NECK. Extension ROM: MMT-Position of Patient. Grade IV & V: Prone with head off end of table, arms at side
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1 NECK Extension ROM: MMT-Position of Patient Grade IV & V: Prone with head off end of table, arms at side Grade III: Prone with head off end of table and supported by therapist, arms at side
2 Grade II, I & 0: Supine with head on table, arms at side. Tape Measurement Neck Extension Starting Position End Position
3 Flexion ROM: Flexor Muscles: Sternocliedomastoid, Longus Coli & Scalenus Anterior Manual Muscle Testing:- Position of Patient: Supine with head on table with arms at sides.
4 Rotation ROM: Sternocleidomastoid, Trapezius & Levator Scapulae Manual Muscle Testing- Position of Patient: Grade V, IV & III: Supine with cervical spine in neutral & head supported on table with face turned as far to one side as possible. Tape measurement neck Rotation
5 TRUNK Lumbar Extension ROM: Manual Muscle Testing- Position of Patient: Grade V & IV: Prone with head and upper trunk extending off the table from about the nipple line
6 Grade III, II, I & 0: Prone with arms at sides. Trunk Extension Patient position: Standing, feet shoulders' width apart Bony landmarks for tape measure alignment: Midline of spine in line with PSIS, 15 cm above base line mark
7
8 Trunk Flexion ROM: Trunk Flexors: Rectus Abdominis, Obliquus externus abdominis & Obliquus internus abdominis. Manual Muscle Testing-Position of Patient: Grade V: Supine with hands clasped behind head Grade IV: Supine with arms crossed over chest
9 Grade III: Supine with arms outstretched in full extension above plane of body Grade II: Supine with arms at sides. Knees flexed. Grade I: Supine with arms at sides. Knees flexed. PALPATE the abdominal muscle
10 Trunk Flexion Lumbar Spine Patient position: Standing, feet shoulders' width apart Bony landmarks for tape measure alignment: Midline of spine in line with PSIS, 15 cm above base line mark.
11 Trunk Rotation ROM: Trunk Rotators: Obliquus externus abdominis & Obliquus internus abdominis. Manual Muscle Testing- Position of Patient: Grade V: Supine with hands clasped behind head. Grade IV: Supine with arms crossed over chest.
12 Grade III: Supine with arms outstretched above plane of body. Grade II: Supine with arms outstretched above plane of body. Grade I & 0: Supine with arms at sides. Hips flexed with feet flat on table. Trunk Lateral Flexion Patient position: Standing, feet shoulders' width apart; palm of hand against thigh. At maximal lateral flexion, distance from tip of middle finger to floor is measured
13 Trunk Rotation Patient position: Sitting erect, arms crossed and hands on opposite shoulders Bony landmarks for tape measure alignment: lateral tip of ipsilateral acromion, Greater trochanter of contralateral femur.
14 LOWER EXTRIMITY HIP JOINT: Flexion Hip flexors: Illacus & Psoas Major Manual Muscle Testing: Body Position Grade III, IV & V: Sitting with hip & knee flexed to 90 0
15 Grade II: Side lying Goniometric Measurement Body Position : Supine ROM: 0 to Bony landmarks for goniometer alignment Fixed arm: lteral midline of pelvis/trunk Fulcrum: Greater Trochanter Movable arm: Lateral femoral epicondyle Extension Hip Extensors: Gluteus Maximus, Biceps Femoris, Semimembrenous & Semitendinosus Manual Muscle Testing: Body Position
16 Grade III, IV & V: Prone lying Grade II: Side lying Goniometric Measurement Body Position : Supine ROM: 0 to 20 0 Bony landmarks for goniometer alignment Fixed arm: lateral midline of pelvis/trunk Fulcrum: Greater Trochanter Movable arm: Lateral femoral epicondyle Abduction
17 Abductors: Gluteus Medius, Gluteus Minimus & Tensor Faciae Latae(TFL) Manual Muscle Testing: Body Position Grade III, IV & V: Side lying Grade II: Supine lying Goniometric Measurement Body Position : Supine Range of motion: Bony landmarks for goniometer alignment Fixed arm: lateral midline of pelvis/trunk
18 Adduction Fulcrum: ASIS Movable arm: Midline of patella Adductors: Adductor longus, Adductor Magnus, Adductor Brevis, Pectinius & Gracilis Manual Muscle Testing: Body Position Grade III, IV & V: Side lying with upper leg abducted. Grade II: Supine
19 Goniometric Measurement Range of motion: Body Position : Supine with contra lateral hip abducted Bony landmarks for goniometer alignment Fixed arm: lateral midline of pelvis/trunk Fulcrum: ASIS Movable arm : Midline of patella Internal rotation Internal Rotators: Gluteus Medius, Gluteus Minimus & Tensor Faciae Latae Manual Muscle Testing (Body position) Grade III, IV & V: Short Sitting (with hip & knee flexed at 90 0)
20 Grade II: Supine Goniometric Measurement Range of motion: Body Position : Seated, with hip and knee flexed to 90 degrees, Bony landmarks for goniometer alignment Fixed arm: Tibial Crest Fulcrum: Midpoint of Patella Movable arm: Tibial Crest External Rotation External rotators: Obturator internus & Externus, Superior & Inferior Gemellus, Quadratus Femoris, Piriformis & Gluteus Maximus Manual Muscle Testing (Body position)
21 Grade III, IV & V: Short Sitting (with hip & knee flexed at 90 0) Grade II: Supine Goniometric Measurement Range of motion: Body Position : Seated, with hip and knee flexed to 90 degrees, Bony landmarks for goniometer alignment Fixed arm: Tibial Crest Fulcrum: Midpoint of Patella Movable arm: Tibial Crest KNEE JOINT Flexion
22 Knee Flexors: Hamstring (Semimembrenous, Semitendinosus & Biceps Femoris) Manual Muscle Testing (Body position) Grade III, IV & V: Position of Patient: Prone with limbs straight and toes hanging over the edge of the table.
23 Grade II: Side lying Goniometric Measurement Range of motion: Body Position : Supine with towel roll under ipsilateral ankle to promote full knee extension. Bony landmarks for goniometer alignment Fixed arm: Greater trochanter Fulcrum: Lateral femoral epicondyle Movable arm : Lateral malleolus Extension Knee Extensors: Quadriceps (Vastus medialis, vastus lateralis, vastus intermedius & Rectus femoris) Manual Muscle Testing (Body position)
24 Grade III, IV & V: Short sitting with hip & knee flexed at 90 0 Grade II: Side lying ANKLE JOINT Plantar flexion
25 Ankle Plantar flexors: Gastronomies & Solius Manual Muscle Testing (Body position) Position of Patient: Patient stands on limb to be tested with knee extended. Grade 5: Patient successfully completes a minimum of 25 heel rises through full range of motion without a rest between rises and without fatigue. Grade 4: Heel rises between 24 and 10 with no rest between repetitions and without fatigue. Grade 3 (Fair): Patient completes between nine and one heel rises correctly with no rest or fatigue. Grade 2: Side lying with feet clearing the end of table. Goniometric Measurement Range of motion:
26 Body Position : Long sitting with knee in extension & ankle in neutral position (90 0 ) Bony landmarks for goniometer alignment Fixed arm: Fibular head Fulcrum: Lateral malleolus Movable arm : Lateral midline of 5th metatarsal Dorsiflexion Ankle Dorsiflexors: Tibialis Anterior, Extensor Hallucis Longus, Extensor digitorum Longus & Peroneus Tertius Manual Muscle Testing (Body position)
27 Grade III, IV & V: Short sitting with knee & ankle flexed at 90 0 Grade II: Side lying Goniometric Measurement Range of motion: Body Position : Long sitting with knee in extension & ankle in neutral position (90 0 ) Bony landmarks for goniometer alignment Fixed arm: Fibular head. Fulcrum: Lateral malleolus Movable arm: Lateral midline of 5th metatarsal Inversion
28 Ankle Invertors: Tibialis posterior Manual Muscle Testing (Body position)
29 Grade III, IV & V: Short sitting with hi & knee flexed at 90 0 Resistance: Antero-medial border of foot Grade II: Long sitting with knee in extension & ankle in neutral position (90 0 ) Eversion
30 Ankle Evertors: Peroneous longus &Peroneous brevis Manual Muscle Testing (Body position) Grade III, IV & V: Short sitting with hi & knee flexed at 90 0 Resistance: Antero-Lateral border of foot Grade II: Long sitting with knee in extension & ankle in neutral position (90 0 )
31 Tape Measurement Trunk Flexion Thoracolumbar Spine Patient position: Standing, feet shoulders' width apart Bony landmarks for tape measure alignment: Midline of spine in line with PSIS, spinous process of C7 vertebra. Trunk Lateral Flexion Patient position: Standing, feet shoulders' width apart; palm of hand against thigh At maximal lateral flexion, distance from tip of middle finger to floor is measured Trunk Flexion Lumbar Spine Patient position: Standing, feet shoulders' width apart Bony landmarks for tape measure alignment: Midline of spine in line with PSIS, 15 cm above base line mark. Trunk Extension Patient position: Standing, feet shoulders' width apart Bony landmarks for tape measure alignment: Midline of spine in line with PSIS, 15 cm above base line mark Trunk Rotation Patient position: Sitting erect, arms crossed and hands on opposite shoulders Bony landmarks for tape measure alignment: lateral tip of ipsilateral acromion, Greater trochanter of contralateral femur. Chest Expansion Maximum Expansion 2 to 6 cms Locations for measuring the expansion a. T1 or at the level of Axilla b. T4 or at the level of Nipples c. T10 or at the level of Xiphisternum Limb length Measurement True length: From Greater trochanter to medial malleolus Apparent length: From Umbilicus/ASIS to medial malleolus Limb Girth Measurement It s the measurement of thigh circumference at 15 cms above the patella. >>>>>>>>>>>>>>>XXXXXXXXXXX,<<<<<<<<<<<<<<<<<<<<<<
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