TERMS USED IN DESCRIPTION OF MUSCLE STRENGTH TESTS

TERMS USED IN DESCRIPTION OF MUSCLE STRENGTH TESTS

Patient

In the description of each muscle test, this entry is followed by the position in which the patient is positioned to perform the desired test. Position is important in relation to the test in two respects. First, to the extent that practice, your body position should allow for function against gravity for all muscles where gravity is at evaluation factor. Secondly, the body must be positioned in such a way that the parts that are not tested remain as stable as possible. (This point is discussed later in Fixation.)

Fixation

This entry refers to the firmness or stability of the body or part of the body, necessary to ensure a test of a muscle or muscle group. Stabilization (i.e. firm seal or low seal), support (i.e. seal) and back pressure (i.e. equal and opposite pressure) are included in the device, which implies sealing. Fixation will be affected by the firmness of the table, body weight and, in some tests, the muscles that provide fixation. Correct fixation strongly depends on the firmness of the examination table, which offers many of the the necessary support. Strength testing and assessment will not be accurate if the table the patient is lying on has a thick, soft cushion or soft mattress that "gives way" when the examiner applies pressure. Body weight can provide the necessary fixation. Since body weight is an important factor in providing stability, the horizontal, supine, prone or sideways position offers the best fixation for most tests. In the extremities, the part of the body that is close to the tested part must be stable. The examiner can stabilize the proximal portion in finger, wrist, foot, and toe muscle tests, but in other tests, body weight should help stabilize the proximal portion. In some cases, the examiner may offer fixation in addition to the weight of the proximal portion. It may be necessary to hold a piece firmly on the table so that the pressure applied to the distal piece (plus the weight of that piece) does not displace the weight of the proximal piece. In rotational testing, the examiner must apply back pressure to ensure accurate test performance.

Strength Testing

On muscle testing, weakness must be distinguished from restricted range of motion. Often a muscle cannot complete normal range of joint motion. The muscle may be too weak to complete the movement, or it may be that the range of motion is limited due to a shortening of the muscles, capsule or ligaments structures. The examiner must passively bring the piece through the range of motion to determine if there are any restrictions. If there is no restriction, the subject's inability to maintain the test position can be interpreted as weakness, unless there is joint or tendon laxity. When evaluating muscles in a joint where the ability to hold the part is expected upon completion of range of motion, the examiner must distinguish between muscle weakness and tendon failure. For example, the quadriceps may be strong but cannot fully extend the knee because the patellar tendon or quadriceps tendon has been stretched.

Test Position

Test position is the position in which the part is placed by the examiner and held (if possible) by the patient. It is the position used for the purpose of evaluating strength for most muscles. The optimal test position is at the completion of range for one-joint muscles and for two or multijoint muscles that act like one-joint muscles. The optimal test position for other two or multijoint muscles is at midrange of overall length, in accordance with the length-tension principle.

Test Movement

Test motion is the movement of the part in a specific direction and through a specific range of motion. by force tests of muscles in the extremities that are too weak to act against gravity (i.e. muscles that qualify in the poor range), tests are performed on the horizontal plane. The test move is also used when testing the lateral flexors of the trunk, the upper abdomen flexors, posterior extensors, quadrate lumbar, serratus anterior (standing) and gastrocnemius. The test movement can be used for certain muscles, such as those that cross joint joints, but is impractical when a test requires a combination of two or more joint positions or movements. It is difficult for a patient to assume the exact position through verbal instructions or by imitating a movement demonstrated by the examiner. For an accurate test, the examiner must position the part exactly in the desired test position.

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