End Feel and Muscle Testing

Question 1

What is an end-feel?

Answer 1

The type of resistance felt when passively moving a joint through the end ROM.

Question 2

What are normal end-feels?

Answer 2

Firm (stretch)
Hard (bone to bone)
Soft (soft tissue approximation)

Question 3

List 4 examples of motions with a firm end-feel.

Answer 3

Ankle dorsiflexion
Finger extension
Hip medial rotation
Forearm supination

Question 4

List an example of a hard end feel.

Answer 4

Elbow extension

Question 5

List 2 examples of soft end feels.

Answer 5

Elbow flexion

Knee flexion

Question 6

What are common causes of empty (painful) end feels?

Answer 6

Joint inflammation
Bursitis
Fracture

Question 7

What are common causes of abnormal firm end feels?

Answer 7

Increased tone
Tightening of the capsule
Ligament shortening

Question 8

What are common causes of abnormal soft end feels?

Answer 8

Edema
Synovitis
Ligament instability/tear

Question 9

Describe 0/5 on MMT testing.

Answer 9

No palpable muscle contraction

Question 10

Describe 1/5 on MMT testing.

Answer 10

Trace

Muscle contraction can be palpated but there is no joint movement.

Question 11

Describe 2-/5 on MMT testing.

Answer 11

Poor minus

Cannot complete ROM in a gravity eliminated position

Question 12

Describe 2/5 on MMT testing.

Answer 12

Poor

Completes ROM in gravity eliminated position

Question 13

Describe 2+/5 on MMT testing.

Answer 13

Poor Plus

Can initiate movement against gravity

Question 14

Describe 3-/5 on MMT testing.

Answer 14

Fair plus

Cannot complete the ROM against gravity but does complete more than half of the range

Question 15

Describe 3/5 on MMT testing.

Answer 15

Fair

Completes ROM against gravity without resistance

Question 16

Describe 3+/5 on MMT testing.

Answer 16

Fair plus

Completes ROM against gravity with only minimal resistance

Question 17

Describe 4-/5 on MMT testing.

Answer 17

Good minus

Completes ROM against gravity with minimal-moderate resistance

Question 18

Describe 4/5 on MMT testing.

Answer 18

Good

Completes ROM against gravity with moderate resistance

Question 19

Describe 4+/5 on MMT testing.

Answer 19

Good plus

Completes ROM against gravity with moderate-maximal resistance

Question 20

Describe 5/5 on MMT testing.

Answer 20

Normal

Completes ROM against gravity with maximal resistance

Question 21

What is muscle insufficiency?

Answer 21

A muscle contraction that is less than optimal due to an extremely lengthened or shortened position of the muscle

Question 22

What is the difference between active and passive muscle insufficiency?

Answer 22

Active: when a two joint muscles contracts across both joints simultaneously

Passive: when a two joint muscles is lengthened across both joints simultaneously

Question 23

What is a power grip? What position is the hand in?

Answer 23

A grip used when a strong grip is needed and involves stabilization of the object against the palm.

Fingers are in flexion and the wrist is in ulnar deviation and slight extension

Question 24

What are four types of power grips?

Answer 24

Cylindrical grasp
Fist grasp
Spherical grasp
Hook grasp

Question 25

What is a precision grip? What joints are involved?

Answer 25

A grip used when accurate and precise movements of the hand are needed. Involves the IP and MCP joints on the radial side of the hand.

Question 26

What are 3 types of precision grips?

Answer 26

Digital prehension grip (three finger grip) Lateral prehension grip Tip prehension grip

Question 27

When might you use a digital vs lateral vs tip prehension grips?

Answer 27

``` Digital = when holding a pencil Lateral = turning a key Tip = Holding a needle ```

Question 28

What are 3 types of dynamometry?

Answer 28

Hand held Isometric Isokinetic

Question 29

Describe hand held dynamometry.

Answer 29

Used to assess grip strength | Pt asked to exert maximal force against the dynamometer, keeping the elbow close to the trunk

Question 30

Describe isometric dynamometry. When is this contraindicated?

Answer 30

Measures static strength of a muscle group without any movement Contraindicated for patients with fractures and significant hypertension.

Question 31

Describe isokinetic dynamometry.

Answer 31

Measures the strength of a muscle group during movement with constant, predetermined speed.

Question 32

What is the difference between a make vs a break test?

Answer 32

Make test: evaluation procedure where a patient is asked to apply a force against the dynamometer Break test: evaluation procedure where a patient is asked to hold a contraction against pressure that is applied in the opposite direction of the contraction