End Feel and Muscle Testing Flashcards
What is an end-feel?
The type of resistance felt when passively moving a joint through the end ROM.
What are normal end-feels?
Firm (stretch)
Hard (bone to bone)
Soft (soft tissue approximation)
List 4 examples of motions with a firm end-feel.
Ankle dorsiflexion
Finger extension
Hip medial rotation
Forearm supination
List an example of a hard end feel.
Elbow extension
List 2 examples of soft end feels.
Elbow flexion
Knee flexion
What are common causes of empty (painful) end feels?
Joint inflammation
Bursitis
Fracture
What are common causes of abnormal firm end feels?
Increased tone
Tightening of the capsule
Ligament shortening
What are common causes of abnormal soft end feels?
Edema
Synovitis
Ligament instability/tear
Describe 0/5 on MMT testing.
No palpable muscle contraction
Describe 1/5 on MMT testing.
Trace
Muscle contraction can be palpated but there is no joint movement.
Describe 2-/5 on MMT testing.
Poor minus
Cannot complete ROM in a gravity eliminated position
Describe 2/5 on MMT testing.
Poor
Completes ROM in gravity eliminated position
Describe 2+/5 on MMT testing.
Poor Plus
Can initiate movement against gravity
Describe 3-/5 on MMT testing.
Fair plus
Cannot complete the ROM against gravity but does complete more than half of the range
Describe 3/5 on MMT testing.
Fair
Completes ROM against gravity without resistance
Describe 3+/5 on MMT testing.
Fair plus
Completes ROM against gravity with only minimal resistance
Describe 4-/5 on MMT testing.
Good minus
Completes ROM against gravity with minimal-moderate resistance
Describe 4/5 on MMT testing.
Good
Completes ROM against gravity with moderate resistance
Describe 4+/5 on MMT testing.
Good plus
Completes ROM against gravity with moderate-maximal resistance
Describe 5/5 on MMT testing.
Normal
Completes ROM against gravity with maximal resistance
What is muscle insufficiency?
A muscle contraction that is less than optimal due to an extremely lengthened or shortened position of the muscle
What is the difference between active and passive muscle insufficiency?
Active: when a two joint muscles contracts across both joints simultaneously
Passive: when a two joint muscles is lengthened across both joints simultaneously
What is a power grip? What position is the hand in?
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
What are four types of power grips?
Cylindrical grasp
Fist grasp
Spherical grasp
Hook grasp
What is a precision grip? What joints are involved?
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.
What are 3 types of precision grips?
Digital prehension grip (three finger grip)
Lateral prehension grip
Tip prehension grip
When might you use a digital vs lateral vs tip prehension grips?
Digital = when holding a pencil Lateral = turning a key Tip = Holding a needle
What are 3 types of dynamometry?
Hand held
Isometric
Isokinetic
Describe hand held dynamometry.
Used to assess grip strength
Pt asked to exert maximal force against the dynamometer, keeping the elbow close to the trunk
Describe isometric dynamometry. When is this contraindicated?
Measures static strength of a muscle group without any movement
Contraindicated for patients with fractures and significant hypertension.
Describe isokinetic dynamometry.
Measures the strength of a muscle group during movement with constant, predetermined speed.
What is the difference between a make vs a break test?
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
