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ACE Fitness PT Exam > Chapter 7: Functional Assessments > Flashcards

Chapter 7: Functional Assessments Flashcards

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1
Q

Structural Integrity

A

The alignment and balance of the musculoskeletal system. Allows for joints, muscles, and nerves to function efficiently together.

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2
Q

Kyphosis & Lordosis

A

Kyphosis: Increased posterior thoracic curve
(rounded shoulders)

Lordosis: Increased anterior lumbar curve (Jen selter)

ASSOCIATED MUSCLE IMBALANCES

Tight/Hypertonic:

  • Hip Flexors
  • Lumbar Extensors
  • Anterior Chest/Shoulders
  • Lats
  • Neck Extensors

Inhibited/Weak Muscles:

  • Hip Extensors
  • External Obliques
  • Upper back extensors
  • Scapular Stabilizers
  • Neck Flexors
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3
Q

Flat Back

A

Flatback: Decreased anterior lumbar curve (posterior pelvic tilt)

ASSOCIATED MUSCLE IMBALANCES

Tight/Shortened:

  • Rectus Abdominis (6-pack muscle)
  • Upper back extensors
  • Neck extensors
  • Ankle plantar flexors

Weak/lengthened muscles:

  • Iliacus/psoas major
  • internal oblique
  • lumbar extensors
  • neck flexors
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4
Q

Sway Back

A

Sway back: Decreased anterior lumbar curve + increased posterior thoracic curve (full hunchback)

ASSOCIATED MUSCLE IMBALANCES

Tight/Shortened Muscles:

  • Hamstrings
  • Upper fibers of posterior obliques
  • Lumbar Extensors
  • Neck Extensors

Weak/Lengthened muscles:

  • Iliacus/psoas major
  • External Obliques
  • Rectus Femoris (Quad muscle)
  • Upper back Extensors
  • Neck Flexors
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5
Q

Scoliosis:

A

Lateral spine curve, often combined with vertebral rotation

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6
Q

Muscular imbalances

Correctable/ Uncorrectable conditions

A

Correctible:
- Poor posture from habit, repetitive movements, bad joint mobility/stability, side dominance and strength programs that are not balanced.

Non-correctable:
- Certain pathologies (rheumatoid arthritis), congenital conditions (such as scoliosis), structural deviations and traumas (amputation and surgeries etc.)

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7
Q

Static Postural Assessment

A
  • Give insight into muscle imbalances; which often lead to dysfunctional movement.
  • When performing plumb line static posture assessment it is KEY to focus on MAJOR imbalances, as bodies are rarely ever symmetrical.
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8
Q

Deviation 1: Ankle pronation

A

Supination – high arches

  • Inversion foot movement
  • knee (tibial) movement – external rotation
  • Viewpoint: from the front
  • Femoral movement – external rotation

Pronation – Arch flattening

  • Eversion foot movement
  • Knee (tibial) movement – Internal rotation
  • Viewpoint: from the front
  • Femoral movement – Internal rotation
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9
Q

Deviation 2: Hip adduction/hiking

A

One hip is elevated above the other due to lateral tilt of pelvis (me)

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10
Q

Deviation 3: Pelvic Tilting

A

Anterior pelvic tilt: The anterior and superior portion of the pelvis rotates forward and downward from the sagittal view

  • Pouring water out of the front of a bucket
  • Tight hip flexors. Associated with a sedentary lifestyle and spending lots of time sitting.

Posterior Pelvic Tilt: The superior and posterior portion of the pelvis rotates backward and downward.

  • Pouring water out of the back of a bucket
  • Dominant/tight rectus abdominis and tight hamstrings
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11
Q

Deviation 4: Shoulder Position & Thoracic Spine

A

Depression, elevation, abduction, adduction, downward rotation, and upward rotation

SUSPECTED OVERLY TIGHT/SHORTENED MUSCLES

Shoulders that are not level – Tight/overactive Upper trapezius, rhomboids, and levator scapula
Asymmetry to midline – flexed side/lateral trunk flexors
Forward rounded shoulders (protracted) – Upper trapezius, Serratus anterior and anterior scapulohumeral muscles
Depressed chest/kyphosis – Pectoralis minor, internal obliques, rectus abdominis, and shoulder adductors
Medially rotated humorous – latissimus dorsi and pectoralis major, subscapularis

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12
Q

Deviation 5: Forward Head

A

The forward head position – Overactive/tight upper trapezius, cervical spine extensors, and levator scapulae.

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13
Q

5 Movements of ADL

A
  • Bending & Lifting
  • Single- Leg Movements
  • Push Movements
  • Pull Movements
  • Rotational Movements
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14
Q

Lift and bend (Movement Screens)

A

COMPENSATIONS

  1. Knees move inward in the anterior view
  • Tight/overactive hip adductors and TFL(Tensor Fascia Latae)
  • Lengthened/underactive gluteus Maximus and medius
  1. When the movement initiates at the knees sagittal view
  • Not enough glute activation
  • Indicates hip flexor and quadriceps dominance
  1. Back arches extensively in sagittal view
  • Tight/overactive latissimus dorsi, back extensors, and hip flexors
  • Weak/underactive rectus abdominis, core, hamstrings, and gluteal group
  1. Back rounds forward in the sagittal view (Has the same focus as number three)
  • Underactive/weak upper back extensors
  • Overactive/tight Teres major (front shoulder), Pec minor and major and latissimus dorsi
  1. Heels come off ground
    - Overactive plantar flexors (calve muscle)
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15
Q

The hurdle step (Movement Screens)

A

COMPENSATIONS

  1. Inward leg hip rotation in the anterior view
  • Raised leg internal rotators or a tight stance leg
  • Raised leg external rotators or an underactive stance leg
  1. The hiking of the raised hip from the anterior view
    - A tight stance leg hip flexors (Will limit the posterior hip rotation during the raise)
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16
Q

Shoulder push stabilization (Movement Screens)

[Push up Screen]

A

COMPENSATIONS

  1. Noticeable “winging” during the push-up movements at the scapulothoracic joint (sagittal view)
  • The trapezius, levator scapula, serratus anterior and rhomboids (parascapular muscles) cannot stabilize the scapulae on the rib cage.
  • This can also be caused by a flat thoracic spine.
  1. Hyperextension (lower back collapses)
    - Lack of core, abdominal, and lower back strength.
17
Q

Thoracic spine mobility (Movement Screens)

[Ball b/w legs, sitting rotation of spine holding dowel in front squat position]

A
  1. Bilateral discrepancy in the transverse view (assuming they had no other previous issues)
  • Side dominance possibility
  • Possible paraspinal development differences
  • Possible torso rotation (Maybe connected to hip rotation)
  1. 45 degree rotation on both sides = good
18
Q

The Thomas test (Quadriceps/hip flexion length)

  • Flexibility assessments and muscle length
A
  • Pull one knee toward chest while other leg is down, until lower back touches the bench*

COMPENSATIONS

  1. Back of lowered leg does not touch bench + knee does not flex to 80 degrees
    - Tight hip flexors
  2. Back of lowered leg does not touch the bench + knee flexes to 80 degrees
    - iliopsoas tight, preventing hips from posterior rotation -> not allowing thigh to touch
  3. Thigh touches, knee don’t flex to 80
    - Tight rectus femoris (quad)
19
Q

Passive Straight Leg (PSL) Raise

  • Flexibility assessments and muscle length
A
  • One hand on raised leg calf, other hand under lumbar spine; client plantar-flexes; pull leg until pressure is felt on your hand under client’s back*
  • If leg raises more than or equal to 80 degrees… then hams are normal
  • if leg raises less than 80 degrees… then hams are tight
20
Q

Shoulder Mobility Screen(s)

Flexion, Extension, Rotation

A

Flexion: Client lies supine, knees bent, and raises arms above head trying to touch the floor.

  • If shoulders can flex to 170-180 degrees (touching or nearly touching floor) then mobility is good
  • Discrepancies in limbs or inability to reach 170 degrees could indicate tightness in pecs, lats, teres major, rhomboids, and subscapularis

Extension: Client lies prone, legs extended, both arms at sides; and tries to raise arms

  • 50-60 degrees = good mobility

Internal/External rotation of Humerus: Have client lie supine with knees bent; arms are abducted to 90 degrees, with a 90 degree bend at elbow, then they must rotate forearm forward and backward trying to touch ground.

  • External rotation to 90 (touches ground) = good mobility
  • Internal rotation to 20 off ground = good mobility
21
Q

Sharpened Romberg Test

A
  • Client stands with one foot directly in front of the other, arms crossed at shoulders, eyes closed, and attempts to balance as long as possible*

STOP TEST WHEN:
- client opens eyes, uncrosses arms, loses balance, moves feet, exceeds 60 sec. w/ good posture

22
Q

Stork Stand Test

A
  • client stands on one leg on tippy toes, hands on hips, with the other leg against the standing leg like a yoga bitch, and then balances*

STOP TEST WHEN:
- Client loses balance, or the stork stand position,

23
Q

Mcgill’s torso muscular endurance test

A

Flexor: Hold a crunch @ 60 degrees
Extensor: Hold a low back extension
Lateral: hold a sideplank, both sides.

READINGS:
- Flexion : Extension ratio should be less than 1.0
For example: A flexion of 120 sec. and a extension of 150 sec. = 0.8 ratio which is good

  • RSB : LSB score should be no more than 0.05 from a balanced score
    Example: rsb =88sec, lsb = 92sec… ratio = 0.96 which is within a 0.05 range of 1.0
  • SB : Extension Ratio should be less than 0.75
    Example: RSB = 88sec, Extension = 150, generates a ratio of 0.59 = good

ACE Fitness PT Exam (15 decks)

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