1. Whatarethedifferencesbetweenfunctionalmuscletestingandmanualmuscletesting? MMTisthemostcommonlyusedmethodfordocumentingimpairmentsinmusclestrength.Manualmuscletestingengagesrangeofmotionactivityandresistance. FMTmeasuresandratesyourabilitytoengageinandperformactivitiesrequiredfordailyliving,suchaswalking,bending,squattingorholdingorliftingobjectsofvarioussizesandweights.Functionalmuscletestingevaluationstakeintoconsiderationyourabilitytobalance,bearweight,climbstairs,walk,lungeandjumporhopfromonespottoanother.

2. Whatcriteriaareusedtodeterminemusclegrades? Subjectively:OT’simpressionofamountofactualresistancetogiveOT'simpressionofamountofresistancepatientwillactuallytolerate.Objectively:AbilityofpatienttocompletefullAROM,Abilitytoholdbodypartinposition,Abilitytomoveagainstgravityormoveatall.Thepatientshouldhavegoodcardiovascularfunction,beinstructed,andbepositionedappropriately.Careshouldbetakenwithanybodypartthatisundermovementrestrictionsduetofracture,post-surgery,orothertissueintegrityissues.

3. Listanddescribethemuscletestinggradesthatarecommonlyused(includenumbergradeandwordorlettergrade).

5 Normal(N) Holdstestpositionagainstmaximalresistance4+ Good+(G+) Holdstestpositionagainstmoderatetostrongpressure

4 Good(G) Holdstestpositionagainstmoderateresistance4- Good–(G-) Holdstestpositionagainstslighttomoderatepressure

3+ Fair+(F+) Holdstestpositionagainstslightresistance3 Fair(F) Holdstestpositionagainstgravity3- Fair-(F-) Gradualreleasefromtestposition2+ Poor+(P+) MovesthroughpartialROMagainstgravityORMovesthroughcompleteROM

gravityeliminatedandholdsagainstpressure

2 Poor(P) AbletomovethroughfullROMgravityeliminated

2- Poor–(P-) MovesthroughpartialROMgravityeliminated1 Trace(T) Novisiblemovement;palpableorobservabletendonprominence/flicker

contraction0 0 Nopalpableorobservablemusclecontraction

4. List3purposesforassessingmusclestrength. 1.Muscletestinginanyindividualwithsuspectedoractualimpairedmuscleperformance,includingstrength,power,orendurance. 2.Identificationofspecificmusclesormusclegroupswithimpairedfunction. 3.Providesfeedbackthatresultsinassistingintheplanoftreatment,interventions,andtherapy.

5. Defineenduranceanddiscussitscorrelationwithmusclestrength. Muscularendurancereferstotheabilitytoperformaspecificmuscularactionforaprolongedperiodoftime.Muscularstrengthisamuscle’scapacitytoexertforceagainstresistance.

6. Definewhatismeantbysubstitution. Whenastrongermuscletriestosubstitutefortheweakermuscle.EX:hipabductorsweakness:substitution-useoflateraltrunkmusclesortensorfascialatae.Alsoknownascompensatorymuscles.

7. Outlinetheproceduralstepsinperformingamanualmuscletestandafunctionalmuscletest.MMT:quietandcomfortableenvironmentdetermineifpatientcangetintothestandardtestingposition-modifyifcannotmoveclothingsoitdoesnotrestrictmovementorganizetestssothatpositionchangesareminimizedhavepatientmovethroughavailableROM

placeonehandtosupportorstabilizeuseotherhandtoapplyresistanceifindicatedforthegradetestingassistpatienttoreturntorestingpositionnotegradeandanymodificationofstandardtestingprocedurerequired

8. Outlinethesuggestedsequenceforpositioningyourclienttocompleteamanualmuscletest. DetermineROMpassively.Lineupthepartwithfibersofthemuscletobetested.Provideadequatestabilization.Havethepatientattemptmotionthroughthetestrange.LOOKatmusclemovementfirst,PALPATEatthetendonormusclebellysecond.Applyresistanceattheendoftherangeifthemuscleisstrongenough,calledthebreaktest.

9. Picturethatdescribesthefunctionalmuscletestingpositionusedineachofthefollowingmovements:a. Scapularevaluation

b. Shoulderflexion

c. Elbowflexion

d. Elbowextension

e. Wristflexion

f. Wristextension

1. Definerangeofmotion(ROM).Thefullmovementpotentialofajoint,usuallyitsrangeofflexionandextension.

2. Describewhatismeantbyactiverangeofmotion(AROM).Patientperformstheexercisetomovethejointwithoutanyassistancetothemusclessurroundingthejoint.

3. Describewhatismeantbypassiverangeofmotion(PROM).Amountofmotionatagivenjointwhenanexternalforceortherapistmovesthejoint.

4. Describewhatismeantbyactiveassistedrangeofmotion(AAROM)Patientusesthemusclessurroundingthejointtoperformtheexercisebutrequiressomehelpfromthetherapistorequipment(suchasastrap)

5. Whatisagoniometer?aninstrumentfortheprecisemeasurementofangles

6. Usingthe180°system,whatrowoffiguresdoyoureadonthegoniometerinmeasuringtheelbow?Theshoulder?

7. Onwhatdoesglenohumeraljointmotiondepend?multiaxialsynovialballandsocketjointandinvolvesarticulationbetweentheglenoidcavityofthescapulaandtheheadofthehumerus

8. Whyisitimportanttoassessscapulamobility?Becauseallthemusclesforshouldermovementsandstabilizationattach,atsomepoint,tothescapula.

9. Listseveralcausesofjointlimitation.ankylosingspondylitis,atypeofarthritisthatprimarilyaffectsthespineosteoarthritis,themostcommonformofarthritisrelatedtoolderageandwear-and-teartothejointsrheumatoidarthritis,anautoimmuneformofarthritiscausedbyyourimmunesystemattackingyourjointsjuvenilerheumatoidarthritis,anautoimmuneformofarthritisthatoccursinchildrenundertheageof16yearscerebralpalsy,agroupofneurologicaldisordersthatcausesmuscleparalysisandlossofbodycontrolthecongenitalformoftorticollis,astiffneckassociatedwithmusclespasmsLegg-Calve-Perthesdisease,adisorderthatcausesthethighbonetodiebecauseoflackofbloodflowtothejointseptichip(andothersepticjoints),abacterialinfectionofthejointssyphilis,asexuallytransmittedinfection(STI)inflammationofthesofttissuessurroundingthejoint(jointswelling)musclestiffnesspainjointdislocationelbowfracturesorfracturesinotherareasofthebody

10. WhatistheimportanceoflookingatfunctionalactivitiesindoingROM?Becausefunctionalactivitiessimulatethoseusedindailyactivities.

11. WhatcanbedoneifaparticularjointhasapermanentROMlimitation?Adaptiveequipment,environmentaladaptations

12. ListseveralreasonswhyaROMassessmentmaybeneeded.Earlydisorderintervention,recovery,ADLperformance.Movementcanhelpkeepyourjointsflexible,reducepain,andimprovebalanceandstrength.Helpmaintainnormaljointfunctionbyincreasingandpreservingjointmobilityandflexibility.

13. DescribethegeneralproceduresforevaluatingROM.Step1-SetthebedlevelTobeginwith,youneedtoadjustthebedlevelofthepatient,whereyouwilleasilygettotheclient’sbodywithoutanydifficulty.Forthis,youcanraisetheheadsideoftheclient’sbed.

Step2-StartwiththeheadStartwiththepatient’sheadbyaskinghim/hertomakeheadmovementsfromlefttotherightdirectionslowly.Nowletthepatientdotheheadexercisebynoddingtheheadinupanddownwardspositions.Makesure,thepatientdoesalltheseexercisesinnotmorethan3to10motions,inaday.Step3-NowChecktheArmsNow,checkthepassiverangeofmotionofpatient’sarm.Youmayalsoaskthepatienttodotheexercisepersonally.

• Extendtheclient’sarmssoftlyandholditattheelbowbykeepingitstraightonthebed.• Whiledoingthisassistthepatienttobringhis/herarmsstraighttowardsthebody(sideways)andthen,

takeitawayfromthebody.• Now,askhim/herdothisexerciseinupanddowndirections.Dothebodymotions,onlynumberoftimes

areprescribedbythedoctor.• Afterwards,asktheclienttoloosenuphiswristsandmakemovementsofthefingers.

Step4-DothemotionexerciseswiththekneesandlegsAftertheheadexercises,youalsohavetocheckthekneesoftheclient.

• Startitbykeepingbothofthekneesofthepatientinstraight.• Askhim/hertoloosenupthelegs.• Now,askhimtocarrythelegsnearthecenterofthebodyandagaintakeitfarther.• Conductthisactivitynotmorethan10motions,afterseekingpermissionbythedoctor.• Suggestthepatienttoexpandthefeetatanklesandloosenup.• Also,telltheclienttotwirlandmovethetoes.

Step5-The5typesofexercisepositions,youmustknowforpassiverangeofmotions:TheHigh-FowlerPosition:–Underthisposition,youhavetokeeponeside(i.e.Thesideofthehead)ofthebedelevatedintherangeof60to90degrees.Thepatient’sheadshouldbesupportedbytheelevatedsideofthemattress.Checkthatthebedshouldnotbeelevatedmorethan90degrees.Step6-TheSupinePositionInthisposition,thepatienthastobepositionedonthebedonhis/herbackwithkeepingthefaceintheupwarddirectionandarmsstretchedonbothsides.Step7-TheSemi-FowlerPositionThispositionissimilartothehigh-fowlerpositionwithhead-sideofthebedelevatedbutnotupto60or90degrees.Afterlayingdownthepatientonthebed;thehead-sideofthepatientbedshouldnotberaisedmorethan45degrees.Step8-TheSimsPositionUnderthisposition,youhavetorollthepatienttoonesidebykeepingthelegsstraight.Youcanalsoprovidepillowsorcushionstopatientsforpropersupportandcomfort.However,whilesleepingthiswaythepatientscanbendtheirlegs,iftheywouldwant.Step9-TheLateralPositionThepatientisturnedtoonesideofthebedbykepttheleginflexedformandlittleraisedupwiththehelpofasoftcushionorapillow.Thearmandtheleg,whichisonthetoparepositionedabitelevated.14. Identifythemovementsthefollowingsymbolsrepresent:

a. /EXTEN.b. √FLEX.c. ROTATION