muscle length tests Flashcards
why do muscle length tests assess?
- flexibility and extensibility of muscles which cross a joint
what do muscle length tests help to identify?
- tightness
- restrictions
- asymmetries
what are the two main ankle muscles that can be measured?
- gastrocnemius
- soleus
how do you distinguish between soleus and gastrocnemius?
- knee position
- extended for gastrocnemius vs flexed for soleus
what is the pt starting position when testing gastrocnemius length?
- pt in supine with foot hanging over the end of the plinth
- knee extended
what movement is completed in the gastrocnemius muscle length test?
- passively dorsiflexed by grabbing the calcaneus and allowing the ankle to rest on your hand
what is the pt starting position when testing soleus muscle length?
- pt sits with legs hanging off plinth so knee at 90 degrees
what movement occurs for the soleus length test?
- passively dorsiflex the ankle
what is the WBLT? what is the starting position?
- weight bearing lunge test
- standing knee to wall test
- pt moves forwards in kneeling lunge until knee touches the wall
what needs to stay in contact in the WBLT? what do you do during the test?
- heel needs to always stay in contact with the floor
- foot is moved away from the wall to the point where the knee can only make slight contact with the wall while the heel remains in contact
what is the normal result of the WBLT?
- 10 to 15cm
what are the three main muscle length tests for the knee?
- elys test
- hamstring 90-90 straight leg raise
- back saver sit and reach test
what is the Ely’s test measuring? what is the muscle’s action?
- rectus femoris
- knee extensor
- hip flexor
what is the starting position of the ely’s test? what movement do you complete?
- pt in prone lying
- passively flex the knee maximally using a hand around the ankle
- stabilise the pelvis
when is the ely’s test positive?
- rectus femoris tightness if hip simultaneously flexes with knee flexion
what does the 90-90 striaght leg raise measure? what does this muscle do?
- hamstrings
- knee flexor
- hip extensor
what is the starting position of the 90-90 straight leg raise?
- pt in supine lying
- hip and knees flexed to 90 degrees
what movement occurs in the 90-90 straight leg raise test? how is the pt stabilised?
- pt can stabilise the legs by holding around the back of thighs
- pt asked to extend knee as far as possible
what should the end feel of 90-90 straight leg raise be?
- muscle stretch
when is the 90-90 straight leg raise positive?
- no further than 20 degrees from full extension
what does the backsaver sit and reach test measure?
- hamstrings
what is the starting position of pt in back saver sit and reach test?
- sitting position
- one knee flexed against chest (stabilise pelvis)
- other leg should be extended in front
what is the pt asked to do in the back saver sit and reach test? when is the test positive?
- pt asked to reach forward as far as possible
- positive if pt cannot reach toes
what are the 7 main hip muscle length tests?
- elys test
- thomas test
- obers test
- straight leg raise
- popliteal angle
- gluteus maximus
- adductors/ abductors
what does the thomas test measure?
- hip flexor
- iliopsoas
what is the starting position of the thomas test?
- pt lies in supine with knees bent over the end of the plinth
- knee at 90 degrees
what movement occurs in the thomas test?
- knee brought towards chest and pt hugs it
- lumbar spine should be flat
- tested leg remains extended
what is the normal result of the thomas test?
- extended leg remains flat on the table
what is the result of the thomas test when different muscles are tight?
iliopsoas = extended leg lifting off the table
RF= leg remains flat but knee extends
Tensor fascia latae= leg deviates laterally
sartorius= leg deviates medially
what does the ober test measure? what does the muscle do?
- tensor fascia latae
- hip abductor and internal rotator
what is the starting position of the ober test?
- pt in side lying with lower leg flexed at hip and knee
- extended top leg at hip
what movement occurs in the obers test? what should be stabilised?
- passively lower the top leg into adduction
- pelvis should be stabilised
when does the obers test indicate weakness?
- if leg remains above neutral (doesn’t adduct)
what does the straight leg test assess? what do these muscles do?
- biceps femoris, semitendinosus and semimembranosus
- knee flexor
- hip extensor
what is the starting position of the straight leg raise test?
- pt in supine with leg extended
- lumbar spine flat
- place roll/ pillow under knee if needed
what movement occurs in the straight leg raise? what needs to be maintained?
- passively flex hip with knee extended until resistance or pelvis tilt
- maintain legs in straight/ flat position
what needs to remain relaxed in the straight leg raise and why?
- foot needs to remain relaxed to avoid impact of gastrocnemius
- if dorsiflexed and gastrocnemius is tight this may cause the knee to flex
what should you watch out for in the straight leg raise test?
- look out for increased lumbar lordosis / anterior tilt (hip joint in flexion to start with so hamstrings of normal length may appear short)
what may be excessive in the straight leg raise test? what does this cause?
- excessive posterior tilt
- apparent length appears greater than actual length
what does the popliteal angle measure?
- measures knee position
- between tibia and vertical
- how many degrees the knee is off full extension
what is the starting position of the popliteal angle test?
- pt in supine with hip at 90 degrees
- opposite leg in extension
what movement occurs in the popliteal angle test? what shouldn’t move?
- passively extend knee as far as you can
- ensure pelvis doesn’t move
what movement does gluteus maximus contribute to?
-extension
- abduction
how do you test the gluteus maximus ?
- pt lies in supine
- passively flex the hip with the knee flexed towards chest
how do you test the hip adductors?
- pt lies in supine
- adduct the hip passively
- compare range with other side
how do you test the hip abductors?
- pt lies in prone
- abduct the hip passively
- compare range with other side
what are the three main shoulder muscle length tests?
- pec major (lower sternocostal fibres and upper clavicular fibres)
- latissimus dorsi
how do you test lower sternocostal fibres? what is the starting position?
- pt starts in crook lying with flat lumbar spine
- place pt arm in approx 135 degrees abduction with the elbow extended
what will the shoulder be in during the lower sternocostal fibre test?
- will be in lateral rotation
what is the normal length of the lower sternocostal fibres?
- arm drops to table level
- lumbar spine remains flat
when is there shortness shown in the lower sternocostal fibres?
- extended arm does not drop to table level
what is the test for upper clavicular fibres?
- pt arm placed in horizontal abduction with elbow extended and shoulder in lateral rotation
- palm facing upwards
what is the normal length of upper clavicular fibres?
- full horizontal abduction with lateral rotation
- arm flat on table w/out trunk rotation
when is shortness present in upper clavicular fibres?
- arm does not drop down to table level
what is the starting position for the latissimus dorsi test?
- pt starts in crook lying
- lumbar spine flat with arms by side
- elbows extended
what movement occurs in the latissimus dori test?
- pt raises both arms in flexion overhead
- keeping the arms close to the head
what is the normal length of the latissimus dorsi?
- ability to bring the arms down to table level
- keeping them close to the head (without changing lx position)
when is shortness of the latissimus dorsi clear in the test?
- unable to get the arms to table level
what are the two main muscles that can be tested in the elbow?
- biceps and triceps brachii
what is the starting position for biceps muscle length test?
- pt supine at side of the bed
- shoulder in extension
- elbow flexed and supinated
what movement occurs in the biceps muscle length test?
- wrist passively extended
- compare both sides
when is biceps muscle length test indicative of tightness?
- when there is limited wrist extension
- not the normal bone to bone
what is the starting position of the triceps muscle length test?
- pt sat upright
- arm maximally flexed with a lateral rotation
where should your hands be during the triceps test? what is performed?
- humerus fixated
- perform flexion at the elbow
when is triceps tightness indicated?
- if there is limited range
- not the normal tissue apposition end feel
what are the two muscle length tests of the wrist?
- wrist extensor muscle test
- wrist flexor muscle test
what is the starting position for both of the wrist muscle length tests?
- pt starts sitting with forearm supported on plinth
- in pronation
- elbow extended
what movement occurs in the wrist extensor muscle test?
- therapist passively flexes the wrist
when is tightness in wrist extensor muscles indicated?
- limited wrist flexion
what movement occurs in the wrist flexor muscle test?
- extend the fingers and wrist
- compare both sides
