Muscle Strength Testing Flashcards
How should you measure endurance and power?
Endurance = use functional tests
Power = only test when they are large enough for isokinetic systems (at least 6 years old)
How do you test using functional methods in infants
Body, arm, leg movements against gravity — use toys to get them to move
Reflexes and postural responses - ATNR, Moro, righting reactions
How do you test using functional methods in toddlers/preschoolers?
Tip toes - gastroc/soleus
Get up from the floor — quads and hamstrings and glutes
Jump — whole LE
Stand on one foot — hip abd, ext, gastroc soleus
When do you use observation/movement activation/palpation method?
- infants, toddlers, children, under 4 years old
- 4-6 year olds that have trouble following directions or staying on task
- children with cognitive impairments
What is the procedure for observation/activation/palpation?
Observe movement -> activate mms bu tickling, tapping, stroking -> palpate the muscles
Grade: present or absent and apparently normal, weak, or absent. Remember to describe any associated movement characteristics
When do you use standard MMT?
- children over 4 years old who can attend to a task and follow directions
grading is the same from 0-3 as adults. 4-5 is subjective, not great reliability
When do you use modified MMT?
- children 4 years old or older who move with substitution patterns or synergistic movement patterns
What is the modified MMT procedure?
Use resistance only to the point of substitution or synergy.
How do you grade using Modified MMT?
Standard 0-5 grading for non-synergistic movements.
Children with substitutions/synergies you grade…
3- = moves through entire ROM against gravity
2- = moves throug full ROM in gravity eliminated position
1+ = initiates movement in gravity eliminated position
review lab cases
What is the procedure for dynamometry?
MAKE TEST — less chance for injury
Sustain mm contraction for 5 seconds but remember not to resist a child’s isometric contraction.
Make sure child understands the directions.
Stabilize when measuring the hip and knee
Take 2 measurements and average
Give them a practice round
What muscles is dynamometry best for?
LE
Hip flexors — do it in sitting or supine
Hip extensors — do it in supine
Knee flexors/extensors — do it in sitting
DF — do it in sitting
What is one of the major impairments in children with CP?
Inadequate force generation
— impact of abnormal mm tone, synergies, substations.
— poor selective control of isolated muscle groups — which leads to poor reliability with some mm groups
kids with CP are the most difficult group to test strength reliably
What are the recommendations to test strength in children with CP
Use dynamometry or functional testing.
Dynamometry can detect changes. And functional testing should be age appropriate
Test all mm groups
For endurance you can test the distance they can walk — 6MWT
When do you test strength in children with MM?
- Newborns pre-surgery
- About 10 days after surgical closure
- At regular intervals through adolescence and adulthood.
Procedure, muscles tested, and use of data for strength testing in kids with MM pre surgery ?
Procedure — limited positions to test. Observe movement —> palpate
Muscles — head/neck, trunk above and below lesion
Use of data — helps determine level of lesion, document pre surgery levels of mm activity
