P8 - Assessment of De-conditioning

Question 1

What is de-conditioning and what are its primary causes?

Answer 1

De-conditioning refers to the decline in physical function and fitness due to inactivity or prolonged immobility. It can affect cardiovascular (CVR), musculoskeletal (MSK), and functional systems. Causes include prolonged bed rest, sedentary lifestyle, illness, or injury.

Question 2

What cardiovascular (CVR) factors contribute to de-conditioning?

Answer 2

CVR factors include reduced cardiac output, decreased blood flow, decreased endurance, increased heart rate at rest and during exertion, and poor oxygen exchange due to inactivity.

Question 3

What musculoskeletal (MSK) factors contribute to de-conditioning?

Answer 3

• muscle atrophy
• joint stiffness
• reduced muscle strength
• decreased range of motion (ROM)
• and loss of bone density

which can impair movement and functional independence.

Question 4

What functional factors are impacted by de-conditioning?

Answer 4

Functional factors include decreased balance, poor coordination, reduced proprioception, impaired movement patterns (e.g., sit-to-stand), and diminished ability to perform daily activities (ADLs).

Question 5

How does de-conditioning impact posture in sitting?

Answer 5

De-conditioning in sitting can lead to slouched posture, rounded shoulders, forward head position, reduced lumbar support, and muscle imbalances, particularly in the core and back muscles.

Question 6

How does de-conditioning impact posture in long sitting?

Answer 6

In long sitting, de-conditioning may cause difficulty maintaining an upright position due to weak core muscles and hamstring tightness, resulting in posterior pelvic tilt and slumping of the spine.

Question 7

How does de-conditioning impact posture in standing?

Answer 7

In standing, de-conditioning may result in poor alignment with forward head, rounded shoulders, weak core muscles leading to anterior pelvic tilt, and instability in the knees and ankles.

Question 8

What are the key aspects of assessing sit-to-stand movement in a de-conditioned person?

Answer 8

• lower limb strength
• ROM at the hip, knee, and ankle
• balance, and functional strength.

Techniques may include timed get-up-and-go (TGUG) test and Oxford scale muscle strength testing.

Question 9

How do you assess the movement of stand-to-sit in a de-conditioned individual?

Answer 9

Assessment involves observing controlled descent, balance, lower limb strength, and proprioception. Functional strength testing (e.g., squats) and timed get-up-and-go (TGUG) can help identify difficulties.

Question 10

What are the assessment considerations for step-ups?

Answer 10

Evaluate lower limb strength, joint ROM (hip, knee, ankle), balance, and coordination. Functional strength testing, such as single-leg squats, and step-up endurance can be used to assess ability.

Question 11

What should you assess in walking movement analysis?

Answer 11

Assess gait pattern, balance, coordination, and strength. Consider joint ROM (hip, knee, ankle), strength using the Oxford scale, and dynamic balance tests (e.g., TGUG, gait speed, step length).

Question 13

What does the TGUG test measure and how is it performed?

Answer 13

The TGUG test measures functional mobility and balance. It involves timing how long it takes for a person to rise from a chair, walk 3 meters, turn, walk back, and sit down.

Question 15

What is the 30-second chair stand test, and what does it assess?

Answer 15

The 30-second chair stand test assesses lower body strength and endurance. The individual stands up fully from a chair as many times as possible in 30 seconds without using arms.

Question 16

How is goniometry used to assess lower limb ROM in de-conditioned individuals?

Answer 16

Goniometry measures joint ROM in the hip, knee, and ankle. It helps identify limitations in movement due to de-conditioning, muscle tightness, or joint stiffness.

Question 17

How is muscle strength in the lower limbs assessed using the Oxford Scale?

Answer 17

The Oxford Scale assesses strength from 0 (no muscle activity) to 5 (normal strength) in the hip, knee, and ankle. Strength is tested through manual resistance against specific movements.

Question 18

What movements are required for the functional task of putting on a coat?

Answer 18

Movements include shoulder flexion, abduction, and rotation; elbow flexion and extension; and wrist and hand movements for grasping and pulling.

Question 19

What does the CKUES test measure, and how is it performed?

Answer 19

The CKUES test measures upper extremity stability and strength. It involves the participant performing push-ups while alternating hand placements on markers. It tests shoulder and arm stability under load.

Question 20

How do you assess grip strength in de-conditioned individuals?

Answer 20

Grip strength is measured using a dynamometer to assess the force generated by the hand muscles. It helps evaluate functional strength in tasks like opening jars or carrying objects.

Question 21

How is goniometry used to assess upper limb ROM?

Answer 21

Goniometry is used to measure ROM in the shoulder, elbow, and wrist joints. It identifies restrictions in movement due to joint stiffness or muscle weakness, common in de-conditioning.

Question 22

How is muscle strength in the upper limbs assessed using the Oxford Scale?

Answer 22

Muscle strength in the shoulder, elbow, and wrist is assessed using manual resistance, grading strength from 0 (no contraction) to 5 (normal strength).

Question 23

What is a common outcome measure for assessing cardiovascular de-conditioning?

Answer 23

A common measure is the 6-minute walk test (6MWT), which evaluates cardiovascular endurance by measuring the distance an individual can walk in 6 minutes.

Question 24

What outcome measure is used for assessing functional tasks like walking?

Answer 24

The TGUG (Timed Get-Up-And-Go) test is used to assess functional mobility, including walking, balance, and coordination.

Question 25

What is a common outcome measure for assessing balance?

Answer 25

The Berg Balance Scale (BBS) assesses balance by testing static and dynamic abilities through 14 tasks like standing on one leg or reaching forward.

Question 26

What assessment techniques are appropriate for analyzing sit-to-stand movements?

Answer 26

Assessment techniques include strength testing (e.g., Oxford Scale for hip, knee, and ankle muscles), ROM evaluation (goniometry), functional strength testing (e.g., squats), and balance tests (e.g., TGUG, 30-second chair stand).

Question 27

What are the appropriate techniques to assess stand-to-sit movements?

Answer 27

Techniques include observing controlled lowering, assessing lower limb strength with the Oxford Scale, checking ROM at the hip, knee, and ankle with goniometry, and balance tests such as the TGUG

Question 28

What techniques are used to assess step-ups in individuals with de-conditioning?

Answer 28

Assessment techniques include strength testing using the Oxford Scale (hip, knee, and ankle muscles), ROM assessment with goniometry, balance testing (e.g., single-leg balance), and functional strength tests such as single-leg squats.

Question 29

What assessment techniques are used for analyzing walking?

Answer 29

Techniques include gait analysis (observing step length, stride, and cadence), strength testing with the Oxford Scale, ROM assessment (goniometry for hip, knee, and ankle), balance testing (TGUG or Berg Balance Scale), and endurance tests (6MWT).

Question 30

How is joint ROM for the hip, knee, and ankle assessed using a goniometer?

Answer 30

Place the goniometer on the joint axis (e.g., hip, knee, ankle) to measure flexion, extension, abduction, and other movements. Compare the measured values to normal ROM ranges to assess limitations.

Question 31

How is the Oxford Scale used to assess muscle strength in the lower limbs?

Answer 31

The Oxford Scale grades muscle strength from 0 (no contraction) to 5 (normal strength). It is applied to muscles in the hip (flexors, abductors), knee (extensors, flexors), and ankle (dorsiflexors, plantarflexors) by applying resistance.

Question 32

How is functional strength assessed using squats and single-leg squats?

Answer 32

Functional strength is tested by having the individual perform squats and single-leg squats to assess lower limb strength, balance, and stability. Observing compensatory movements helps identify weaknesses in hip, knee, or ankle musculature.

Question 33

What is the purpose of the Timed Get-Up-And-Go (TGUG) test?

Answer 33

The TGUG test assesses functional mobility, balance, and risk of falls. It times how long it takes for a person to rise from a chair, walk 3 meters, turn around, walk back, and sit down.

Question 34

What does the 30-second chair stand test evaluate?

Answer 34

The 30-second chair stand test evaluates lower limb strength and endurance. The test counts how many times an individual can stand up fully from a seated position in a chair within 30 seconds, without using arms for support.

Question 35

How do you assess shoulder ROM with a goniometer?

Answer 35

Place the goniometer’s axis at the center of the shoulder joint and measure ROM for movements like flexion, extension, abduction, and external/internal rotation. Compare values to normal ROM ranges.

Question 36

How is elbow joint ROM assessed using a goniometer?

Answer 36

Align the goniometer on the elbow joint axis and measure flexion and extension. Measure the angle from full extension to full flexion to assess the functional range.

Question 37

What are the steps to assess wrist ROM with a goniometer?

Answer 37

Position the goniometer on the wrist joint axis, then measure flexion, extension, radial deviation, and ulnar deviation. Compare results to normal ROM ranges to assess for restrictions.

Question 38

How is the Oxford Scale applied to assess upper limb muscle strength?

Answer 38

The Oxford Scale is used to assess strength in shoulder (flexion, abduction), elbow (flexion, extension), and wrist muscles. Strength is graded from 0 (no movement) to 5 (normal strength) based on resistance testing.

Question 39

What functional assessments are used for upper limbs during tasks like writing or opening jars?

Answer 39

Grip strength tests using a dynamometer assess hand strength for tasks like opening jars. Dexterity tasks such as writing evaluate fine motor control, wrist stability, and finger strength.

Question 40

What is the CKUES test and what does it assess?

Answer 40

The CKUES test assesses upper limb stability and strength by having the individual perform push-ups while alternately moving their hands to touch designated markers. It evaluates shoulder and core stability under a closed-chain load.

Question 41

How is grip strength assessed in de-conditioned individuals?

Answer 41

Grip strength is measured with a dynamometer, which assesses the force exerted by the hand. It helps evaluate overall hand and wrist strength, important for functional tasks like holding objects or opening containers.

Question 42

What is the 6-minute walk test (6MWT), and what does it assess?

Answer 42

The 6MWT measures cardiovascular endurance by assessing the distance an individual can walk in 6 minutes. It evaluates overall fitness, endurance, and response to rehabilitation.

Question 43

How does the TGUG test serve as a functional outcome measure?

Answer 43

The TGUG test measures functional mobility, balance, and risk of falls by timing how long it takes for a person to rise from a chair, walk 3 meters, turn around, walk back, and sit down.

Question 44

What is the Berg Balance Scale (BBS), and what does it assess?

Answer 44

The BBS is a 14-item test that assesses static and dynamic balance. Tasks include sitting to standing, standing on one leg, and reaching forward. It is used to identify balance impairments and fall risk.

Question 45

What does the Functional Reach Test assess, and how is it performed?

Answer 45

The Functional Reach Test measures dynamic balance. The individual stands next to a wall and reaches forward as far as possible without losing balance. The distance reached is recorded to assess balance and fall risk.

Question 46

What is the Four-Stage Balance Test and what does it assess?

Answer 46

The Four-Stage Balance Test assesses balance by having the individual stand in four progressively challenging positions, from feet together to standing on one foot. It helps identify balance impairments and risk of falls.