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MUSCULOSKELETAL EXAM, TESTS AND MEASURES, SPECIAL TESTS AND OUTCOME MEASURES
Assignment # 4 (5 points)
Musculoskeletal Exam ScreeningLook for deformity, observe spontaneous movement, tone, palpate for tenderness & masses, assess joint motion
Range of Motion (Chapter 5 Table 5.1, 5.2A, 5.2B, 5.3 Changes with age, greatest in infancy, declines
with age Varies widely Specific joints are affected by intrauterine
position
UE table 5.1 page 188, LE table 5.2A & 5.2 B pps 189-190
Strength (isolated vs synergy) Movement against gravity MMT-more subjective
SCALE specific testing to determine isolated muscle control
4 years reliability with hand held dynamometer
Spasticity / Tone Ashworth Scale Tardieu Scale Hypotonia Assessment Tool (HAT)
Scales to document assessment of SPASTICITY: Modified Ashworth Scale - MAS (refer to
page 236, box 8.2 of PR text for a more detailed description) 0 No increase in tone (normal) 1 Slight increase in tone, end of the range (may
catch and release) 1+ Slight increase in tone through less than ½ the
range 2 Marked increase through most of the range (still
moves easily) 3 Passive movement difficult 4 Rigid (no movement) in flexion or extension Modified from Bohannon and Smith3
NM1 notes p.194
Tardieu ScaleThis test is performed with patient in the supine position, with head in midline.• Measurements take place at 3 velocities (V1, V2, and V3).• Responses are recorded at each velocity as X/Y, with X indicating the 0 to 5
rating,and Y indicating the degree of angle at which the muscle reaction occurs.• By moving the limb at different velocities, the response to stretch can be
moreeasily gauged since the stretch reflex responds differently to velocity.Velocities:V1: As slow as possible, slower than the natural drop of the limb segment under gravityV2: Speed of limb segment falling under gravityV3: As fast as possible, faster than the rate of the natural drop of the limb segment under gravityScoring0 No resistance throughout the course of the passive movement1 Slight resistance throughout the course of passive movement, no clear catch at a precise angle2 Clear catch at a precise angle, interrupting the passive movement, followed by release3 Fatigable clonus with less than 10 seconds when maintaining the pressureand appearing at the precise angle4 Unfatigable clonus with more than 10 seconds when maintaining thepressure and appearing at a precise angle5 Joint is immovable
NMI notes p.187Video http://www.youtube.com/watch?v=JOL6FjY0-zkhttp://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=1038
Musculoskeletal exam & Specific MS Tests and Measures: Effgen Pages 200-2141. Leg length2. Adams3. Thomas test4. Staheli test5. Ober Test6. Ryder or Craig
Test7. Popliteal angle
test8. Hamstring Length
test9. Straight leg test
10. Valgus and Varus11. Tibial Torsion12. Weight bearing13. Dorsi Flexion14. Plantar Flexion15. Foot Supination and Pronation16. Metatarsus adductus
Musculoskeletal Exam/Specific tests and measures Leg length
Limp, obliquity, asymmetrical gait, back pain
ASIS
Medial
Malleolus
Galeazzi sign
Musculoskeletal Exam/Specific tests and measures Range of Motion
Spine Scoliosis
Adams test Kyphosis
Musculoskeletal Exam/Specific tests and measures
Hip Thomas test Staheli test
Musculoskeletal Exam/Specific tests and measures
Hip Ober test Ryder or Craig test
Musculoskeletal Exam/Specific tests and measures Knee
Popliteal angle test Hamstring length
test Straight leg test
Musculoskeletal Exam/Specific tests and measures
Knee Valgus and
varus Tibial torsion
Posture Posture what is normal posture as a
child develops in Sitting Kneeling Crawling Standing Walking
Posture in sitting, kneeling, crawling, standing and walking (Describe how you will check posture for all positions listed).
Length and Weight for AgeDevelopmental Age Length for Age and Weight for Age (Use
chart provided) What % of the standard is the child you are working with? What does this tell you?
Gross Motor– score the child using the HELP provided in your packet. Explain why you chose the developmental age you gave to the child.
Pediatric Balance and Gait Tests and Measures Timed Up & Go (Tug) Timed Floor to Stand Thirty Second Walk Test Pediatric Reach Test PRT or Pediatric Functional
Reach Test
Pediatric Balance Scale (PBS) or Pediatric Berg Balance Scale
Once you have complete your exam and reviewed and practicing all tests: List 6 lessons learned about exam and evaluation of pediatric clients that will help you in POINT Lab.