Muscle Testing Procedures

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Questions and Answers

What is the correct procedure regarding resistance during muscle testing?

Resistance should only be applied if the patient feels fatigued.

Resistance can be adjusted after reaching peak muscle contraction.

Resistance should be applied quickly to prevent discomfort.

Resistance must be directed opposite to the line of pull of the muscle tendon. (correct)

In what scenario should a therapist provide more support during muscle testing?

When the strength grade is between 0 and 2. (correct)

When full range of motion against gravity is achieved.

When the patient displays grade 4 strength.

When the patient can hold against moderate pressure.

During the break test, when is resistance applied?

Immediately as the muscle starts to contract.

Once the muscle is fully fatigued.

When the patient reaches the end of their range of motion. (correct)

At the beginning of the range of motion.

What defines a muscle strength grade of 3?

Ability to move through full range of motion against gravity. Signup and view all the answers

What differentiates the active resistance test from the break test?

In the active resistance test, resistance prevents movement rather than breaking the hold. Signup and view all the answers

What is the primary focus of muscle testing?

Evaluating voluntary muscle strength of individual muscles Signup and view all the answers

Which grading scale introduced in 1932 describes a muscle with no palpable contraction and no motion?

Gone Signup and view all the answers

What is NOT a requirement for conducting muscle testing?

Knowledge of patient’s medical history Signup and view all the answers

Which grade indicates a muscle can hold the position against maximum resistance through the full range of motion?

Grade 5 Signup and view all the answers

In muscle testing, what should be the first action taken according to the basic principles?

Assess unaffected side strength Signup and view all the answers

What describes a 'Fair' grade in muscle testing?

Can raise part against gravity Signup and view all the answers

Which of the following is an objective factor in assessing muscle strength?

Completion of the range of motion Signup and view all the answers

Which historical figure contributed to the development of the grading system utilized in muscle testing in 1917?

Wilhelmine Wright Signup and view all the answers

Signup and view all the answers

Study Notes

Muscle Testing

Muscle testing is a manual test of voluntary muscle strength and function as a prime mover.
Muscle testing is used to assess individual muscle strength and function.

History of Muscle Testing

Wilhelmine Wright & Robert Lovett (orthopedic surgery professor) created a 1917 book on resistance gravity system (grades 0-6).
Legg & Janet Merrill (PT) created a 1932 book on muscle testing used in polio.
Lowman (1940) used muscle testing in physiotherapy.
Lucille Daiels & Marian Williams (PT) created a 1946 book on manual muscle testing (0-5).

Basic Principles of Muscle Testing

Learn how much resistance normal muscles can tolerate.
Start testing on the unaffected side.
All tests must be bilateral.
Need to know the normal for the patient.

Factors Considering Muscle Strength

Ability of the muscle to contract.
Ability of the muscle to move through its full range.
Amount of resistance given to the working muscle.

Requirements for Muscle Testing

Knowledge of muscle and joint structure.
Knowledge of nerve supply and function of the muscle.
Knowledge of test procedure and grading of muscles.
Ability to accurately observe, handle, and palpate the muscle.
Ability to recognize muscle substitution.

Preparation for Manual Muscle Testing

Room should be quiet, warm, and well-lit.
Use a firm examination table.
Explain the test to the patient.
Maintain a comfortable, supported position for the patient (allow them to see).
Review the medical notes.
Observe patient's posture and muscle wasting.

Technique of Muscle Testing

Maintain adequate joint fixation.
Test all joints throughout the range of motion (active or passive).
Resistance should be provided by the therapist's hand.
Resistance should be smooth and adjustable, directed opposite to the muscle's line of pull.
Perform all tests in one position, before moving to another.
Avoid fatigue in the patient.
Record the results on the appropriate chart.

Factors During Muscle Testing

During grades 0-2, provide more support in the horizontal plane.
During grades 3-5, the position is held against gravity.

Grading Scales (Daniel & Worthingham 1995)

Grade 5: Full ROM against maximum resistance.
Grade 4: Full ROM against strong to moderate resistance.
Grade 3: Full ROM without resistance.
Grade 2: Partial ROM against gravity.
Grade 1: Muscle contraction is palpable but no movement.
Grade 0: No muscle contraction.

Grading Scales (1932 and Other Scales)

Gone: No contraction felt.
Trace: Muscle contraction felt (tight), no movement.
Poor: Movement eliminated against gravity.
Fair: Can raise part against gravity.
Good: Can raise part against gravity and resistance.
Normal: Can over come resistance greater than normal.

Break Test

Performed at the end of the range of motion (ROM).
Therapist applies resistance to break a held position.
The part will move downward.

Active Resistance Test

Alternative to the break test.
Therapist applies manual resistance against active muscle contraction, preventing movement.
Resistance increases gradually to the maximum level the patient can tolerate.

Muscle Testing Scores and Descriptions

Scores and descriptions of tests and findings for grading muscle scores. (See pages 18 and 19 for these details.)

Manual Muscle Testing of the Upper Extremity

Topic focused on upper extremities.

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Description

Test your knowledge on the correct procedures for muscle testing in therapy. This quiz covers key concepts like resistance application, support scenarios, strength grading, and the differences between active resistance tests and break tests. Enhance your understanding of muscle assessment techniques.