Chapter 7 Assessments Flashcards
- pronation
Flat foot
ADL
Activities of Daily Living
What represents the alignment of the body segments, or how the person holds him- or herself “statically” or “isometrically” inspace.
Static posture
Facilitated/Hypertonic (Shortened) -Hip flexors -Lumbar extensors -Latissimus Dorsi -Neck extensors Inhibited (lenghtened) -Hip extensors -External obliques -Upper-back extensors -Scapular stabilizers -Neck flexors
Muscle imbalances associated with Kyphosis-lordosis posture
Facilitated/Hypertonic (shortened) -Rectus abdominus -Upper-back extensors -Neck extensors -Ankle plantar flexors Inhibited/Lengthened -Iliacus/psoas major -Internal oblique -Lumbar extensors -Neck Flexors
Muscle imbalances associated with Flat-back posture
Facilitated/Hypertonic (shortened) -Hamstrings -Upper fibers of posterior obliques -Lumbar extensors -Neck extensors Inhibited (Lengthened) -Iliacus/psoas major Rectus femoris External oblique Upper-back extensors Neck flexors
Muscle imbalance associated with Sway-back posture
Correctibe factors:
-Repetitive movements (muscular pattern overload)
-Akward positions and movements ( habitually poor posture)
-Side dominance
-Lack of joint stability
- Imbalanced strength-training programs
Non-correctable factors
- congenital conditions(e.g. scoliosis)
- some pathologies (e.g. rheumatoid arthritis)
- structural deviations(e.g. tibial or femoral torsion or femoral anteversion)
- certain types of trauma (e.g. surgery, injury, or amputation)
Factors that can attribute to muscle imbalances
What imbalances should personal trainers focus on?
Obvious and gross, trainers should I avoid getting caught up in minor postural asymmetries
What is another word for supination
High arches
A lateral tilt of the pelvis that elevates one hip higher than the other also called hip hiking
Hip adduction
*Frequently occurs in individuals with tight hip flexors
*Generally associated with sedentary lifestyles
Increases lordosis in the lumbar spine.
* rotates the superior, anterior portion of the pelvis forward and downward
* in figure 7 - 11 the bucket would spill water from the front.
* tight hip, erector spinae lengthen hamstrings, rectus abdominis
* can be seen from the sagittal plane of view
Anterior pelvic tilt
Noticeable protrusion after vertebral medial border outward
Palms face backward
Scapular protraction
Protrusion of the inferior angle and vertebral medial border outward
Winged scapula
Muscle suspected to be tight
Cervical spine extensors, upper trapezius, levator scapulae
Can be observed from the sagittal plane of view
Forward head position
Is an effective method to determine the contribution of muscle imbalances and poor posture on neural control and also helps identify moving compensation
Observing active movement
- bending raising and lifting lowering movements
- single leg movements
- pushing movements( in vertical/ horizontal planes) and resultant movement
- pulling movements ( in vertical/ horizontal planes) and resultant movement
- rotational movements
ADL are essentially the integration of one or more of these primary movements.
5 primary movements
He’ll trainers observe the ability and efficiency with which a client performs many ADL’s
Movement screens
Examines symmetrical lower extremity mobility and stability, and upper extremity stability during a bend and lift movement
- The equipment required for this screen are 2 2 to 4 foot dowels or broomsticks
- the client is to perform a series of bend and lift movements holding the lower position for 2 seconds so that the trainer Ken make observations.
- frontal view observations:
A. First repetition: observe the stability of the foot ( example pronation)
B. Second repetition: observe alignment of knees over second toe.
C. Third repetition: their competition observe the overall symmetry of the entire body over the base of support ( evidence of lateral shift the rotation so on so forth) - Sagittal view observations:
A. First repetition: observe whether the heel remains in contact with the floor through the movement.
B.Second repetition: second. Determine whether the client exhibits glutes sore quadriceps dominance (i.e., does he or she initiate the downward phase by driving the nice forward or pushing the hips backward?)
C. Third repetition: observe whether the client achieves a Pearla position between the tibia and torso in the lowest position (sometimes referred to as the figure 4 position) while also observing whether he or she controls The descent to avoid resting the hamstrings against the calves.
D. Fourth repetition: observe the degree of lordosis in the lumbar/thoracic spine during the lowering movement and while the client is in the lowered position (i.e., flat to neutral or demonstrated increase in lirdosis )and watch for excessive thoracic extension in the lowered position.
D. Fifth repetition: observe any changes of head position during the lowering phase.
Bend and lift screen
Rotation of the foot to direct the plantar surface outward occurs in the frontal plane.
Eversion
Rotation of the foot to direct the plantar surface inward; occurs in the frontal plane
Inversion
Examine simultaneous mobility of one limb and stability of the contralateral limb while maintaining both hip and torso stabilization during a balance challenge of standing on one leg.
Hurdle step screen
Examines stabilization of the scapulothoracic joint and core control during closed-kinetic-chain movements.
Shoulder push stabilization screen
To examine bilateral mobility of the thoracic spine.
Thoracic spine mobility screen
Assesses the length of the quadriceps muscles involved in hip flexion. This test can actually assess the length of the primary hip flexors.
Observations:
- does back of lowerbleg touch the table?
- does knee of lowered leg achieve 80 degrees flexion?
-does knee remain aligned straight or does it fall into internal or external rotation.
Thomas test for hip flexion/quadricep length
What test does this interpret? -Movement/limitation: Back and sacrum flat, Back of thigh does not tpuch the table and knee does not flex to 80 degrees -Suspected muscle tightness: Primary hip flexors
-Movement/Limitation:
Back and sacrum flat and back of lowered thigh does not touch the table, knee does flex to 80 degrees.
-Suspected muscle tightness:
The illiopsas, which is preventing the hip from rotating posteriorly and inhibiting the thigh from being able to touch the table.
-Muscle/Limitation
Back and sacrum flat, back of lowered thigh does touch the table, knee dies not flex to 80 degrees.
‘Suspected muscle tightness:
The rectus femoris, which does not allow the knee to bend
The Thomas Test
- Involves multiple and simultaneous movements of the scapulothoracic and glenohumeral joints in all three planes.
- is done in conjunction with the shoulder flexion-test and an internal-external rotation test of the humerus.
Apley’s scratch test
-Movement/limitation:
The raised leg achieves >80 degrees of movement before the pelvis rotates posteriorly.
-Hamstring length:
Normal
-Movement limitation:
The raised leg achieves <80 degrees of movement before the pelvis rotates posteriorly pr there are any vislible signs of the opposite leg lifting off the mat or table.
-Hamstring lenght
Tight
Passive straight leg raise
- Client lies supine on mat, w/ flat back bent-knee position
- Client should engage abdominal muscles to hold neutral spine w/o raising hips from mat
- Client should raise both arms simultaneously overhead, keeping them close to head and brinfing them to floor or close as possible
- Client should maintain extendedd elbows and neutral wrist.
Observations:
- measure degree of movement in each direction
- note bilateral differences.
Interpretations:
-Movement/Limitation:
Ability to flex the shoulders to 170-180 degrees (hands touching nearly touching the floor)
*good mobility
-Movement/Limitation:
Inability to flex the shoulders to 170 degrees or discrepancies between limbs
-mobility:
Potential tighnness in pectoralis major and minor, latissimus dors,i teres major, rhomboids and scapularis
* tightness in The Testament Doris I will force the lower back to arch
* tightness in the pectoralis major May tilt the scapula forward (anterior tilt) and prevent the arms from touching the floor
* tight abdominals May depress the rib cage, tilting the scapula forward (anterior tilt), and prevent the arms from touching the floor.
* thoracic kyphosis around the thoracic spine and prevent the arms from touching the floor.
Shoulder flexion assessment test
- instruct the client to lie prone, extending both legs, with arms at the sides, and resting the forehead gently on a pillow or the mat.
- ask the client to slowly raise both arms simultaneously lifting them off the mat I’ll keep the arms close to the sides * note the arms will naturally rotate internally during this movement.
- a small amount of extension of the thoracic spine is acceptable during the movement.
- the client should avoid any arching in the lower back or any rotation of the torso during the movement.
- the client should avoid any attempts to lift the chest or head off the mat during the movement.
Observations:
- measure the degree of movement in each direction.
- know any bilateral differences between the left and right arms in performing both movements.
General interpretations:
-Movement/ limitation:
Ability to extend the shoulders to 50 - 60 degrees off the floor
- Mobility
good
- Movement/ limitation:
Inability to extend the shoulders to 50° or discrepancies between the limbs.
- Mobility
Potential tightness in pectoralis major, abdominals, subscapularis, certain shoulder flexors (anterior deltoid), coracobrachialis, and biceps brachii
* tightness in abdominals May prevent normal extension of the thoracic spine and rib cage.
* tightness in the biceps brachii May prevent adequate shoulder extension with an extended elbow (but may permit extension with a bent elbow).
Shoulder extension assessment test
*What is excessive posterior curvature of the spine, typically seen in the thoracic region.
Kyphosis
Toward the back or dorsal side
Posterior
- Excessive anterior curvature of the spine that typically occurs at the lower back may also occur at the neck.
- increased anterior lumbar curve
- excessive inward curvature of the spine
Lordosis
Anatomical term meaning toward the front. Same as ventral opposite; of posterior
Anterior
Decreased anterior lumbar curve
Flat back
Decreased anterior lumbar curve and increased posterior thoracic curve from neutral
Sway back
Lateral spinal curvature often accompanied by vertebral rotation
Scoliosis
*The objective of this assessment is to observe the clients symmetry against the \_\_\_\_\_\_\_\_\_ and the right angles that the weight-bearing joints make relative to the line of gravity. Should use the following views: A. Frontal plane view anterior B. Frontal plane view posterior C. Sagittal plane view
Plumb line
Rotates the superior, posterior portion of the pelvis backward and downward, in figure 7 - 11 the water would spill out of the back of the bucket
- would decrease lordosis in the lumbar spine
- caused by tight rectus abdominis, hamstrings
And lengthened hip flexors, erector spinae - can be seen from the sagittal plane of view
Posterior pelvic tilt
If the ___________ are not level from the frontal plane of view these muscles are suspected to be tight the upper trapezius, levator scapula, rhomboids
Shoulders
If there was no asymmetry to midline what muscles are suspected to be tight?
Lateral trunk flexors flexed side.
If from the sagittal plane of view the shoulders are protracted ( forward, rounded) what’s muscles are suspected to be tight
Serratus anterior, anterior scapulohumeral muscles, upper trapezius
If You observe a medially rotated humerus from the frontal plane of view what muscles are suspected to be tight?
Pectoralis major and latissimus dorsi ( shoulder adductors), subscapularis
If You observe kyphosis and depressed chest from the sagittal plane of view what muscles are suspected to be tight?
Shoulder adductors, pectoralis minor, rectus abdominis, internal oblique
