ROM and MMT for exam 2 Flashcards
Steps for the explanation of procedure for ROM
-explain purpose of measurements
-introduce goni/inclinometer
-position patient
-explain procedure
-Confirm the individual’s understanding and willingness to participate
ROM general procedures
-Assess ROM bilaterally (unaffected side first)
-typically perform 2-3 reps for each movement (first being goni vision ROM and second being measurement if doing AROM) (third step would be measurement if doing PROM
Inclinometer process (steps)
- patient in base position
- AROM w/ visual estimate (goni-vision)
- Locate landmarks
- Place inclinometer so that the center of the base is over the appropriate landmark
- Zero inclinometer
- AROM while maintaining placement of inclinometer
7.Read inclinometer
8.Remove and return patient to comfortable resting position
Hip flexion AROM
-Norms
-Position of patient
-Axis on what
-Proximal & distal arm on what
-Stabilize what
Norms: 120-140 degrees
Position: supine (non-testing hip flat on table)
Axis: Greater trochanter
Proximal/stationary arm: Lateral midline of the pelvis (bisect innominate)
Distal/moving arm: along femur inline with lateral epicondyle of the femur at the knee
Stabilize: monitor ASIS/PSIS on the ipsilateral (same side) pelvis to avoid Posterior pelvic tilt
Hip abduction AROM
-Norms
-Position of patient
-Axis on what
-Proximal & distal arm on what
-Stabilize what
Norms: 40-55 degrees
Position: supine (knees extended with 0 degrees of flexion/extension/rotation)
Axis: ASIS of extremity being measured
Proximal/stationary arm: Imaginary line along to ASIS on opposite side
Distal/moving arm: Anterior midline of the femur using the midline of the patella
Stabilization: Monitor ipsilateral iliac crest to avoid lateral tilting
Knee Flexion AROM
-Norms
-Position of patient
-Axis on what
-Proximal & distal arm on what
-Stabilize what
Norms: 130-140 degrees
Position: supine with knees extended (0 degrees of flexion, extension, rotation, abduction, adduction)
Axis: Lateral epicondyle of the knee
Proximal/stationary arm: midline of the femur in line with the greater trochanter
Distal/moving arm: Lateral midline of the fibula between the fibular head and lateral malleolus
Stabilization: monitor femur to avoid rotation
Ankle Plantarflexion AROM
-Norms
-Position of patient
-Axis on what
-Proximal & distal arm on what
-Stabilize what
Norms: 45-55 degrees
Position: seated, knee flexion to 90 degrees (0 degrees of inversion or eversion)
Axis: lateral malleolus
Proximal/stationary arm: lateral midline of the fibula using the fibular head for reference
Distal/moving arm: parallel to lateral aspect of fifth metatarsal
Stabilization: monitor tibia and fibula to avoid hip rotation
Ankle dorsiflexion
-Norms
-Position of patient
-Axis on what
-Proximal & distal arm on what
-Stabilize what
Norms: 15-20 degrees
(starting at zero degrees for this one!)
Position: seated, knee flexion to 90 degrees (0 degrees of inversion or eversion)
Axis: lateral malleolus
Proximal/stationary arm: lateral midline of the fibula using the fibular head for reference
Distal/moving arm: parallel to lateral aspect of fifth metatarsal
Stabilization: monitor tibia and fibula to avoid hip rotation
MMT general procedures
- explain assessment , answer questions, and obtain permission
- Position patient
- Assess PROM
- Screen AROM
- stabilize as needed
- Apply resistance (builds over 3-5 seconds)
- Determine grade
- Palpate as needed if <2/5 or if assessing for compensations
Hip flexion MMT
-Position
-Stabilize
-Resistance applied where?
-Vocal cues
Position: sitting on edge of the table
stabilize: pelvis
Resistence: distal thigh, just proximal to the knee (do not grasp thigh)
Vocal cues: “Don’t let me push it down”
Hip extension MMT
-Position
-Stabilize
-Resistance applied where?
-Vocal cues
-Position: prone with knee flexed and slight hip abduction and external rotation
-Stabilize: pelvis
-Resistance applied: distal thigh
-Vocal cues: “lift your foot to the ceiling” or “lift your leg keeping your knee bent”
Hip abduction MMT
-Position
-Stabilize
-Resistance applied where?
-Vocal cues
-Position: side-lying with examiner behind them (uppermost hip should be in slight extension while lowermost limb should be in slight flexion)
-Stabilize: pelvis to make sure they don’t compensate by hip rotation, hip flexion, or hip hiking
-Resistance applied: ankle but sometimes thigh (max resistance at ankle=5/5 but max resistance at thigh=4/5)
-max resistance via ankle=5/5
-max resistance via thigh=4/5
-strong-> moderate resistance via ankle=4/5
-Vocal cues: “Lift your leg up and back. Hold it and don’t let me push it down”
Knee flexion MMT
-Position
-Stabilize
-Resistance applied where?
-Vocal cues
-Position: prone (legs straight and toes off the end of table)
-Stabilize: posterior thigh (as needed)
-Resistance applied: just above the ankle with the knee flexed at 45 degrees
-Vocal cues: “hold it and don’t let me straighten it”
-“looking to see how strong your hamstrings are”
Knee Extension MMT
-Position
-Stabilize
-Resistance applied where?
-Vocal cues
-Position: sitting on the edge of the table with hands on table; can lean back slightly to remove hamstring tension
-Stabilize: hip area as needed
-Resistance applied: just proximal to the ankle with the knee in about 15 degrees of flexion
-Vocal cues: “Hold it! Don’t let me bend it”
-“looking at your muscles that straighten your knee all the way out”
-Avoid hyperextension of the knee!
Foot dorsiflexion and inversion MMT
-Position
-Resistance applied where?
-Vocal cues
-Position: supine (better leverage for therapist even though its not an anti- gravity position)(flex the patients knee slightly (as needed) to ensure the gastrocs are on slack)(patients toes should stay relaxed)
-Resistance applied: one hand under the achilles area and the other on top of the foot pulling down and out
-Vocal cues: “bring your foot up and in and don’t let me pull it down”
-“looking at the muscles on the front of your shin that help you bring your toes to your nose”
