Practical section 3

Question 1

Shoulder: Concentric/eccentric (0-90; 90- 180)
In supine with dumbbell

Answer 1

0-90 flexion: concentric flexors (against gravity)
90-180 flexion: eccentric extensors (with gravity)
180-90: concentric extensors (against gravity)
90-0:eccentric flexors (with gravity)In supine with theraband
0-180 flexion: concentric flexors
180-0 extension: eccentric flexors

Question 2

Isometrics of shoulder elevation, ER and IR (all submax)

Answer 2

have client laying supine
shoulder elevation: have elbow flexed ask them to punch air for shoulder elevation - hold it down so they don’t move
ER: have client’s elbow flexed at 90 degrees ask them to bring forearm toward the wall or you and resist that movement
IR: client arm flexed at 90 ask them to attempt to put their forearm toward their belly button- resist their movement
make sure not to apply too much pressure

Question 3

Techniques of strengthening based on muscle grade
MMT 2-/5: shoulder flexion

Answer 3

Little bit of movement (less than full ROM)
Lay on side (gravity eliminated)
Cannot do full range
Do something functional like a rag to dust or reaching for a cup or something

Question 4

MMT 2/5: shoulder flexion

Answer 4

Full range of motion gravity eliminated
Have your hand below their arm so it doesn’t plop, but it’s AROM, so they’re doing the work
Still doing something functional in gravity eliminated

Question 5

MMT 3/5: shoulder flexion as an example

Answer 5

Full range of motion against gravity
No weight
Functional like reaching above a cabinet (reach into kitchen cabinet like you are grabbing something and then bring it down)

Question 6

MMT 4/5 with weight

Answer 6

(something light ex: salt shaker)

Question 7

MMT 5/5 heavier weight

Answer 7

(something heavier ex: anything heavier)

Question 8

Pursed lip breathing during reaching activity and lower body dressing

Answer 8

Inhale through nose for 2 counts (you should see abdomen rise)
Exhale through mouth for 4 counts, like blowing out a candle
To make it functional have them breathe in and as they breathe out, encourage them to do steps of the activity
Example: They are sitting. Have them practice pursed lip breathing a few times, then have them breathe in and as they breathe out, have them cross one leg over the other. Breathe in again and then as they breathe out, have them don a sock, etc. Just have them breathe and integrate the movements as they breathe out

Question 9

MMT 3/5 to 5/5: shoulder flexion as an example

Answer 9

3: Full flexion in seated or standing with gravity
Activity: Reaching overhead to don a T-shirt
3+: Full flexion with minimal resistance and gravity
Activity: Reaching overhead to grab a cup
4-: Full flexion with less-than-moderate resistance and gravity
Activity: Reaching overhead to empty the dishwasher (put a plate up in a cupboard)
4: Full flexion with moderate resistance and gravity
Activity: Picking textbooks up off the floor and putting them away on a bookshelf

Question 10

MMT 2/5: shoulder flexion

Answer 10

Full ROM, some resistance, gravity eliminated
PROM: Side-lying with the affected arm supported on the surface, producing flexing motion through full range (as if to wipe a table)
AAROM: Side lying with unaffected arm assisting affected arm in flexing motion through full range (as if to wipe a table)

Question 11

MMT 2-/5: shoulder flexion

Answer 11

Less than Full ROM, gravity eliminated
PROM: Side-lying with the affected arm supported on the surface, producing flexing motion through the patient’s range (as if to wipe a table)
AAROM: Side lying with unaffected arm assisting affected arm in flexing motion through patient’s range (as if to wipe a table)