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PM Exam 4 > Muscle Performance and ROM Measures > Flashcards

Muscle Performance and ROM Measures Flashcards

1
Q

What is used to measure

A

Universal Goniometer

Visual examination - if expert

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2
Q

Placement of goniometer

A

anatomical landmarks and palpation
Axis of rotation
Distal arm (moving)
Proximal arm (stationary)

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3
Q

Contradictions/Precautions with goniometry

A

Acute dislocations/fractures
Immediately following surgery
Willingness to move issues
Disease (infection, thrombosis)

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4
Q

Which comes first active or passive? then what?

A

Active
Passive
Resistance

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5
Q

Active ROM - what to look at

A 
Pain
Coordination
Attention span
Muscle strength
Stabilization (core)
Ability to follow commands
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6
Q

Passive ROM - what to feel for

A

Joint structure - know which are involved
Pain/tenderness
End feel - take joint to end ROM, to whatever is limiting the motion

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7
Q

Primary Sources of Error with Goniometry

A 
Reading goniometer wrong
Rounding off
Expectation of what reading should be
Inexperience
Lack of stabilization
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8
Q

Acceptable readings indicating improvement

A

Intratester 3-4 degree (Me on multiple occasions)

Intertester 5 degree (Me and then another PT)

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9
Q

Procedure

A
  1. Patient Position/Comfort
  2. Visually Examine
  3. Palpate
  4. Joint Motion
  5. Measure
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10
Q

Procedure - Step 1

A 
Patient Position/Comfort
Explain procedure
Position for correct measurement
Suport body part
Pt. Modesty
Environment
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11
Q

Procedure - Step 2

A 
Visually Examine
Look at joint you will move
Color
Contour
Scars
Skin Condition
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12
Q

Procedure - Step 3

A

Palpate
Joint structures
Anatomical landmarks
Restrictive tissue

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13
Q

Procedure - Step 4

A 
Active
Active assisted if needed
Passive to end feel
Limit substitutions 
Compare sides (start with unaffected)
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14
Q

Procedure - Step 5

A

Measure
Position goniometer
Fulcrum on joint axis
Moving arm on body part that is going to move
Stationary arm on body part that is stabilized

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15
Q

Procedure - Step 6

A

Recording

0-180 method (0 as starting point)

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16
Q

What to mention when recording data

A

If used something other than universal goniometer
Record body part and side you measured
AROM vs PROM
If tested in standard position or not

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17
Q

Define Muscle Performance

A

The capacity of a muscle or group of muscles to generate force

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18
Q

Define Strength

A

The maximal force that is generated at a given velocity

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19
Q

Define Power

A

The product of strength and speed

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20
Q

Define Endurance

A

Ability of a muscle to sustain or repeat contraction over time

21
Q

What is a muscle test

A

Clinical measurement to assist in determining muscle performance

22
Q

Type of muscle tests

A 
Isokinetic devices
MMT
GMT
Functional muscle testing
1 repetition max
23
Q

Gross Muscle Testing

A

Use of manual resistance to test a group of muscles
Screening test only - can only say strong vs. weak
Normal vs. Impaired

24
Q

Manual Muscle Testing

A 
Testing the strength of one muscle by manual resistance
Inc advantage of specific muscle
Or decrease activity of other muscles
Able to delineate levels of strength 
Use of muscle grades
25
Q

Factors involved in ability of a muscle to generate force

A 
Muscle size
Fiber arrangement and type
Neural elements
Anatomical relationship to joint axis
Contraction type
"Normal" function of muscle
Condition of musculotendinous junction
26
Q

Concepts that MUST be remembered for muscle testing

A 
Positioning 
Stabilization
Resistance 
Role of palpation
Part of grading
Testing the correct muscle
Control of substitutions
27
Q

Positioning with muscle testng

A

Where is gravity
Muscle length (shortened vs lengthened)
Action of muscle
Composition of muscle

28
Q

Stabilization with muscle testing

A

Intrinsic is performed by body itself
Extrinsic is imposed on the subject by outside elements
Major factor in control of substitutions

29
Q

Resistance with muscle testing

A

Must be practiced
Must be controlled
Applied in the direction of the resolution of the force generated across the joint
Distance of application is a significant consideration

30
Q

Types of MMT

A

Break and Make (both isometric resistance)
Break = Command = Hold or Do not let me move you
Make = Push against me. Try and move me

31
Q

Contradictions and Precautions to MMT

A 
Dislocations and fractures
Immediately following surgery
Disease (infection, osteoporosis)
Spasticity 
Acute inflammatory 
Pain and fatigue
32
Q

How to - muscle testing

A 
Patient/Body part position
Determine available ROM
Stabilization
Placement of body part
Manual Resistance
- Isometric Hold
Gradual build up of force
3 to 6 sec max resistance
33
Q

Placement for muscle testing

A

Mid-range in primary place where the muscles act

34
Q

Communication

A 
Seek permission
Explain procedure to patient
Take them through movement
Ask for a "hold"
DO NOT ask patient to push into your hand --> that would be make and we want break!
35
Q

In order to give a muscle grade…

A

Rules MUST be followed

Otherwise, can only give weak or strong compared to opposite side

36
Q

ROM

GMT vs. MMT

A 
GMT = Yes
MMT = Yes
37
Q

Body Position

GMT vs. MMT

A 
GMT = not important
MMT = critical
38
Q

Palpation

GMT vs. MMT

A 
GMT = Not important
MMT = Important
39
Q

Stabilization

GMT vs. MMT

A 
GMT = Important
MMT = Critical
40
Q

Side Tested

GMT vs. MMT

A 
GMT = Both sides at once or one side at a time
MMT = One side at a time
41
Q

Normal Bone to Bone End Feel

A

A hard, painless sensation with no give

Ex: elbow extension

42
Q

Normal Soft Tissue Approximation End Feel

A

A mushy, forgiving sensation that stops further motion

Elbow or knee flexion = EX

43
Q

Normal Tissue Stretch End Feel

A

The most common type of normal end feel, felt when the primary restraints for further movement are a ligament or capsule. May be further divided into elastic (a spring) or capsular (no spring)
wrist flexion = soft
knee extension = hard

44
Q

Abnormal Bone to Bone End Feel

A

Similar to feel of normal, but this is painful and occurs before the normal expected ROM
Ex ‘ elbow flexion in presence of excess bone

45
Q

Abnormal Springy Block End Feel

A

A forgiving feeling, similar to tissue stretch but often is painful and felt before the normal end ROM is achieved
Ex = knee extension in presence of meniscus tear

46
Q

Abnormal Capsular End Feel

A

Feels similar to capsular tissue stretch end feel, but can invoke pain and occurs before the normal end ROM is achieved or where end feel is not expected
Ex: frozen shoulder

47
Q

Abnormal Muscle Spasm End Feel

A

Involves a brief, involuntary muscle spasm that occurs in response to pain
Ex: cervical lateral flexion following whiplash

48
Q

Abnormal Empty End Feel

A

Involved no sensation of resistance felt by the examiner, but the patient indicated the motion must stop due to intense pain
Ex: bursitis

PM Exam 4 (3 decks)

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