Lab 1: Tone assessment

Question 1

This is how the modified ashworth (for spasiticity) is scored

Question 2

This is how muscle tone is scored

Answer 2

This is the reason we test muscle tone

Question 3

Rigidity:
* velocity independent (unlike tone / spasticity)
* typically both agonist and antagonist are impacted here
* No point in testing w/ velocity, maybe just take them through the movement (unlike modified ashworth)
* Cogwheel / Lead Pipe

Answer 3

Question 4

Question 5

When testing muscles w/ modified ashworth start in fully shortened position and move to lenghened position to see what that muscle does as it stretches
* EX: Elbow flexion: Start in full flexion –> extension to see if it tenses up when lengthening it
* velocity dependent (speed matters
* 3 total tests, 2 w/ speed, 1 to assess ROM

NOTE: Every movement in modified ashworth is done in supine

Remember, on these tests were going through the avilable range and not trying to push into ROM they don’t have
* This is not a muscle length test

Question 6

Mofidied ashworth scoring I took better notes in the lecture slides

Question 7

Explain how to test shoulder Abduction

Answer 7

Shoulder starts in abduction –> adduction to stretch the abductors
* forearm in neutral (should natrally be there)

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 8

Explain how to test shoulder Adduction

Answer 8

Shoulder starts in adduction –> abduction
* forearm in neutral (should natrally be there)

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 9

Explain how to test shoulder flexion

Answer 9

Start w/ pt in shoulder flexion –> extension
* forearm neutral

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 10

Explain how to test shoulder extension

Answer 10

Start in shoulder extension –> flexion
* forearm neutral

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 11

Explain how to test elbow flexion

Answer 11

Start in elbow flexion –> extension
* forearm in neutral

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 12

Explain how to test elbow extension

Answer 12

Start in elbow extension –> flexion
* forearm in neutral

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 13

Explain how to test wrist flexion

Answer 13

Start w/ pt in wrist flexion –> extension
* Forearm in pronation
* never going toward table w/ movement

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 14

Explain how to do wrist extension

Answer 14

start w/ pt in flexion –> extension
* forearm in supination

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 15

Question 16

Question 17

explain how to test hip flexion

Answer 17

Start w/ hip flexed and knee bent
* straighten the entire leg out
* However, make sure to keep hand just distal to knee (under gastroc area) to avoid the popliteral fossa slapping down on the table

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 18

Explain how to test hip extension

Answer 18

start w/ leg in extension and knee in extension –> hip and knee flexion
* essentially the opposite of the way it was performed in hip flexion

Question 19

For the LE test the flexors before the extensors

Question 20

Question 21

Explain how to test knee extension (quads)

Answer 21

Start w/ hip ~90 degrees of flexion and full knee extension –> full knee flexion
* Note you can decrease that hip angle from the table to get more full knee extension
* The starting position is essnetially that SLR position

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 22

Explain how to test knee flexion (hamstrings)

Answer 22

Start w/ hip and knee in 90 degrees of flexion –> full knee extension
* this will test the length of those hamstring muscles (knee flexors)
* Note your hip doesnt have to be exactly 90 degrees
* you should end near that SLR position

1 trial (4 seconds long) slow to test ROM
2 trials (1 second long) fast

Question 23

Question 24

NOTE: a lot of these postions are libal to bring on clonus > 5 beats
* just take them out of that stretched position to fix it