OSCE - Muscle Strength, Tone/ Spasticity, Length, Sensation, Proprioception, Coordinaiton Flashcards
Muscle strength: lower limb - active assisted
Try get the patient to do the most movement but take the weight of the limb and aid them
Ankle - plantar flexion, dorsiflexion
Knee - flexion, extension
Hip - flexion, internal rotation, external rotation, abduction, adduction
Muscle strength: lower limb - active
Patient does the movement themselves
Toe - flexion, extension
Ankle - plantar flexion, dorsiflexion, inversion, eversion
Knee - flexion, extension
Hip - flexion, internal rotation, external rotation, abduction, adduction
Muscle strength: lower limb - active resisted
Apply resistance throughout the range during the movement
Toe - flexion, extension
Ankle - plantar flexion, dorsiflexion, inversion, eversion
Knee - flexion, extension
Hip - flexion, internal rotation, external rotation, abduction, adduction
Muscle strength: upper limb - active assisted
Try get the patient to do most movement but take the weight of the limb and aid them
Shoulder - flexion, extension, abduction, adduction, internal rotation, external rotation
Elbow - flexion, extension, pronation, supination
Wrist - flexion, extension, ulnar deviation, radial deviation
Finger - extension, flexion, opposition
Muscle strength: upper limb - active
Patient does the movement themselves
Shoulder - flexion, extension, abduction, adduction, internal rotation, external rotation
Elbow - flexion, extension, pronation, supination
Wrist - flexion, extension, ulnar deviation, radial deviation,
Finger - extension, flexion, opposition
Muscle strength: upper limb - active resisted
Apply resistance throughout the range during the movement
Shoulder - flexion, extension, abduction, adduction, internal rotation, external rotation
Elbow - flexion, extension, pronation, supination
Wrist - flexion, extension, ulnar deviation, radial deviation
Finger - extension, flexion
Muscle tone/ spasticity
Passively move the body part/ joint and then quick movements
Positive result - spasms or clonus
Muscle tone/ spasticity: lower limb
Dorsiflexion with leg straight and bent
Knee extension
Hip abduction
Hip adduction
Muscle tone/ spasticity: upper limb
Elbow extension
Wrist extension
Muscle length
Passively move the body part/ joint
Looking for end of range feel
Muscle length: lower limb
Ankle - plantar flexion, dorsiflexion
Knee - flexion, extension
Hip - flexion, internal rotation, external rotation, abduction, adduction
Muscle length: upper limb
Shoulder - flexion, extension, abduction, adduction, internal rotation, external rotation
Elbow - flexion, extension, pronation, supination
Wrist - flexion, extension, ulnar deviation, radial deviation
Finger - extension, flexion
Sensation
Light touch
Deep pressure
Start with cotton wool then use your finger lightly then press into their skin more deeply
Do they feel it
Does it feel the same on both sides
Need their eyes closed
Proprioception: up or down
Move the different parts of the body/ joints and explain one is up and one is down
Get them to close their eyes
Ask them if its up or down
Don’t do the same pattern
Thumb
Wrist
Elbow
Big toe
Ankle - with knee straight and bent
Proprioception: limb matching/ mirroring
Ask the patient to close their eyes
Put their upper and lower limbs (one at a time) in a different position
Ask them to match with the other (non-moved) limb
Coordination: finger to nose
Ask the patient to touch their nose and then touch your finger which is in front of them
Ask them to do it as quickly as they can
Looking for if its slower than expected, wobbling of the finger, over or under shooting and if they can’t find the finger
Coordination: heal to leg
Lying supine
Ask the patient to put their heal of one leg on the opposite knee and drag it down to their foot
Then lift the foot up and place it back onto their knee
Repeat this three times
Looking for if they don’t place their heal on their knee
Coordination: quick palm up and down
Sitting
Ask the patient to put their hands face down on their legs/ thigh
Then ask them to turn so their palms are up and then turn so palms are down
Repeat this as quickly as they can
Looking for the movements being slower than expected or they can’t fully supinate or pronate their arms
Coordination: toe to heal
Sitting
Ask the patient to rock their feet so they’re on their toes
Then ask them to role their feet back so they’re on their heals and their toes are in the air
Then back to toes
Repeat this as quickly as they can
Looking for the movements being slower than expected or they can’t raise onto their toes or heals.
