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DOPS: Assessment > Muscle Length Testing > Flashcards

Muscle Length Testing Flashcards

1
Q

What is the purpose of the technique i.e. what are you measuring and why?

A

Identify changes in muscle extensibility that may be contribute
to movement impairment and/or symptoms.

Assesses the resistance to passive movement

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2
Q

How do you know whether the measurement is normal?

A

Normal quality of movement (including resistance).
The ROM (i.e. normal/short/extended length).
The muscular end-feel.
Reproduction or change to symptoms through range.

This can be a comparison to contralateral side where appropriate, or what is considered normal

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3
Q

What principles are used in carrying out (application) the technique?

A

1) Patient comfortable, explain procedure, informed consent
2) Identify muscle
3) Firmly stabilize one end (usually the origin).
4) Slowly elongate the muscle.
5) Ensure maximal lengthening of the muscle from origin to insertion.
6) Assess the end feel.
7) Adverse affects?

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4
Q

What structures/processes are being assessed?

A

Soft tissue, muscle & tendons

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5
Q

Precautions / contraindications

A

Bony limit to movement
Recent fracture
Acute inflammation/ tissue trauma
Acute pain with movement
Non-compliant patient or unable to give consent
Shortened tissues are compensatory
e.g. to neural mechanosensitivity

Do you have any known injuries to this muscle?
Have you recently suffered a fracture in this area?
Do you have any muscle conditions?

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6
Q

How would you document this?

A

Date, Time, Patient name
Explanation of procedure & gaining informed consent
Muscle being tested
Describe movement quality, RoM, End feel compared to other limb
Any reproduction of symptoms / adverse effects
Sign

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7
Q

Iliospoas normal range

A

0° hip extension, 10° with overpressure

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8
Q

Rectus femoris normal range

A

90° knee extension, 125° with overpressure

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9
Q

Tensor Fascia Lata normal range

A

0° hip abduction (neutral), 15°-20° with overpressure

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10
Q

Adductors normal range

A

0° hip abduction (neutral), 20°-25° with overpressure in the modified Thomas test position
45° hip abduction in supine position

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11
Q

Hamstrings normal range

A

80° hip flexion with contralateral leg extended
90° hip flexion with contralateral leg flexed

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12
Q

Quadratus Lumborum end feel

A

Thoracolumbar curve should be smooth and gradual

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13
Q

Piriformis end feel

A

Gradual soft end feel

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14
Q

Upper traps end feel

A

Gradual soft end feel

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15
Q

Levatator scapulae end feel

A

Gradual soft end feel

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16
Q

Sternocleidomastoid end feel

A

Gradual soft end feel

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17
Q

Sternal lower fibres pec major normal range

A

Sternal portion (lower fibres): with shoulder abducted at 150°, arm should be horizontal to table and 15°-20° with overpressure

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18
Q

Sternal mid fibres pac major normal range

A

Sternal portion (mid-fibres): with shoulder abducted to 90°, arm should be horizontal
to table and 30° with overpressure

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19
Q

Clavicular pec major normal range

A

Clavicular portion: with shoulder abducted to 60°, arm should hang freely over table

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20
Q

Adductors - Patient position

A

Supine
Contralateral leg hangs off the side of the plinth
Tested leg extended and placed on the plinth

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21
Q

Adductors - movement

A

Slowly and progressively produces hip abduction with knee extended
Trick movement: Lateral rotation of the hip

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22
Q

Adductors - measurement

A

Stationary arm: Contralateral ASIS
Axis: Ipsilateral ASIS.
Moving arm: Middle of thigh towards mid-point of patella

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23
Q

Tensor Fasciae latae and Iliotibial band
(Obers test) - Patient position

A

Side-lying, with supporting hip and knee flexed to 90 degrees to stabilize pelvis

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24
Q

Tensor Fasciae latae and Iliotibial band
(Obers test) - movement

A

1) One hand on ipsilateral pelvis to stabilize it and maintain neutral pelvic alignment.
2) Other hand passively abducts hip and extend patient’s hip on upper side in line with trunk, thereby, bringing tensor fasciae latae
over greater trochanter.
3) relax muscles of the lower extremity while allowing uppermost limb to drop into adduction toward table through available ROM.
4) Prevent flexion and internal rotation of hip as the limb drops toward the table

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25
Q

Tensor Fasciae latae and Iliotibial band
(Obers test) - measurement

A

Positive for tight tensor fasciae latae and
iliotibial band if relaxed hip remains abducted and does not fall below horizontal.
Negative for tight tensor fasciae latae and iliotibial band if the relaxed and extended hip falls below horizontal.

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26
Q

Rectus Femoris and Illiopsoas (Thomas
Test) - patient position

A

Supine
hip to be measured extended.
Buttock should be toward edge of supporting
surface
knees extend just past the edge

Patient stands at edge of plinth with non-measured thigh to their chest and lie backwards, letting other leg hang off

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27
Q

Rectus Femoris and Illiopsoas (Thomas
Test) - movement

A

Flex contralateral hip by bringing knee toward chest into full flexion.
The contralateral hip should be flexed only enough to flatten lumbar spine against supporting surface.

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28
Q

Rectus Femoris (Thomas Test) - measurement

A

Stationary arm: Greater trochanter of femur.
Axis: Lateral epicondyle of femur.
Moving arm: Lateral malleolus
If length of rectus femoris is within normal limits, then the knee remains at 90 degrees of flexion.

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29
Q

Illiopsoas (Thomas Test) - measurement

A

Stationary arm: Lateral midline of trunk.
Axis Greater trochanter of femur.
Moving arm: Lateral epicondyle of femur
If length of iliopsoas is within normal limits, thigh remains on examining table

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30
Q

Gastrocnemius - Patient position

A

Supine
Knee extended

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31
Q

Gastrocnemius - movement

A

Dorsiflex patient’s ankle through full available ROM while maintaining knee in full extension.

32
Q

Soleus - patient position

A

Supine, with hip and knee flexed.
Opposite leg straight with knee fully extended

33
Q

Soleus - movement

A

dorsiflex patient’s ankle through full available ROM while maintaining hip and knee in 45 degrees of flexion

34
Q

Gastrocnemius and Soleus - measurement

A

Stationary arm: Head of fibula.
Axis: Lateral malleolus.
Moving arm: Parallel to fifth metatarsal

35
Q

Piriformis (FAIR test) - patient position

A

Upper back flat on plinth, hips twisted
Affected side faces up, the hip flexed to an angle of 60 degrees, and the knee flexed to an angle of 60-90 degrees.

36
Q

Piriformis (FAIR test) - movement

A

stabilize the hip
internally rotate and adduct the hip by applying downward pressure to the knee.
Flexion Adduction Internal Rotation (FAIR)

37
Q

Piriformis (FAIR test) - measurement

A

look for subjective tightness, and decreased RoM compared to the contralateral side

38
Q

Hamstrings - Patient position

A

Supine
Hip & knee extended

39
Q

Hamstrings - movement

A

flex patient’s hip through full ROM - keep knee fully extended.
One hand is placed over anterior thigh to ensure knee is maintained in full extension
Hip is flexed until firm muscular resistance to further motion is felt

40
Q

Hamstrings - measurement

A

Stationary arm: Lateral midline of trunk.
Axis: Greater trochanter of femur.
Moving arm: Lateral epicondyle of femur

41
Q

Triceps - patient position

A

Sitting
Shoulder fully flexed
Elbow extended
Forearm supinated

42
Q

Triceps - movement

A

flex elbow through ROM - keep flexion of
shoulder.
This passive movement allows an estimate of ROM available and demonstrates to patient exact motion required

43
Q

Triceps - measurement

A

Stationary arm: Lateral midline of humerus toward humeral head.
Axis: Lateral epicondyle of humerus.
Moving arm: Lateral midline of radius toward radial styloid

44
Q

Pec minor - patient position

A

Supine
arms at side
shoulders laterally rotated;
forearm supinated (palms up)
lumbar spine should be flat against supporting surface

45
Q

Pec minor - movement

A

Relaxes shoulder muscles, allowing the posterior border of the acromion process to move toward plinth.
Over-pressure can be added to the coracoid process

46
Q

Pec minor - measurement

A

Palpate posterior acromial border. Using tape measure, measure between posterior border of acromion process and plinth

Or

Use a tape measure to measure the distance between the medial-inferior angle of the
coracoid process and just lateral to the sternocostal junction of the inferior aspect of the fourth rib (1 finger width lateral to the
sternum).

47
Q

Biceps brachii - patient position

A

Supine
Shoulder at edge of plinth
Elbow extended
Forearm pronated

48
Q

Biceps brachii - movement

A

Maintain elbow extension
Perform passive, or have patient perform active, extension of the shoulder

49
Q

Biceps brachii - measurement

A

Stationary arm: Lateral midline of thorax.
Axis: Lateral midline of humerus toward lateral aspect of acromion process.
Moving arm: Lateral epicondyle of humerus

50
Q

Wrist extensors - patient position

A

Supine
Shoulder abducted 70 to 90 degrees
Elbow extended
Forearm pronated
Fingers flexed

51
Q

Wrist extensors - movement

A

flex patient’s wrist through ROM - keep elbow extension & fingers in flexion
This passive movement allows an estimate of ROM available and demonstrates to patient .
Maintaining elbow in extension and fingers in flexion have patient perform active, flexion of the wrist

52
Q

Wrist extensors - measurement

A

Stationary arm: Lateral epicondyle of humerus.
Axis: Lunate.
Moving arm: Dorsal midline of 3rd metacarpa

53
Q

Pec major - patient position

A

Supine
Shoulder laterally rotated and abducted to 90
degrees
Elbow fully extended
Forearm supinated
Lumbar spine flat

54
Q

Pec major - movement

A

Maintain shoulder lateral rotation and
90 degrees of abduction, extension of elbow and supination of forearm
patient to relax all shoulder muscles, allowing shoulder to move into maximal horizontal abduction.
Ensure that patient maintains flat lumbar spine & no trunk rotation (especially to side of extremity being measured)

55
Q

Pec major - measurement

A

Using tape measure, measure between lateral epicondyle of humerus and support surface

56
Q

Flexor Digitorum superficialis - patient position

A

Supine
Shoulder abducted 70 to 90 degrees
Elbow extended
Forearm supinated
Fingers extended

57
Q

Flexor Digitorum superficialis - movement

A

Extend wrist through ROM - keep elbow and fingers in extension.
This passive movement allows an estimate of ROM available and demonstrates to patient exact motion required.

Maintaining elbow and fingers in full have patient perform active extension of the wrist

58
Q

Flexor Digitorum superficialis - measurement

A

Stationary arm: Insertion of biceps muscle.
Axis: Lunate (palmar surface).
Moving arm: Palmar midline of 3rd metacarpal

59
Q

Latissimus Dorsi - patient position

A

Crook lying (supine with knees bent) with posterior pelvic tilt (to ensure neutral lumbar
lordosis),
Arms at side with elbows extended;
lumbar spine flat on plinth

60
Q

Latissimus Dorsi - movement

A

Flex shoulder through ROM - keeping arms close to head & full elbow extension;
lumbar spine should remain flat
This passive movement allows an estimate of ROM available and demonstrates to patient exact motion required.
Patient performs actively

61
Q

Latissimus Dorsi - measurement

A

Using tape measure, measure distance between lateral epicondyle of humerus and plinth

62
Q

SCM - patient position

A

Supine, shoulders just beyond end of plinth.
Support patient head

63
Q

SCM - movement

A

Extend middle and lower cervical spine, Contralateral side flexion
Ipsilateral rotation.
Upper cervical flexion

64
Q

SCM - measurement

A

Compare to other side

65
Q

Upper fibre traps - patient position

A

Supine, head slightly over end of plinth.
Support patient head.

66
Q

Upper fibre traps - Movement

A

Depress the scapula
Flexes the cervical spine,
Contralateral lateral flexion
Ipsilateral rotation.

67
Q

Upper traps - measurement

A

A tape measure is used to measure the distance between mastoid process and acromioclavicular
joint when the upper trapezius muscle is fully lengthened. (second person needed)
Compare to other side

68
Q

Levitator scapulae - patient position

A

Supine, head slightly over end of plinth
Support patient head

69
Q

Levitator scapulae - movement

A

Depresses the scapula
Flexes the cervical spine,
Contralateral lateral flexion
Contralateral rotation.

70
Q

Levitator scapulae - Measurement

A

Compare to other side

71
Q

Scalenes - patient position

A

Supine, head slightly over end of plinth
Support patient head

72
Q

Anterior Scalene - movement

A

Stabilise 1st rib
Extend the head
Contralateral side flexion until the stretch sensation or resistance is felt,
Ipsilateral rotation

73
Q

Middle scalene - movement

A

Stabilise first rib
Contralateral side flexion

74
Q

Posterior scalene - movement

A

Stabilise second rib
Contralateral rotation
Ipsilateral side flexion

75
Q

Anterior scalene - measurement

A

Tape measure
Mastoid process to the acromioclavicular joint

76
Q

Middle scalene - measurement

A

Tape measure
Earlobe to the acromioclavicular joint

77
Q

Posterior scalene - measurement

A

Tape measure
Middle of the chin to the acromioclavicular joint

DOPS: Assessment (22 decks)

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