F&A II Ch 8 Assessment of Muscle Strength Flashcards
What is the role of the OTA ?
- Service competency
- State regulations
- Facility policy
- data collection
- measurement for muscle testing
- basic gross muscle testing of the UE.
What must OT link strength to?
Performance
Name the general purposes of muscle strength measurement.
- Used for assessment for various conditions
- Establish a baseline for tx
- Assess its effect on occupational performance
- Prevent deformities
- Determine the need for assistive devices
- Evaluate tx
What are the methods of evaluation?
- Testing individual muscles
- Assessing groups performing a specific function
- Observing the performance of activity
- Using the functional muscle test for screening
- Relationship between joint ROM & muscle testing
Name the relationship between joint ROM & muscle testing.
- Strength of the muscle to move the joint through the available ROM
- Strength of the muscle to hold the joint against resistance
What is the purpose of manual muscle testing?
Used to measure maximal contraction
What are the limitations of manual muscle testing?
- Cannot measure muscle endurance, coordination, or performance capabilities
- Cannot be used when spasticity is present
How does the OTP prepare for manual muscle testing?
Visual check of muscle & observation of quality of movement during ROM
How does the OTP position for manual muscle testing?
Comfortable on a firm surface
Name the 2 factors for influencing muscle function.
- Gravity
- Substitution
For muscle grades, who determines the resistance to be assigned?
Examiner
What Pt factors must be considered when determining muscle grade?
- Age, gender, occupation
- Pain, swelling, spasm
- Psychological factors
What is the muscle grade for no contraction?
0, zero
What is the muscle grade for contraction felt, no motion?
1, trace
What is the muscle grade for incomplete ROM, no gravity?
2-, poor minus
What is the muscle grade for complete ROM, no gravity?
2, poor
What is the muscle grade for incomplete ROM against gravity or complete ROM against slight resistance?
2+, poor plus
What is the muscle grade for incomplete ROM (>50%) against gravity?
3-, fair minus
What is the muscle grade for complete ROM against gravity?
3, fair
What is the muscle grade for complete ROM against gravity with slight resistance?
3+, fair plus
What is the muscle grade for complete ROM against gravity with moderate resistance?
4, good
What is the muscle grade for complete ROM against gravity with full resistance?
5, normal
What are the steps for manual muscle testing?
1- Position, 2- Stabilize, 3- Palpate, 4- Observe
5- Apply resistance at the end of ROM
6- Grade, 7- Assess general strength
The manual muscle testing is performed with or without gravity?
If possible, the test is performed against gravity
When is resistance applied to the extremity during manual muscle testing?
Subject completes full motion before resistance is applied at the end of ROM
The product of strength, endurance, and coordination is…
Muscle function.
Mention some consequences of muscle weakness…
The restriction of performance in self-care, vocational, leisure, and social activities.
List the purposes for evaluating muscle strength…
- Determine amount of muscle power available to establish a baseline of treatment.
- Assess limitation performance of occupation.
- Prevent deformities.
- Determine the need of assistive devices.
- Aid in selecting appropriate activities.
- Evaluate effectiveness of treatment.
What are essential factors that provide validity to a muscle test?
Correct positioning, careful stabilization, muscle palpation, and observation of movement.
What gravity provides to the muscle power?
Resistance
For testing purposes, what does the term gravity eliminated mean?
The reduction of resistance to muscle power by eliminating the effect of gravity.
What are the factors that influence muscle function?
Gravity and substitution.
Define the term substitution…
A muscle or group of muscles may attempt to compensate for the function of a weaker muscle to accomplish the desired movement.
Even though the definition of muscle grades are standard, the assignment of muscle grades during a manual muscle test depends on…
The examiner’s clinical judgement, knowledge, and experience
What is the purpose of using plus and minus designations with muscle grades?
To “fine-grade”the muscle strength grades.
Define muscle coordination
Harmonious functioning of muscles or group of muscles in the execution of movements.
Define hypertrophy
Enlargement of an organ or a tissue as result of increase in the size of cells.
Define atrophy
A wasting or decrease in size of a body organ, tissue, or part due to disease, injury, or lack of use.
When performing joint ROM evaluation, when is Pt pain assessed?
Beginning, during, & end of session
What is end-feel?
The characteristic feeling of resistance to motion experienced by therapists as they passively take a joint to its end range.
What is soft normal end-feel?
The range is limited by soft tissue compression. Ex: elbow flexion (the forearm pressing against the bulk of the bicep)
What is firm normal end-feel?
Hip flexion with knee straight
Ex: (passive elastic tension of hamstring muscles)
What is hard normal end-feel?
Elbow extension
Ex: (contact between olecranon process of ulna & olecranon fossa of humerus)
When will MMT not be performed?
Pt has spasticity
What is soft abnormal end-feel?
Occurs sooner in the ROM than is typical, or in a joint that normally has a firm or hard end-feel.
Name 2 examples of soft abnormal end-feel.
- Soft tissue edema
- Synovitis
What is firm abnormal end-feel?
Occurs sooner in the ROM than is typical, or in a joint that normally has a soft or hard end-feel.
Name 2 examples of firm abnormal end-feel.
- Increased muscular tone
- Capsular or soft tissue shortening
What is hard abnormal end-feel?
Occurs sooner in the ROM than is typical or in a joint that normally has a soft or firm end-feel. A bony grating or bony block is felt.
Name 3 examples of hard abnormal end-feel.
- Chondromalacia
- Osteoarthritis
- Loose bodies in joint
What is empty end-feel?
No end-feel is reached because pain or other symptoms limit the ROM before resistance is felt.
Name 3 examples of empty end-feel.
- Acute joint inflammation
- Bursitis
- Psychogenic disorders
