Week 2 Flashcards
How do we assess muscle function
Strength testing
Manual muscle testing
Dynamometry
Electromyography
Manual Muscle Testing is used…
How is it used to aide
To determine the extent of muscular weakness as the result of disuse, injury or disease
Aid diagnoses and plan therapeutic exercise when a strength deficit exists
Manual Muscle Testing scores go from
0 - 5
0 being none
5 being normal
What type of test is used in manual muscle testing
Isometric
but can also test through range of motion
Examiners in manual muscle testing place the participant in…
A position and try to break the participant by moving them away from their isometric hold
They then grade muscle contraction based on MMT grading scale
Patient positioning in Manual Muscle testing involves
Muscle is placed at optimum muscle length tension relationship
Exact position varies per muscle group
Patient is physically placed in position to best test that muscle group
How could you modify the test for hip flexion using MMT if the patient cannot lift their own leg to optimal position
Have them lie on their side to neglect the gravity effects
Examiner positioning during MTT involves
Placing the resistance to maximise your mechanical advantage
In order to resist the patient isometrically, the amount of torque you apply must match the amount of torque the patient applies - static equilibrium
Muscle torque = resistance torque
Torque =
Force x Moment arm
How do we maximise your leverage
By increasing the moment arm of your resistance force
Isometric is
Pushing against immobile resistance
Concentric is
Pushing against resistance
Speed not consistent
Eccentric is
Push against resistance
Resistance wins
Isokinetic is
Pushing against resistance at constant speed
Isometric dynamometry is most common because
All types exist
What can you measure with Dynamometry
Peak force
Average force
Power (force/time)
Time to force peak or decline (fatigue)
What are the benefits of handheld dynamometry
Cheap
Easy to Perform
Quick in clinic
What are the benefits of Isokentic
Gold standard in accuracy
Can compare between subjects
Multiple measurement modes
Can measure any joint
Not reliant on tester strength
Range of motion testing is…
Biomechanical assessment of human movement
How do we assess ROM/Flexibility
Stretching Assessment
Goniometry
What can limit ROM
Muscle tightness Tendons stiffness Ligament stiffness Other tissues (fascia, rentinaculum) Injury
Positioning goniometer involves
Lining up goniometer axis on joint center
Line up stationary arm with stationary body segment
Move joint to end ROM (passive or active) and align goniometer moving arm with moving body segment
Read gonionmeter (degrees)
Black numbers on goniometer used
Red numbers on goniometer used
If joint neutral position is 0 or 180
If joint neutral position is 90
Goniometry exception is
Why
Trunk flexion/extension
This is because it is not accurate because spine is multi segmented
Passive vs active testing in goniometry
Passive = you move the patient to their end range
Active = patient moves to end of range
What should you consider in goniometry testing
Patients strength
Whether the patient is injured or in pain
Which of the following is not a method of testing muscle function or strength
Goniometry
Manual muscle testing (MMT) and dynamometry are most commonly performed using what type of muscle contraction
Isometric
If a patient is only able to achieve full range of motion in a gravity eliminated position, they would score what on the MMT scale
2
For MMT, you should place the participant in a position where the muscle is shortened and weaker relative to the optimum length-tension relationship
False
What factor can you most easily manipulate in order to improve your mechanical advantage when resisting the patient
The moment arm of your resistance force
A Biodex or HUMAC Norm machine is able to perform what type of dynamometry, that is essentially impossible with a handheld dynamometer
Isokinetic
Which portion of the goniometer do you line up with the joint center
Axis of rotation
The angle of the joint in neutral position will affect how you read the dynamometer
True
Measuring trunk flexion/extension range of motion is done by lining the goniometer axis with the hip joint, the stationary arm with the thigh, and the moving arm with the shoulders
False
Moving the patient to the end of their range of motion during goniometry is called what type of test
Passive ROM testing
0 on a MMT scale represents
No visible contraction
1 on a MMT scale represents
Visible or palpable contraction with no motion
2 on a MMT scale represents
Full ROM gravity eliminated
3 on a MMT scale represents
Full ROM against gravity
4 on a MMT scale represents
Full ROM against gravity, moderate resistance
5 on a MMT scale represents
Full ROM against gravity, maximal resistance
Muscle for ankle plantarflexion
Gastrocnemius
Muscle for ankle dorsiflexion
Tibialis anterior
Muscle for ankle inversion
Tibialis anterior
Muscle for ankle eversion
Peroneus longus/brevis
Muscle for knee flexion
Bicep femoris
Muscle for knee extension
Rectus femoris
Muscle for hip flexion
Psoas major
Muscle for hip extension
Gluteus maximus
Muscle for hip abduction
Gluteus medius
Muscle for hip adduction
Adductor longus
Muscle for hip IR
Tensor fasciae latae
Muscle for hip ER
Piriformis
Muscle for trunk flexion
Rectus abdominis
Muscle for trunk extension
Erector spinae
Muscle for shoulder flexion
Anterior deltoid
Muscle for shoulder extension
Latissimus Dorsi
Muscle for shoulder abduction
Trapezius
Muscle for shoulder adduction
Pectoralis major
Muscle for shoulder IR
Subscapularis
Muscle for shoulder ER
Infraspinatus
Muscle for elbow flexion
Brachialis
Muscle for elbow extension
Tricep brachii
Muscle for wrist flexion
Flexor Carpi Ulnaris/radialis
Muscle for wrist extension
Extensor Carpi Ulnaris/radialis
Muscle for ulnar deviation
Flexor & Extensor Carpi Ulnaris
Muscle for radial deviation
Flexor and Extensor Carpi Radialis