Eval 2 - MSK

Question 1

What are we mostly screening for? (3)

Answer 1

Kyphosis
Osteoporosis
Fractures

Question 2

Occiput to Wall - purpose, pt position, procedure, (+)

Answer 2

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.

Question 3

Rib-Pelvis Distance - purpose, pt position, procedure, (+)

Answer 3

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.

Question 4

Back Scratch Test- purpose, pt position, procedure, gender norms

Answer 4

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

Question 5

Chair Sit & Reach- purpose, pt position, procedure

Answer 5

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).

Question 6

Sock Test - purpose, pt position, procedure, (+)

Answer 6

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.

Question 7

Sock Test Scoring

Answer 7

0 = can reach toes, no difficulty.
1 = can reach toes, but difficult.
2 = can reach past malleoli, cannot reach toes.
3 = cannot reach malleoli.

Question 8

Osteoporosis precautions

Answer 8

No flexion
No extreme/loaded/end-range rotation
DO NOT DO: Chair Sit & Reach, Sock Test.

Question 9

Post Hip precautions

Answer 9

No 90deg flex
No add past mid
No IR

Question 10

Sternotomy precautions

Answer 10

No pushing or WB thru hands.
No OH reaching.
No reaching behind (shld ext).
No lift >10lb.
Keep prop under scapulae when lying supine.

Question 11

Grip Strength - pt position, procedure

Answer 11

Pt position: shoulder width apart, 90deg elbow, NOT on arm rest.
Procedure: “2” on dynamometer, max score of 3 trials, alternate hands each rep.

Question 12

30sec STS - purpose, pt position, procedure, MDC

Answer 12

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

Question 13

5x STS - purpose, pt position, procedure, cutoff scores, MDC

Answer 13

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

Question 14

How is the Modified 30sec STS different?

Answer 14

Using hands/arm rests.
MDC = 1

Question 15

Arm Curl Test - purpose, pt position, procedure

Answer 15

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.

Question 16

Timed Loaded Standing Test - purpose, pt position, procedure

Answer 16

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.

Question 17

Supine Hip Ext Test - purpose, pt position, procedure

Answer 17

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.

Question 18

Supine Hip Ext Test scoring

Answer 18

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.

Question 19

Bridge Test - purpose, pt position, procedure

Answer 19

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.

Question 20

Prone Extensor Test - purpose, pt position, procedure

Answer 20

Purpose: lumbar extension endurance.
Pt position: prone, pillow placed just above ASIS, arms at sides.
Procedure: lift sternum & hold as long as possible.

Question 21

Plank Test - purpose, pt position, procedure

Answer 21

Purpose: lumbar stabilization endurance (mostly flexors).
Pt position: low plank on elbows.
Procedure: as long as possible.

Question 22

Curl Up Test - purpose, pt position, procedure

Answer 22

Purpose: ab strength.
Pt position: hooklying, arms crossed over chest, crunch up and hold.
Procedure: as long as possible.

Question 23

Sitting Rising Test - purpose, pt position, procedure

Answer 23

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.”

Question 24

Sitting Rising Test scoring

Answer 24

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.