application for active assisted exercise?

Answer 42

``` Examination, evaluation and treatment planning Communication Remove restrictive clothing Clear the work space Starting position of the patient Your position Demonstrate with passive movement first ```

Question 43

What are the types of active assisted exercise?

Answer 43

Manual active assisted exercise Auto-assisted exercise Mechano- assisted exercise (poles, slippy boards, gym balls, wall, hoops, stationary bikes)