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.