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NMSK1 - physio 1 > assessment of strength > Flashcards

assessment of strength Flashcards

1
Q

define strength

A
  • ability to generate force to create movement
  • capacity to exert force
  • ability to do work against resistance
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1
Q

what are 4 causes of muscle weakness?

A
  • lesion of pathology affecting the nerve which innervates the muscle
  • any lesion, injury or pathology of the muscle tissue
  • disuse of muscle
  • immobilisation
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2
Q

compare upper vs lower motor neuron lesion

A
  • upper lesion - lesion in brain or spinal cord
  • lower lesion - lesion in peripheral nerves
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3
Q

what are the various effects of immobilisation or disuse on muscle?

A
  • decrease in muscle fibre size
  • decrease in size and number of mitochondria
  • decrease in total muscle weight
  • decrease in protein synthesis
  • decrease in muscle tension produced
  • atrophy
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4
Q

how do you know if a muscle is weak -ie what would a patient say to you? what might you notice?

A
  • might not be able to do ADL’s everyday
  • stiffness - less ROM due to muscle weakness - person cannot actively move the muscle etc
  • the use of the word ‘heavy’ - can describe muscle weakness
  • unexplained tripping - may point to a weakness in the muscles that produce ground clearance
  • intrinsic hand muscles becoming weak - difficulty with handling money or taking keys out of pocket
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5
Q

what are the 4 options to assess strength?

A
  • measuring the cross sectional area - eg tape measure, through CT/ultrasound - not directly measuring muscle strength
  • **manual muscle testing **(eg manual or hand on hand resistance ) - eg oxford scale
  • **objective measurment **- strain gauge, dynamometry (eg hand grip strength)
  • **functional assessment **- eg 1RM
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6
Q

what is the 1 repetition maximum?

A

max amount of weight you can lift for one repetition on any given exercise

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7
Q

what does the reduction in muscle fibre cross sectional area mean?

A
  • a marker of muscle atrophy
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8
Q

what can CSA be a good predictor of?

A

mortality in some diseases eg COPD

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9
Q

how is true CSA measured?

A

using CT or ultrasound

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10
Q

how do we indirectly measure CSA?

A
  • tape measurements of muscle bulk - taken when the muscle is relaxed
  • common measurements would be mid thigh, mid calf and upper arm
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11
Q

what is the oxford scale?

A

a numerical rating scale (from 0-5) that measures the power or strength produced by the contraction of a muscle

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12
Q

what are the 6 different numerical ratings of the oxford scale?

A

0- no contraction
1- flicker or trace of contraction
2- full AROM with gravity eliminated - ie muscle movement is easier without gravity
3- full AROM against gravity
4- full AROM against gravity and resistance
5- normal

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13
Q

what can hand held dynamometry (HHD) testing used for?

A
  • suitable for assessing strength of people who score 4 or 5 on the oxford scale
  • allows measurment of maximum voluntary isometric contraction
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14
Q

what are the limitations of hand held dynamometry?

A
  • requires training
  • if the patient is strong, tester may not be able to fully resist the patients effort
  • isometric testing ONLY
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15
Q

what are some advantages of using hand grip dynamometry?

A
  • reliable
  • easy to use
  • useful predictor of physical function in aging adults
  • fundamental to ADL’s
16
Q

what is maximum voluntary isometric contraction (MVIC)?

A

a standardised method for measuring strength for patients with neurological diseases

17
Q

what is an isokinetic exercise?

A
  • type of exercise that uses a special machine
  • the machine creates diff levels of resistance - that way your movements are at a constant speed, no matter how much force you apply
18
Q

what are the advantages of isokinetic testing?

A
  • sensitive
  • accurate
  • tests isometric, concentric and eccentric strength
19
Q

what are the **disadvantages **of isokinetic testing ?

A
  • expensive
  • bulky
  • takes a long time to set
  • limited to a small number of muscle groups
  • limited to open chain kinetic mvt
20
Q

what is the one repetition maximum?

A
  • the maximal weight that can be lifted once using a proper lifting technique
  • gold standard for assessing muscle strength
21
Q

why would you use 1RM?

A
  • no expensive equipment
  • functional and meaningful (ie knowing what weight you can lift can be helpful)
  • very reliable
  • motivating for the patient
  • allows dynamic movement - concentric and eccentric
22
Q

what are the 2 ways that you can calculate 1RM?

A
  • option 1 - calculate 1RM by determining the maximum weight that a patient can lift without failure of compensatory body movements, with good technique (try to get it in 5 attempts to prevent patient fatigue)
  • **option 2 **- calculate the 1RM from a lower weight, using an equation (if u have safety concerns about taking patient to max effort or if you dont have a weight corresponding to the 1RM available
23
Q

other than the 1RM, what is another method for functional testing of strength?

A
  • performance of a compound movment, such as sit to stand, heel raise, pull up or push up
  • reported as either power (speed of performance), absolute repetition number (endurance) and sustained maximal duration (endurance)
24
Q

what is endurance?

A
  • the ability to undergo prolonged activity
25
Q

what is muscular endurance?

A
  • the ability of a muscle to sustain an isometric contraction or to continue a dynamic contraction
26
Q

what is cardiovascular endurance?

A
  • the capacity of the individual to maintain strenous activity of a number of muscle groups or of the whole body for a prolonged period
27
Q

what is fatigue?

A
  • decrease in max power produced by a muscle, the feeling of discomfort and tiredness and also the increased perception of effort
28
Q

what is DOMS?

A

delayed onset muscle soreness
* worse with eccentric exercise
* peak is 24-48 hours post exercise

29
Q

what is DOMS caused by?

A

microscopic damage to myofibrils and cytoskeletal framework (endomysium, perimysium and epimysium)

30
Q

what are the effects of muscle strength training?

A
  • increase in max strength
  • increase in endurance
  • hypertrophy - increas in muscle mass
  • decrease in fatigue
  • decrease in soreness and stiffness
31
Q
A

NMSK1 - physio 1 (36 decks)

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