Muscle assessment Flashcards
Which areas are assessed in a muscle assessment?
- bulk
- length
- power
- strength
Why is muscle length assessed?
tight muscles are more likely to be injured
Can lead to imbalanced and altered biomechanics
Muscle length can determine loss in strength
Why is strength/power assessed?
strength provides stability and mobility for functional movement
How are subjective assessments of muscles conducted?
with tape measures, measuring muscle size
Negatives of subjective muscle assessment (tape measure)
- can underestimate muscle loss by 22-33%
- little differentiation between anatomical structures such as muscles, bones, subcutaneous fat and peri muscular fascia
How are objective assessments of muscles conducted?
- dynamometers
- force platforms
How do force platforms assess muscles?
Assess dynamic strength and can measure peak force, leg power and jump height
Strengths of objective muscle assessments
- high sensitivity
- produce normative data
- reliable
- valid
- consistant
What are some physiological considerations for muscle strength?
- muscle fibre type
- neural factors
- connective tissue integrity
- age
Which factors influence muscle strength?
- contractions
- muscle architecture
- cross-sectional area
-mechanical properties - motor unit recruitment
- neuromuscular inhibition
- speed of contraction
What is muscle strength and function predictive of?
- QoL
- mortality
- length of hospital stays
- hospital readmission
What is muscle strength and function impaired by?
- injury
- infection
- major surgery
- medical conditions
- muscle control
What are some correlates of muscle strength?
- age
- sex
- muscle fat ratio
- muscle size
- cross-sectional area
- pennation angle
- mechanical properties
- physical activity
- co-morbidity
- medication
Which diseases are associated with muscle function?
Osteoarthritis, DM, CV disease
What is an isometric muscle contraction?
a contraction with no change in muscle length, static resistance
What is eccentric muscle contraction?
contraction where the muscles lengthens with movement
What is concentric muscle contraction?
contraction where muscle shortens with movement
What are strength and length assessment outcomes limited by?
- Pain
- Fatigue
- ROM
- Mechanical properties
- Emotions – mental health
- Occupation
- Hobbies
- Age and maternity
- Handedness
- Physical activity levels
Contraindications of muscle assessments
- Unhealed fracture
- Dislocation or unstable joint
- Situations where active range of motion or resistance work are contraindicated (e.g. post- operative protocols etc)
- If pain limits participation
- Severe inflammation
- Severe osteoporosis
- Haemophilia
- Cognitive concerns / decreased ability to complete the test
Cautions of muscle assessments
- Abdominal Surgery or Hernia
- Bony Ankylosis
- Haematoma
- Cardiovascular disease
- Pulmonary Disease
- Prolonged Immobilisation
- Cases where fatigue may be harmful or exacerbate the person’s condition (e.g. lower motor neuron disease, COPD, multiple sclerosis).
What is manual muscle testing used for?
To determine the extent and degree of muscle weakness resulting from disease, injury and disuse
Manual muscle testing scales
- MRC scale/oxford scale
- Kendall muscle testing scale
- Daniels and Worthingmans manual muscle testing scale
What are the limitations of the Oxford grading system?
- non-linear
- patient is variable over time due to things such as fatigue
- only assesses concentric contraction
- inter-rater reliability
- difficult to apply to all patients
- strength rarely assessed throughout full ROM
What is the Oxford grading system of muscle strength testing?
0- no contraction
1- flicker or trace of contraction
2- full range of active motion with gravity minimised
3- full range of active motion against gravity
4- full range of active motion against gravity with minimal resistance
5-full range of active motion against gravity with maximal resistance
