Musculoskeletal assessment Flashcards
Postural analysis - 3 different views
- anterior
- lateral
- posterior
Postural analysis:
Anterior
- is head and neck in midline of the body?
- is slope of shoulder muscles equally bilateral?
- do shoulders have well-rounded musculature, with no prominent bony structures?
- is space between arms and body the same on both sides?
- review arm hang?
- symmetry of ribcage
- equal height of wrist folds, anterior superior iliac spine and greater trochanter?
- hip tilt?
- patella - height, orientation, genu valgum/varum?
- feet - pronate/supinate, internal or external rotation?
Postural analysis:
Lateral view
- straight plumb line from ear to middle of shoulder, hip, knee and ankle?
- excessive curvature of neck of back?
- elbows held near full extension?
- muscle tone of chest, back and abdominal muscles?
- level pelvis?
- knees - straight, flexed or hyperextended?
Postural analysis:
Posterior view
- straight spine?
- scapulae height and angle
- rib protrusion?
- glute folds - equal height?
- are skin creases on posterior knee level?
- Adam’s position for scoliosis assessment
Hamstring ROM assessment (90-90 test)
Aim: to measure hamstring flexibility, by assessing hamstring-popliteal angle, via goniometer.
- lay subject supine
- gently move leg so hip is flexed to 90 degrees and thigh is vertical.
- passively move leg so knee is extended to a point where it becomes tight.
- opposite leg must remain on the table, fully extended.
- with the goniometer, draw a line parallel to the femur and the angle that forms between the vertical tibia and lateral malleoli of the measured leg.
Hamstring ROM assessment (90-90 test) test - scoring
180 degrees = full extension is achieved
less than 170 degrees = tightness in hamstring.
Thomas test
Aim: to measure tightness of hip flexors - iliopsoas, rectus femoris, tensor fascia latae (TFL)
- lie supine on table with legs unsupported
- bring one knee towards chest, while other leg remains extended.
Thomas test positive score
- contralateral hip flexes without knee extension = tight iliopsoas
- contralateral hip abducts during test = tight tensor fascia latae
- contralateral knee extension occurs = tight rectus femoris
Single leg stance test
Measures: lumbo-pelvic stability
- stand unassisted on each leg, whilst examiner monitors subjects’ pelvis and weight distribution.
- in normal function - hip is held stable by gluteus medius and minimus acting as an abductor in supporting leg.
Single leg stance test positive score
- pelvis drops on unsupported side
- trunk tilts laterally onto ipsilateral side
- suggests poor lumbo-pelvic stability
Single leg squat test
Measures: dynamic lower extremity strength/control and stability of hip, knee and ankle.
- raise foot on the contralateral side from the floor by bending at the knee so they are standing on one leg.
- squat down as far as comfortable
- complete several reps on each leg.
- monitor abnormal motions at the trunk, hip, knee and foot
Poor dynamic lumbo-pelvic stability in single leg squat test
- inward knee (valgus)
- internal hip rotation
- contralateral pelvic drop (Trendelenburg)
Hawkins-kennedy test
Measures: subacromial (shoulder) impingement syndromes.
- sit in relaxed sitting position
- arm being tested is moved passively by the examiner, 90 degrees of forward flexion and elbow is flexed to 90 degrees.
- forcefully move the patient’s shoulder into internal rotation to the end of ROM or until reports of pain.
- place firm pressure on the scapula to ensure patient does not compensate for pain or reduced ROM in glenohumeral joint by elevating scapula.
Hawkins-kennedy test positive score
- pain is reported in superior - lateral aspect of shoulder
