Eval 2 - MSK Flashcards
What are we mostly screening for? (3)
Kyphosis
Osteoporosis
Fractures
Occiput to Wall - purpose, pt position, procedure, (+)
Purpose: hyperkyphosis.
Pt position: stand with both heels, sacrum, & scap on wall. “Stand as tall as you can.”
Procedure: measure distance with 2 perpendicular rulers.
(+) = >2cm, hyperkyphotic, higher risk of T-spine fx.
Rib-Pelvis Distance - purpose, pt position, procedure, (+)
Purpose: fx risk.
Pt position: standing, shoulders flexed to 90, examiner stands behind.
Procedure: finger distance btwn inferior ribs & superior ileum (mid-axillary line).
(+) = <2 fingers, higher risk of fx.
Back Scratch Test- purpose, pt position, procedure, gender norms
Purpose: assess shoulder mobility.
Pt position: standing, one arm IR, other ER behind back, try to touch fingertips together.
Procedure: measure distance btwn middle fingers.
Norm (M) < 8in
Norm (F) < 4in
Chair Sit & Reach- purpose, pt position, procedure
Purpose: assess HS length & trunk flexion.
Pt position: seated, one leg bent with foot on floor, other leg extended, heel on floor, neutral DF.
Procedure: hip hinge to reach forward, hold for 2sec, measure btwn middle finger & toes (inches).
Sock Test - purpose, pt position, procedure, (+)
Purpose: hip/trunk mobility.
Pt position: short-sitting, feet off floor.
Procedure: lift one foot (hip flex in sagittal plane), reach for toes with both hands.
(+) = score of 2 or 3 = 6x more likely to have functional difficulty in 1yr.
Sock Test Scoring
0 = can reach toes, no difficulty.
1 = can reach toes, but difficult.
2 = can reach past malleoli, cannot reach toes.
3 = cannot reach malleoli.
Osteoporosis precautions
No flexion
No extreme/loaded/end-range rotation
DO NOT DO: Chair Sit & Reach, Sock Test.
Post Hip precautions
No 90deg flex
No add past mid
No IR
Sternotomy precautions
No pushing or WB thru hands.
No OH reaching.
No reaching behind (shld ext).
No lift >10lb.
Keep prop under scapulae when lying supine.
Grip Strength - pt position, procedure
Pt position: shoulder width apart, 90deg elbow, NOT on arm rest.
Procedure: “2” on dynamometer, max score of 3 trials, alternate hands each rep.
30sec STS - purpose, pt position, procedure, MDC
Purpose: functional mobility & falls risk.
Pt position: 17in chair, no arms, supported against wall.
Procedure: “as many times as you can,” no counting out loud, more than halfway on last rep counts (ONLY on last rep).
MDC = 2
5x STS - purpose, pt position, procedure, cutoff scores, MDC
Purpose: functional mobility & falls risk.
Pt position: standard chair, no ams, NOT against wall.
Procedure: “as fast as you can,” stop timer when they sit all the way back down.
>13.6 sec = higher disability.
>12 sec = fall risk.
MDC = 2.5 sec
How is the Modified 30sec STS different?
Using hands/arm rests.
MDC = 1
Arm Curl Test - purpose, pt position, procedure
Purpose: UE strength & endurance (household tasks requiring lifting/carrying).
Pt position: armless chair, dominant hand, suitcase grip.
Procedure: 5lb (F) or 8lb (M), supinated at top, # of reps in 30sec.
Timed Loaded Standing Test - purpose, pt position, procedure
Purpose: arm endurance and functional trunk performance.
Pt position: standing, hold 2lb weight in each hand, wrists neutral, arms extended.
Procedure: stand in front, hands below weights in case they need a boost, time how long they can hold.
Supine Hip Ext Test - purpose, pt position, procedure
Purpose: hip extension strength if they can’t lie prone for MMT.
Pt position: supine, heels off table, “keep hips locked.”
Procedure: test leg is the side we are NOT lifting. Passively raise 1 leg against pt resistance, pt actively raises test limb to mirror.
Supine Hip Ext Test scoring
5 = stable pelvis, both hips off surface, test hip stays locked.
4 = test hip not locked initially but catches up.
3 = test hip not locked, good resistance but pelvis doesn’t rise or only rises a little bit.
2 = hip flexes, pelvis does not rise.
0 = no contraction.
Bridge Test - purpose, pt position, procedure
Purpose: lumbar stabilization endurance (mostly extensors).
Pt position: supine, bridge up.
Procedure: hold as long as possible, 1 cue allowed if they start dropping, then 2nd time stop test.
Prone Extensor Test - purpose, pt position, procedure
Purpose: lumbar extension endurance.
Pt position: prone, pillow placed just above ASIS, arms at sides.
Procedure: lift sternum & hold as long as possible.
Plank Test - purpose, pt position, procedure
Purpose: lumbar stabilization endurance (mostly flexors).
Pt position: low plank on elbows.
Procedure: as long as possible.
Curl Up Test - purpose, pt position, procedure
Purpose: ab strength.
Pt position: hooklying, arms crossed over chest, crunch up and hold.
Procedure: as long as possible.
Sitting Rising Test - purpose, pt position, procedure
Purpose: MSK fitness, flexibility, and strength; predicts mortality.
Pt position: standing barefoot.
Procedure: “sit down on floor and get back up using as little support as you can. Don’t worry about how long it takes.”
Sitting Rising Test scoring
Max 10 points (5 for getting down, 5 for getting up).
Lose 1 point for any point of contact.
Points of contact may include: hand on floor, hand on knee, knee on floor.
