Lab Final Flashcards
Key Movement Patterns to know
Hip Extension Hip Abduction Trunk Flexion Shoulder Abduction Neck Flexion
KMP Guidelines
Expose the area to be examined
Inform of pain or discomfort during the movement
Give minimal cues to see the most natural movement
Observe from two directions to best identify results
Be able to give a possible muscle imbalance for the movement
KMP Hip Extension Procedure
Lie patient prone not the table with the low back exposed
Instruct patient to lift leg towards the ceiling (no more than 20-25 degrees)
Observe from side and head of the table
Hip extension common faults
Early hyperlordosis = Glut max inhibition, possible functional instability
Lateral or rotational deviation of pelvis or lumbar spine = glut max inhibition
Decreased extension = Inhibited glut max or tight hip flexors
Knee flexion = Tight/overactive hamstrings
Upper back/cervical contraction = Overactive upperback/cervical compensating for inhibited glut max
KMP Hip Abduction Procedure
Have patient lie side posture with bottom leg bent and lower back exposed
Instruct patient to lift leg towards the ceiling
Observe from behind the patient and at the head of the table
Hip Abduction common faults
Cephalad shift of the pelvis = Inhibited/weak glut med.; overactive or tight QL
Hip Flexion = Inhibited glut med; overactive/tight TFL, psoas
Hip extension = Inhibited or weak glut med; overactive/tight adductors
Pelvic rotation = Overactive/tight TFL
Trunk Flexion/curl-up Procedure
Patient is supine with neck in neutral, knees bent, and hands crossed over chest
Instruct patient to curl-up until shoulder blades come up off of the table
Observe from the heels (palpate?)
Observe from the side and palpate
Trunk Flexion/Curl-Up Common Faults
Back is straight, Pelvis tilts anteriorly = inhibited/weak bdominal muscles; overactive/tight psoas
Decreased heel pressure = Inhibited/weak abdominal muscles; overactive/tight psoas
chin protrusion = Inhibited/weak abdominal muscles; overactive/tight SCM
Shaking = Inhibited/weak abdominal muscles; overactive/tight adductors
Shoulder Abduction Procedure
Patient is sitting or standing With back exposed and elbows bent to the side
With elbows bent instruct patient to abduct to 100 degrees
Observe from behind the patient
Shoulder Abduction Common Faults
Elevation of shoulder/scapula during first 60 degrees of abduction = inhibited/weak middle and lower trapezius and levator scapula
Winging of inferior angle = inhibited/weak serratus anterior; overactive/tight pec major and minor
Contralateral flexion of the trunk = inhibited/weak shoulder abductors; overactive/tight QL
Head Neck Flexion procedure
Patient is supine with head in a neutral position and neck exposed
Instruct patient to bring their chin to their chest
Observe from the side and the head of the table
Head/Neck Flexion Common Faults
Chin protrusion = Inhibited/weak neck flexors; overactive/tight SCM, scalene, or suboccipital
Chin Deviation = inhibited/weak deep neck flexors; overactive/tight unilateral SCM, scalene, or suboccipital
Shaking = general weakness of deep neck flexors
Tracks to know
Bridge Dead bug Quadruped Side lying Side bride
What to cue patient on for tracks
Neutral pelvis
Abdominal bracing
Breathing
General guidelines for Tracks
Keep hands on patients back and belly to monitor the pelvis and bracing
Take patient step by step through the track
When they lose form the step is too hard for them
The step prior is then their homework
Give specific sets, reps, and frequency
Tell them to stop if they shake, lose form or aggravate pain
Muscle to know for trigger point technique
Temporalis Upper Trapezius Pectoralis Major Infraspinatus Gastrocnemius Piriformis Wrist extensors
Criteria for diagnosis of a Trigger Point
Presence of a tender nodule within a tight band
recreates a familiar sensation or pain
Muscle is shortened and tight and is painful to the touch
Other findings with trigger point
Pain or sensation may refer in a typical way
Patient may jump
Local twitch response is seen/felt within a disturbed muscle
Muscle may be weak or inhibited
General guidelines for Trigger Points
Treat superficial, then deep Treat proximal to distal Treat medial prior to lateral No more than 5 active points a session Direct pressure is contraindicated acute injury
Trigger point palpation guidelines
Cross fiber palpation or “flick” to identify taut band
Pincer or finger pad along the band towards the center to identify the trigger point
Check near attachment to identify satellite trigger points
Pressure can be increased as tissue begins to release and symptoms decrease
NIMMO
Muscle is relaxed
Apply pressure for 3-7 seconds, then release
Repeat until improved or 5 minutes has passed
Travell
Muscle is in a stretched position
Apply pressure for 10-60 seconds with up to 20% pressure
Repeat until improved or 5 minutes has passed
Follow with a moist hot pack
The patient performs an active stretch after treatment
Pin and Stretch: Muscles to know
Upper trap Levator scapulae Pec major Serratus anterior Temporalis Masseter Biceps Brachii Gastrocnemius Piriformis Psoas Major Iliacus
Pin and stretch general guidelines
Start with the muscle in a shortened position
Using the thumb or digit pin down the muscle near the origin
Take a tissue pull AWAY from the joint that will be moved
Lengthen muscle while maintaining pressure and tissue pull through the thumb and digit
Can also strip along muscle belly length while lengthening muscle
Muscle Energy Technique: Muscles to know
Upper trapezius Levator Scapulae Scalenes (Anterior, Middle, Posterior) Subscapularis Pectoralis major Iliopsoas Hamstrings
Muscle Energy Technique: General Guidelines
Find the first barrier of resistance (lengthen muscle) before start of contraction
20% isometric contraction for 6-10 seconds
(Post Isometric Contraction - agonist contracts; Reciprocal Inhibition - antagonist contracts; CRAC - both a PIR and RI need to be performed)
After complete relaxation (up to 5 seconds of rest), move muscle to the new barrier and hold for 30 seconds (do not allow muscle to shorten between rounds)
Repeat 3-5 times
