Goniometry & Manual Muscle Testing

Question 1

what is the difference between screen exam ROM and regional exam ROM?

Answer 1

Screen ROM tests active and active with over pressure
Regional can tests AROM, AROM TPO and PROM

Question 2

what is the difference in muscle performance testing between a screen exam and regional exam?

Answer 2

Screen exam uses isometric break test
Regional Exam uses MMT or FTPO

Question 3

What are the main points to include when obtaining consent?

Answer 3

-explanation of what you are doing
-show the tool
-point to the area and explain what needs to be exposed
-explain & demonstrate testing position
-explain risk & benefits
-ask if any questions
-get the consent

Question 4

what is the basic documentation for goniometry?

Answer 4

-Right or Left
-Type of motion
-Direction of Motion
-Range of Motion
-Quality

Question 5

what are the key points for assessing AROM & AROM TPO?

Answer 5

-establish baseline
-how did that change symptoms?
-what degree did symptoms change?
-when in range did symptom occur?

Question 6

describe the key points for assessing PROM?

Answer 6

-establish baseline
-move slowly
-how does that change symptoms
-does the end feel normal for that joint
-did the end feel occur early in the range

Question 7

what are the causes of limitation in AROM and describe them?

Answer 7

-organic weakness (naturally weak)
-reflexive inhibition (brain will shut muscle off in protective way)
-abnormal motor recruitment (bad movement pattern; functional but not normal)
antagonist: guarding
synergists: substitution (compensation)
-passive motion restriction (tissue does not allow it)
-joint stability (unstable joint too much ROM; arthritic will not have enough ROM)

Question 8

what are the reason for PROM to not be full?

Answer 8

-passive insufficiency (only muscles that cross 2 joints, one joint will change position and that limits another)
-adaptive shortening (a period where tissues aren’t being used so tissue gets tight & loses muscle strength)
-intra-articular obstruction (something in joint & blocking motion)
-muscle guarding (pain & fear causes)

Question 9

what are some of the reasons that AROM < PROM?

Answer 9

-active muscle dysfunction
-tensile load intolerance
-patient reluctance

Question 10

what is some causes when AROM = PROM?

Answer 10

-passive insufficiency
-intra-articular obstruction
-muscle guarding or splinting
-adaptive shortening

Question 11

what does manual muscle testing do & when can it be used?

Answer 11

strength is the force/torque produced by a muscle during a maximum voluntary contraction
-only can be done if no pain was found

Question 12

what is the difference in muscle performance testing in a screen exam and regional exam?

Answer 12

Screen: resistive isometric testing
Regional: MMT, FTPO, & functional task testing

Question 13

what is the procedure for resisted isometric testing?

Answer 13

-test position in neutral joint
-joint kept still
-intruct patient to hold position and resist force
-record

Question 14

what is the procedure for resisted isometric force to pain onset?

Answer 14

-PT gradually increases force until onset of pain
Handheld dynamometer
Weights
TIme

Question 15

When performing MMT what does active resistance testing do?

Answer 15

determines ability of muscle to move against gravity and external force

Question 16

When doing basic grades of traditional MMT what grade is given if the amount of resistance that can be given to the muscle group against gravity?

Answer 16

Grades 4 or 5

Question 17

when performing conventional MMT what grade is given when the ability of muscle group to move part through complete against gravity or gravity eliminated?

Answer 17

Grades 3 or 2

Question 18

describe MMT +/- grading

Answer 18

+ is less than 1/2 range
- is greater than 50% but not full range

Question 19

what is the definition of osteokinematic motion?

Answer 19

large motion in frontal, sagital & transverse plane

Question 20

when documenting goniometry what needs to be included if documenting PROM?

Answer 20

end feel or if no pain say empty

Question 21

what is special about documenting goniometry in AROM?

Answer 21

intensity of symptoms and location in range

Question 22

Normally when a muscle is the tissue that is the issue what will be present in AROM & PROM in agonist and antagonist?

Answer 22

For agonist
PROM will not hurt & be full because the muscle is not contracting
AROM will be painful & limited
For antagonist
AROM will be limited b/c tension loading & painful
PROM still limited & painful

Question 23

what will likely be present with AROM & PROM if a ligament is the issue?

Answer 23

End range will be painful for both

Question 24

What will be present in PROM & AROM if a joint capsule is the issue?

Answer 24

Active & passive will be limited because there will be a road block