ROM, MMT
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| POSTURE | alignment of the body | relative disposition of joints | in any motion the placement of one joint effects another | show |
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| Plumb line lateral aspect | EAM--> acromion process | greater trochanter--->lat epicondial of femur--->lat maleolus | bodies of lumb--->Posterior to hip | ant to knee--->ant to lat maleolus | lat epicondyle of knee | show 🗑
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| Anterior plumb line | nose | sternum | belly button | pubic symphysis | right between legs | show 🗑
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| Sitting posture | neutral to slight anterior pelvic tilt | show |
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| ROM | degree of mvmnt in joint | show |
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| ROM limitation | tight tissue | shortend muscles | show | AROM- muscle weakness |
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| PROM affected by | CVA (spastic) | tight ligament, burn scar(joint contracture and abnormqal bone mvmnt) | hand trauma | dislocation of joint/ disaligned surface | foreign bodies in the joint( calcification) | show 🗑
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| Why measure ROM | may effect occupations | choose modalities | show | assistive devices | baseline ( see if pt is progressing)(effectiveness of treatment |
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| show | screening- for adequate rom for occup performance | AROM ( for muscle strength) | measure PROM (for joint deficits) | look for symmetrt/compen./quality/post/color/facial expressions | can always observe coordination and pain | if there is a limitation in AROM do PROM
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| End feel | soft ( knee/ elbow flex) | hard ( elbow ext) bone to bone | show |
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| Abnormal pathology | swelling soft instead of hard | spacticity firm- when occurse sonner than expect (full rom not reached) | bone protrusion- hard instead of soft or firm | show |
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| Precautions for ROM | never do with our written orders | don't do it on a dislocated joint | don't do it on a non healed fracture | don't do immediately post op of tissue around joint | myositis ossifications ( disease calcified)osteoperosis- (easily fracture) inflamation- (joint is unstable) | show 🗑
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| MMT | muscles strength | show |
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| Causes of muscle strangth limitations | direct disease (MD, myas grav) | an injury to muscle itself | lmn issues ( perph nerve injury, periph neurophathy( disease processin pns distalmuscles not recieve sensation),guillian barre, spinal chord injury effects nerev roots even through cns injury) | indirect/misuse imobilization (amputations, arthritis, fracture) | show 🗑
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| Why do we do MMT | need to assess individuals meaningful occupations and decide if deficit interferes with performance | show |
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| DO not perform MMT | on disorders related to tone | CNS- message from brain arent being transmitted so they willnot be able to control and isolate movmnt | show 🗑
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| Types of muscle contractions | show | Isotonic (joint movement and change in length of muscle) |
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| ISOTONIC movement | concentric ( muscle gets shorter) | eccentric (muscle is lengthend) | show 🗑
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| When do we test strength? | when we do a quick ROM asessment - they have grade of 3 bec no resistance applied | show | add resistance/ you can test strength with their available ROM |
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| Endurance | When testing strength we are NOT testing endurance | show | measure of muscle strength over time | if you are weak coordination and endurance will be effected (effects functional ability) |
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| Functional Muscle test | show | asess external rotators/ not supraspinatus | saves time/ position change/ energy | not precise mmt but can be used as screening toolIn spinal chord injury we use MMT ( need to know specifics) |
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| Contraindications for FMT/mmt | post op/ after surgery | show | pain | mobility issue ( weight bearing?) | osteoperosis and pain medication | high BP- no isometric contraction
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