Spinal MMT Flashcards
what muscles are involved in neck flexion
longus capitis
longus colli
rectus capitis anterior
anterior scalene
sternocleidomastoid
gravity resisted test for neck flexion
supine with shoulders in 90/90 and forearms resting on testing surface
chin is passively tucked and flexed
patient is told to repeat and hold at end range of motion
resistance applied over forehead with stabilization of the anterior thorax
gravity eliminated test for neck flexion
no gravity eliminated
what over compensation will occur during neck flexion?
SCM
patient will lose the chin tuck
muscles involved in neck anterolateral flexion
SCM
gravity resisted test for neck anterolateral flexion
same as neck flexion testing
head rotated to opposite side of testing side
laterally flexed with rotation passively
patient to repeat and hold at end range
resistance applied over lateral aspect of forehead toward table with stabilization of the thorax
gravity eliminated test for neck anterolateral flexion
aint one
what can be an issue with neck anterolateral flexion testing
compromise of the vertebral arteries blood flow
muscles involved in neck extension
erector spinae
– iliocostalis cervicis, longissimus capitis, longissimus
oblique capitis superior
rectus capitis posterior major/minor
semispinalis capitis/cervicis
spinalis cervicis/capitis
splenius capitis/cervicis
upper trap
gravity resisted test for neck extension
prone with shoulders/elbows in 90/90 position with forearms resting on table
head/neck passively taken through extension and returned
patient does it/ holds at end range
resistance applied over occiput toward flexion while stabilizing the thorax
gravity eliminated test for neck extension
aint one
muscles used in trunk flexion
rectus abdominis
gravity resisted test for trunk flexion
supine with hands behind neck
lower extremities extended and pelvis posteriorly tilted
trunk is passively flexed until the scapulae have cleared the table
patient asked to repeat the motion
no application of resistance
gravity eliminated test for trunk flexion
aint one
what should one be cautious for when instructing a trunk flexion test
fixation/stabilization of the feet when performing the test
will allow for hip flexors to assist the sit up
how is the sit up test graded?
5 - arms behind neck and scapulae clear the table with PPT
4 - arms folded across chest
3+ - arms by their side
3 - able to raise head, spine, and a portion of the scapulae off table with arms by their side
2 - able to raise head and spine but not scapulae with arms at their side
1 - no motion but palpable contraction
trunk flexion alternative tests
patient is supine with arms across the chest and hips flexed to 90 with legs extended
patients legs are slowly lowered to the table with their back pressed into the table
examiner places one hand under their lower back and asked to repeat the motion
no resistance applied, examiner notes where the spine begins to arch for grading
grading scale for trunk flexion alternative test
5 - able to complete motion without losing PPT
4+ - angle between LE and table is 0-15 when PPT is lost
4 - angle between LE and table is 15-30 when PPT is lost
4- = angle between LE and table is at 30-45 when lost
3+ - angle between LE and table is 45-60 when PPT is lost
3 - angle between LE and table is 60-70 when PPT is lost
2 - angle between LE and table is >70 when PPT is lost
1 = palpable contraction
muscles used during trunk rotation
external/internal abdominal oblique
trunk rotation gravity resisted test
supine with hands behind neck and legs fully extended
passively flexed and rotated until scapulae have cleared table
patient asked to repeat and move elbow/UE toward opposite hip
stabilize anterior aspect of LE if needed
grading scale for trunk rotation test
5 - able to perform motion with arms behind back and clearance of inferior angle of scapulae occurs
4 - with arms folded across the chest
3 - arms by their side
gravity eliminated test for trunk rotation
seated with arms at their side and not allowed to grip table
passively rotated then asked to repeat the motion
stabilize pelvis and palpating a contraction of the external oblique
muscles involved in trunk extension
erector spinae
– iliocostalis thoracis, iliocostalis lumborum, longissimus thoracis
multifidus
semispinalis thoracis
spinalis thoracis
quadratus lomborum
gravity resisted test for trunk extension
prone with hands behind the neck and LE extended with a pillow under the abdomen
trunk is passively extended and returned
patient is asked to actively extend trunk through ROM
gravity eliminated test for trunk extension
aint one
grading scale for trunk extension
5 - able to clear entire sternum including xiphoid process with hands behind neck
4 - able to clear both with arms behind their back
3 - able to clear both but with arms by their sides
2 - extend through partial range of motion with arms at their side
1 - no motion, palpable contraction
muscles involved in pelvic elevation
quadratus lumborum
iliocostalis lumborum
testing procedure for pelvic elevation
no gravity resisted test
patient is positioned supine or prone with feet off the table and hip of testing side slightly abducted
passively elevated through ROM
asked to repeat the hip hike
when at end range, examiner is to pull on LE in the opposite direction of the hip hike
patient is able to hold onto table
grading scale of pelvic elevation test
5 - pelvic elevation is maintained against max resistance
4 - pelvic elevation is maintained against moderate resistance
3 - pelvic elevation is maintained against min resistance
2 - elevates through full ROM but cannot hold against resistance
1 - no motion, contraction of quadratus lumborum right above posterior iliac crest lateral to erector spinae