General tips

Question 1

Why do we test normal side first

Answer 1

Establishes a baseline and gives patient idea of what to expect on painful side

Question 2

If AROM is normal, what can we do?

Answer 2

Apply overpressure to determine end feel

Question 3

What does PROM do?

Answer 3

used to determine available anatomic ROM. Can be used to determine if patient has normal, hypomobile or hypermobile joints. Also used to assess end feel

Also used to determine if pain or restriction is the main problem, which then guides treatment
- Pain is problem - more gentle treatment
- Restriction is problem - more vigorous treatment

Question 4

AROM/PROM Formula

Answer 4

• Explanation of AROM/PROM
  o Active ROM is what is achieved by the individual and Passive ROM is ROM achieved when I move joint for patient
  o We test these to determine if there is any limitation in joint mobility.
• AROM first
• Patient testing position
• Goniometer alignment – fulcrum, stabilising and measuring arm
• Stabilisation
• Normative values
• Patient reading, Both sides, noting down p1 and p2
• PROM
• Same position, goni alignment
• Testing for normal/hyper/hypo mobility and also end feel. Expected end feel is…
• Used to differentiate between contractile and non-contractile injuries. PROM vs AROM  PROM > AROM then contractile. PROM = AROM then non-contractile

Question 5

Main things to remember for AROM/PROM

Answer 5

p1 and p2
test both sides
test unaffected side first
write down findings
reference values

For PROM
- contractile vs non-contractile
- end feel

Question 6

Main things to remember for MMT/IMT

Answer 6

o Test/compare both sides
o Test unaffected side first
o Ask for pain during movement
o Start with grade 3, then progress to grade 4 and 5.

Question 7

Main things to remember for special tests

Answer 7

o Test both sides
o Explain to patient the purpose of the test and how it will be performed
o Patient needs to be relaxed
o Ask patient for any pain or discomfort during test
o Explain results of test and how they relate to the case

Question 8

Special test formula

Answer 8

• Explain purpose of test
• Explain procedure for test – patient position, stabiliser hand, motivator hand and procedure
• Ensure patient is relaxed and ask patient for pain during test
• Explain results of tests and how they relate to test
• Mention specificity/sensitivity and what this means

Question 9

What is one way we could extend an MMT/IMT

Answer 9

use a dynamometer if they score a grade 5 so we can quantify their strength better and also gives us a good outcome measure

Question 10

MMT tips

Answer 10

• start with grade 3 then progress to grade 4/5 if pain free. Can progress to dyno if grade 5 is painless
• ask patient to relax between movements
• good jargon free and clear cues. ‘push against my hand’ / ‘don’t let me push you down’

Question 11

descriptions of pain

Answer 11

• 0 - 10
• where is the pain
• does that replicate the pain when you’re… (swimming, ADL, etc)