BASIC RULES OF PROCEDURE THAT APPLY TO MUSCLE STRENGTH TESTING

 

TEST FOR STRENGTH—CLASS I & II:

AT END RANGE WITH MAXIMAL SHORTENING OF MUSCLE

Class I

Muscles of a joint that are actively shortened (i.e., concentric contraction) throughout the range to complete the joint movement and show maximum strength upon completion of the range (i.e., short and strong).

Examples: triceps, medial and lateral heads; deltoid; large pectoral; three muscles of the thumb of one joint; buttock maximum; iliopsoas; and soleus.

Class II

Two- and multi-joint muscles that act as uniarticular muscles by actively shortening on both or all joints simultaneously and exhibiting maximum strength upon completion of the interval (i.e. short and strong).

Examples: sartorius, anterior and posterior tibialis and long, short and third peroneal.

TEST FOR STRENGTH—CLASS III & IV:

AT MIDRANGE OF OVERALL LENGTH OF MUSCLE

Class III

Two-joint muscles that shorten on one joint and stretch on the other to provide a mid range for the whole muscle length for maximum contraction and strength (represented by the length-tension curve).

Examples: rectus femoris, hamstrings and gastrocnemius.


Class IV

Biarticular or multiarticular muscles that physiologically act in one direction but do not shorten too much by the coordinated action of synergistic muscles.

Two-Joint Muscle Example: The biceps act to flex the shoulder joint and the elbow joint. If it acts to flex both joints at the same time, the muscle would become too short. To avoid this, the shoulder extensors, as synergists, they extend the shoulder joint, thereby stretching the bicep above the shoulder joint when the elbow it is maximally flexed by the biceps.

Example of Multijoint Muscle: If you work in one direction by simultaneously flexing your wrists and fingers, the the flexors and extensors of the fingers would become too short and actively insufficient. Nature, on the other hand, prevents let this happen. In a strong flexion of the fingers, such as when making a fist, the flexors of the finger are shortened. joints, but they are prevented from shortening their entire length by the synergistic action of the wrist extensors which support the wrist in moderate extension, thereby stretching the flexors above the wrist joint so that they can do so shorten above the finger joints.

BASIC RULES OF PROCEDURE THAT APPLY TO MUSCLE STRENGTH TESTING

Position the person in a position that provides the best fixation for the body as a whole (usually supine, prone, or sideways). Stabilize the part near the rehearsed part or, as in the case of the hand, adjacent to the rehearsed part. Stabilization is required for the specificity of the tests. Place the part to be tested in a precise antigravity testing position, where appropriate, to achieve the desired muscle action and aid classification. Use horizontal plane test motions when testing muscles that are too weak to function against gravity. Use the test motions in anti-gravity positions for most torso muscle tests where body weight offers sufficient resistance. Apply pressure directly opposite to the line of traction of the muscle or muscle segment to be tested. Like the anti-gravity position, the direction of pressure helps to elicit the desired muscle action. Apply pressure gradually, but not too slowly, allowing the subject to "settle down and hold". Apply even pressure; Avoid localized pressure which can cause discomfort. Use long leverage whenever possible, unless contraindicated. The length of the lever is determined by the position of the pressure along the lever arm. Better discrimination of force for sorting purposes is achieved by using a long lever. Use a short lever if the muscles involved do not provide sufficient fixation to use a long lever. The order in which muscles are tested is largely a matter of choice, but is generally organized to avoid frequent and unnecessary position changes for the subject. Muscles that are closely related in position or action tend to appear in test order sequentially to distinguish test differences. As a general rule, the length test precedes the strength test. When the specific order of trials is important, this is indicated in the text. In all muscle tests, patient comfort and intelligent management of the affected muscles are important factors. In some cases, the patient's comfort or the condition of the affected muscles will require a change in the test position. For example, insisting on an anti-gravity position can result in an absurd position of the patient. Lying on your side, which offers the best testing position for various muscles, can be uncomfortable and cause tension in other muscles.

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