COMPS MMT Flashcards
Cervical spine flexion
Passively assess cervical spine flexion range of motion
Encourage patient to flex cervical spine to end of range of motion
Palpate cervical flexors
Apply resistance through the forehead
Rectus capitis anterior/lateralis, Longus capitis, Sternocleidomastoid, Longus colli, Scalenus anterior
cervical spine extension
- pt prone
Passively assess cervical spine extension range of motion
Encourage patient to extend cervical spine
Palpate cervical extensors
Apply resistance through the base of cranium
SCM
-pt supine
Passively assess cervical spine lateral flexion from a contralaterally rotated position
Encourage patient to laterally flex from the contralaterally rotated position
Palpate Sternocleidomastoid
Apply resistance through the forehead
trunk flexion- rectus abdominis
Passively assess full trunk flexion range of motion until bilateral inferior angles clear table
Encourage patient to flex trunk until bilateral inferior angles clear table
Palpate trunk flexors
Repeat with various arm positions if patient is unable to perform motion from original starting position
-PT should Maintaining lower extremity and pelvic stability
- look for patient clearing inferior angle of scap
5- hands behind head
4- arms crossed on chest
3- arms at side slide them down
2- arms at side partially come up can clear scap
1- arms at side patient cant lift shoulder w/ activity
0- no motion
trunk extension- erector spinae
stabilze The posterior, mid-thighs
Cues
Passively assess full trunk extension range of motion until sternum clears the table
Encourage patient to extend trunk until sternum clears the table
Palpate trunk extensors
Repeat with various arm positions if patient is unable to perform motion from original starting position
5- arms behind head- clear xiphoid 4- arms behind on lowr back 3- arms at side clear xyphoid 2- arm at side partially come up 1- little movement yes palpation 0- no motion
Pelvic elevation
- supine
Passively assess pelivc elevation range of motion
Encourage patient to elevate pelvis to end of range of motion
Palpate quadratus lumborum
Apply resistance by pulling on the ipsilateral leg proximal to the malleoli in an inferior direction
5- no breaking
4- slight breaking but patient can still maintain resistance
3 -breaks quite easily
2- pt cannot elevate the pelvis fully
1- palpate contraction but no movement
0- no contrcation
Hip flexion with gravity
-pt seated
- Stabilization
Ipsilateral iliac crest
Cues
Passively assess full hip flexion range of motion
Encourage patient to flex hip through the full range of motion
Palpate iliacus and psoas muscles
Apply resistance at anterior distal femur into hip extension
hip flexion GE
-sidelying with test limb on bottom
- facing away from you
- Stabilization
Support upper non-test limb, holding underneath the knee and lower leg
Cues
Passively assess hip flexion range of motion
Encourage patient to flex hip through the full range of motion
Palpation is difficult due to muscle location depth
hip extension against gravity
- prone
- Stabilization
Ipsilateral posterior iliac crest of the pelvis
Cues
Passively assess full hip extension range of motion, keeping knee extended
Encourage patient to extend hip through the full range of motion, keeping knee extended
Palpate gluteus maximus and hamstrings
Apply resistance at posterior distal femur into hip flexion, keeping knee extended
hip extension GE
- side lying, facing therapist
- Stabilization
Support upper non-test limb, holding underneath the inner thigh, knee and lower leg
Cues
Passively assess hip extension range of motion
Encourage patient to extend hip through the full range of motion
Palpate gluteus maximus and hamstrings
hip abduction against gravity
-Stabilization
Non testing limb is flexed at the hip and knee to provide stability
Tester stabilizes at the ipsilateral iliac crest of the limb being tested
Cues
Passively assess hip abduction range of motion
Encourage patient to abduct hip through the full range of motion
Palpate gluteus medius, just superior to greater trochanter
Apply resistance at lateral distal femur into hip adduction
hip abduction GE
- pt supine
Stabilization
Ipsilateral lateral pelvis
Cues
Passively assess hip abduction range of motion
Encourage patient to abduct hip through the full range of motion
Palpate gluteus medius, just superior to greater trochanter
hip adduction against gravity
- side lying test limb on bottom
- tabilization
Support non-test limb on top underneath the inner thigh, medial knee and lower leg
Non tested knee in 60-90 degrees of flexion
Non tested hip maintained in 25-30 degrees of abduction
Cues
Passively assess hip adduction range of motion
Encourage patient to adduct hip through the full range of motion
Palpate adductor muscle group
Apply resistance at medial distal femur into hip abduction
hip adduction GE
- Supine
- Stabilization
Ipsilateral lateral pelvis
Cues
Passively assess hip adduction range of motion
Encourage patient to adduct hip through the full range of motion
Palpate adductor muscle group
hip IR against gravity
- Tensor fascia lata, Gluteus minimus/medius
-seated - Stabilization
Ipsilateral iliac crest
In a seated position, patient’s body weight stabilizes the pelvis
Cues
Passively assess full hip internal range of motion
Encourage patient to internally rotate hip through the full range of motion
Palpate the tensor fasciae latae and gluteus medium muscles
Apply resistance on the lateral surface of the tibia proximal to the ankle into hip external rotation
Hip IR GE
- supine
Stabilization
Ipsilateral pelvis
Cues
Passively assess full hip internal range of motion
Encourage patient to internally rotate hip through the full range of motion
Palpate anterior gluteus medius and tensor fascia lata
Hip ER against gravity
Piriformis, Gemellus superior/inferior, Obturator internus/externus, Quadratus femoris
- Stabilization
In a seated position, patient’s body weight stabilizes the pelvis
Cues
Passively assess full hip external range of motion
Encourage patient to externally rotate hip through the full range of motion
Palpation is difficult due to muscle depth, piriformis can be palpated between the posterior aspect of the pelvis and the grater trochanter
Apply resistance at anterolateral distal femur and medial distal tibia into hip internal rotation
sartorius
Stabilization
Ipsilateral iliac crest, allowing for hip flexion, but preventing elevation of the pelvis
Once patient is positioned, utilize both hands for applying resistance and maintaining alignment
Cues
Passively assess combined motions of hip flexion, abduction, and external rotation
Encourage patient to slide heel of test limb up the contralateral tibia through the full range of the combined motions
Palpate sartorius
Apply resistance at anterolateral distal femur and medial distal tibia
Knee flexion
- prone
- Stabilization
Ipsilateral iliac crest (gluteus maximus), allowing for hamstring contraction, but preventing elevation of the pelvis
Once patient is positioned, utilize a weight shift when applying resistance and maintain alignment of the testing extremity
Cues
Passively assess available knee flexion motion of hip flexion
Encourage patient to lift heel towards the buttocks
Palpate medial and lateral hamstring tendons
Apply resistance through the posterior aspect of the mid-tibia into knee extension
-GE sidelying facing you
knee extension
- Stabilization
Ipsilateral iliac crest
Cues
Passively assess full knee extension range of motion
Encourage patient to extend knee through the full range of motion
Palpation should be performed directly over the anterior thigh (Quadriceps)
Apply resistance over the anterior, mid-tibia into knee flexion
shoulder flexion antigravity
anterior delt, coracobrachialis
stabilization
Superior aspect of the ipsilateral shoulder
Cues
Passively assess shoulder flexion range of motion
Encourage patient to flex shoulder to end of range of motion
Palpate anterior deltoid
Bring shoulder down to 90 degrees of flexion
Apply resistance proximal to the elbow
shoulder extension
lats, post delt, teres major
Stabilization
Ipsilateral border of the scapula staying off of the spinous processes
Cues
Passively assess shoulder extension range of motion
Encourage patient to extend shoulder to end of range of motion
Palpate latissimus dorsi and teres major
Apply resistance to distal humerus
shoulder abduction
middle deltoid, supraspinatus
Stabilization
Ipsilateral superior border of the scapula
Cues
Passively assess shoulder abduction range of motion
Encourage patient to abduct shoulder to end of range of motion
Palpate the middle deltoid
Bring shoulder down to 90 degrees of abduction
Apply resistance to distal humerus
shoulder horizontal abduction
- post delt Stabilization Ipsilateral scapula Cues Passively assess shoulder horizontal abduction to end range of motion Encourage patient to horizontally abduct shoulder to end range of motion Palpate posterior deltoid Apply resistance on distal humerus
shoulder horizontal adduction
- pec major
Stabilization
Ipsilateral shoulder on the distal 1/3 of the clavicle
Cues
Passively assess shoulder horizontal adduction to end range of motion
Encourage patient to horizontally adduct shoulder to end range of motion
Palpate anterior deltoid
Apply resistance through distal humerus
shoulder IR
- subscap
Stabilization
Ipsilateral surface of the scapula
Cues
Passively assess shoulder internal rotation to end range of motion
Encourage patient to internally rotate shoulder to end range of motion
Palpate subscapularis in the axillary border
Apply resistance proximal to the wrist
shoulder ER
- infraspinatus, teres minor Stabilization Ipsilateral border of the scapula Cues Passively assess shoulder external rotation to end range of motion Encourage patient to externally rotate shoulder to end range of motion Palpate teres minor and infraspinatus Apply resistance proximal to the wrist
scapular elevation antigravity
- upp trap and levator scapulae
- seated
tabilization
Ipsilateral side of the head
Cues
Passively assess bilateral scapular elevation range of motion and strength
Position patient to test individual upper trapezius with head turned to the contralateral side
Encourage patient to elevate scapula to end of range of motion
Palpate the upper trapezius muscle
Apply resistance through the acromion towards the ground
scapular elevation GE
- prone
Cues
Passively assess scapular elevation range of motion
Encourage patient to elevate scapula to end of range of motion
Palpate upper trapezius
scapular adduction antigravity
Mid trap
- prone
Therapist Position
Standing on contralateral side of testing limb
Stabilization
Place pressure over the contralateral thorax
Cues
Passively assess scapular adduction range of motion
Encourage patient to adduct scapula to end of range of motion
Palpate middle trapezius
Apply resistance into abduction through the medial border of scapula
scapular adduction GE
- sitting arm at 90
- Stabilization
Prevent the patient from rotating the trunk during testing
Cues
With a towel under the arm, passively assess scapular adduction
Encourage patient to adduct the scapula to end range of motion
Palpate middle trapezius along the medial border of the scapula
scapula add and depression
- lower trap
- Prone with head turned to contralateral side
Shoulder abducted 130 degrees
Therapist Position
Standing on contralateral side of testing limb
Stabilization
Contralateral thorax
Cues
Passively assess scapular adduction and depression range of motion
Encourage patient to adduct and depress scapula to end of range of motion
Palpate lower trapezius
Apply resistance through the lateral surface of the scapula towards scapular abduction and elevation
scapular adduction/ downward rotation
- rhomboid major and minor
- prone
- tabilization
Contralateral thorax from the side you are testing
Cues
Passively assess scapular adduction and downward rotation range of motion
Encourage patient to adduct and downwardly rotate scapula to end of range of motion with shoulder elevation
Palpate rhomboids
Apply resistance through the medial border of the scapula towards scapular abduction and upward rotation
GE- sitting
scapular adduction and upward rotation
-serratus ant
- seated
Stabilization
Superior aspect of ipsilateral shoulder
Cues
Passively assess scapular abduction and upward rotation range of motion in 125-130 degrees shoulder flexion
Encourage patient to abduct and upwardly rotate scapula to end of range of motion in 125 degrees shoulder flexion
Palpate serratus anterior over lateral aspect of upper 8-9 ribs
Apply resistance through inferior angle of scapula and above the elbow into adduction and downward rotation
elbow flexion
- biceps
- seated
- Stabilization
Superior acromion of the ipsilateral limb
Cues
Passively assess elbow flexion to end range of motion
Encourage patient to flex elbow to end range of motion
Palpate biceps brachii muscles
Position elbow in 90 degrees of flexion
Apply resistance through distal forearm into elbow extension
For brachialis fully pronate the forearm and repeat steps 1-5
For brachioradialis place forearm between pronation and supination and repeat steps 1-5
elbow extension
- supine elbow flexed to 90 shoulder 90
Stabilization
Maintain humerus at 90 deg. by stabilizing the proximal, anterior aspect of the shoulder
Cues
Passively assess elbow extension to end range of motion
Encourage patient to extend elbow to end range of motion
Palpate tricep muscles
Apply resistance through distal forearm into elbow flexion
