MSK Objective Assessment Flashcards
What makes up a routine assessment?
Observation Palpation Effusion Active ROM Passive ROM Resisted testing Accessory movement Ligaments Functional tests
What are you observing during the objective assessment?
Alignment
Atrophy
Colour
Deformity
What are you feeling for during active ROM?
Quality Range Pain response (when and where) Occurrence of muscle spasm Any resistance to movement
What movements are you testing during active ROM?
Flexion Extension Abduction Adduction Medial rotation Lateral rotation
What does AROM test for?
Muscle and tendon
Inert tissue
Load
What is a passive ROM?
A test of inert and non-contractile structures
What should you be looking for when performing PROM?
Limit to movement
Pain response
ROM achieved
Any other symptoms produced
What is normal end feel?
Soft - soft tissue approximation
Hard - bony approximation
Spongey - inflamed or effusive joint
Soft with a hard end feel - capsular, ligament or muscle stretch
What are abnormal end feels?
Bone to bone Muscle spasm Capsular/elastic Empty (can’t get an end feel) Springy block
What is effusion testing?
Tap test - tap the patella and find soft end feel, indicative of swelling
Sweep test - sweep fro, inferior medial to superior and then laterally, observe medial aspect of knee or palpate to for fluid
What does resisted muscle testing test for?
Contractile tissues
What does a strong and painful resisted muscle test result mean?
Tendinitis
What does a strong and painless resisted muscle test result mean?
Normal
What does a weak and painless muscle test result show?
Muscle rupture
What does a weak and painful resisted muscle test show?
Fracture
What does it show when a resisted muscle test is painful on repetition?
Intermittent claudication
What does it mean when all movements are painful in a muscle resisted test?
Affective disorder
What are special tests used for during an objective assessment?
To determine which disease, condition or injury is present
What procedure do you use for a soft tissue injury?
POLICE
What does POLICE stand for?
Protection Optimal Loading Ice Compression Elevation
What is the process of mechanotherapy?
Loading of tissue Stimulated cellular response Tissue adapts Tissues improves structure Tissue able to maintain homeostasis = less pain
How can you assess ligaments?
Accessory tests
What are the soft tissue treatment techniques?
Specific soft tissue mobilisations (SSTM) Deep transverse frictions Muscle lengthening Trigger point Exercise
How can SSTM help injuries?
Pain relief
Collagen remodelling and ground substances
Affects visco-elastic properties
What is physiological SSTM?
Self stretch
Therapist stretch
Engage barrier
Oscillate using maitland grading or static holds
What are accessory SSTM techniques?
Direct pressure
Bowing
Transverse mobilisations
What are combined SSTM techniques?
Deep transverse friction massage
How does deep transverse friction massage work (DTFM)?
Breaks down adhesions
Increases blood supply
Activates cells in the area
Helps re-orientate fibres
What are the contra-indications and precautions for DTFM’s?
Open wounds Clotting disorders DVT Acute inflammation Skin infections Acute inflammation Growth plates Skin disorders Possible cancer Rheumatoid arthritis Bursitis
What are graded mobilisations determined by?
SIN factor
Position in the range
Amplitude
Relationship to resistance and pain
What are the grades for mobilisations>
Grade I - small and fast Grade II - large sand slow RESISTANCE Grade III - large and slow Grade IV - small and fast
What are the effects of immobilisation?
Loss of function Decreased ROM Muscle atrophy Soft tissue length changes Cartilage changes Bony changes Pain states
What are the types of joint motion?
Osteokinematic
Arthrokinematic
What is Osteokinematic joint motion?
Movement of the bones
What is arthrokinematic joint motion?
Motion between joint surfaces
What is closed pack position?
Position in which the joint ligaments and capsule are maximally taught
What are the benefits for joint mobilisations?
Restoration of movement to a joint
Specific to joint
What are the effects of joint mobilisations?
Improving ranges of active, passive and accessory joint movements
Increasing length of joint joint soft tissue structures
Increasing length of joint surrounding soft tissue structures
Relief of pain
Decrease muscle spasm
Placebo effect
What are the benefits of exercise?
Reduced stress Increased balance and coordination Decreased body fat Decreased osteoporosis Relaxation Increase muscle tone, flexibly and posture Increased cardiorespiratory function Increased well-being and confidence
What are the principles of strength training?
Overload Specificity Motivation Learning Reversibility Diminishing returns Age Gender
What are some of the goals for active assisted exercise?
Maintain physiological elasticity and contractility of the participating muscles
Provide sensory feedback for the contracting muscles
Increase circulation
Develop coordination and motor skills for functions activities
What are the principles of application for active assisted exercise?
Examination, evaluation and treatment planning Communication Remove restrictive clothing Clear the work space Starting position of the patient Your position Demonstrate with passive movement first
What are the types of active assisted exercise?
Manual active assisted exercise
Auto-assisted exercise
Mechano- assisted exercise (poles, slippy boards, gym balls, wall, hoops, stationary bikes)
