Occupational Therapy Manual for the Evaluation of Range of Motion and Muscle Strength [1st edition] ( PDFDrive )

Appendix C: Sample Evaluation Forms Assessment Report for Functional Observation of the Upper Extremity ACTION OBSERVED FUNCTIONAL LIMITATION FURTHER ASSESSMENT NEEDED Trunk: Neck: Shoulder: Elbow: Forearm: Wrist: Digits: Thumb: 283

284 ■ Appendix C: Sample Evaluation Forms Assessment Report for Functional Observation of the Lower Extremity ACTION OBSERVED FUNCTIONAL LIMITATION FURTHER ASSESSMENT NEEDED Hip: Knee: Ankle: Foot: Example of Assessment Report ACTION(S) OBSERVED FUNCTIONAL LIMITATION(S) POSSIBLE FURTHER Reaching into an overhead cabinet ASSESSMENT(S) NEEDED Shoulder: Humeral flexion • Evaluation of the scapula • Goniometric measurements of the shoulder • Gross manual muscle testing of the shoulder • Decision tree based on above data to determine need for iso lated manual muscle testing • ADL assessment

Appendix C: Sample Evaluation Forms ■ 285 Assessment Report for Goniometry & Gross Manual Muscle Testing of the Upper Extremity LEFT PROM MUSCLE AROM PROM RIGHT AROM GRADE MUSCLE GRADE Trunk: Flexion Extension Lateral Flexion Oblique Rotation Cervical: Flexion Extension Lateral Flexion Rotation Scapula: Elevation Depression Abduction Adduction Shoulder: Flexion Hyperextension Abduction Adduction External Rotation Internal Rotation Horizontal Abduction Horizontal Adduction Elbow: Flexion Extension Forearm: Supination Pronation Wrist: Flexion Extension

286 ■ Appendix C: Sample Evaluation Forms Assessment Report for Goniometry & Gross Manual Muscle Testing of the Hand LEFT PROM MUSCLE AROM PROM RIGHT AROM GRADE MUSCLE GRADE Hand: Digit #2 MCP—Flexion Extension Hyperextension Abduction Adduction PIP—Flexion Extension DIP—Flexion Extension Hand: Digit #3 MCP—Flexion Extension Hyperextension Abduction PIP—Flexion Extension DIP—Flexion Extension Hand: Digit #4 MCP—Flexion Extension Hyperextension Abduction Adduction PIP—Flexion Extension DIP—Flexion Extension (continues)

Appendix C: Sample Evaluation Forms ■ 287 Assessment Report for Goniometry & Gross Manual Muscle Testing of the Hand (continued) LEFT PROM MUSCLE AROM PROM RIGHT AROM GRADE MUSCLE GRADE Hand: Digit #5 MCP—Flexion Extension Hyperextension Abduction Adduction PIP—Flexion Extension DIP—Flexion Extension Thumb: CMC—Flexion Extension Abduction Adduction Opposition MCP—Flexion Extension IP—Flexion Extension

288 ■ Appendix C: Sample Evaluation Forms Assessment Report for Goniometry & Gross Manual Muscle Testing of the Lower Extremity LEFT PROM MUSCLE AROM PROM RIGHT AROM GRADE MUSCLE GRADE Hip: Flexion RIGHT Extension MUSCLE Abduction GRADE Adduction External Rotation (continues) Internal Rotation Knee: Flexion Extension Ankle: Dorsiflexion Plantar Flexion Eversion Inversion Assessment Report for Goniometry & Gross Manual Muscle Testing of the Foot LEFT PROM MUSCLE AROM PROM AROM GRADE Foot: Toe #1 MTP—Flexion Extension Abduction Adduction Foot: Toe #2 MTP—Flexion Extension Abduction Adduction PIP—Flexion Extension DIP—Flexion Extension

Appendix C: Sample Evaluation Forms ■ 289 Assessment Report for Goniometry & Gross Manual Muscle Testing of the Foot (continued) LEFT PROM MUSCLE AROM PROM RIGHT AROM GRADE MUSCLE GRADE Foot: Toe #3 MTP—Flexion Extension Abduction Adduction PIP—Flexion Extension DIP—Flexion Extension Foot: Toe #4 MCP—Flexion Extension Abduction Adduction PIP—Flexion Extension DIP—Flexion Extension Foot: Toe #5 MCP—Flexion Extension Abduction Adduction PIP—Flexion Extension DIP—Flexion Extension

290 ■ Appendix C: Sample Evaluation Forms Assessment Report for Isolated Manual Muscle Testing of the Upper Extremity LEFT RIGHT MUSCLE MUSCLE GRADE GRADE (continues) Trunk: Flexor group Extensor group Lateral flexion group Rotator group Quadratus lumborum Cervical: Flexor group Extensor group Lateral Flexion group Rotator group Scapula: Rhomboids Serratus anterior Pectoralis minor Shoulder: Posterior deltoid Middle deltoid Anterior deltoid Coracobrachialis Pectoralis major (clavicular head) Pectoralis major (sternal head) Teres major Latissimus dorsi Subscapularis Infraspinatus Teres minor Supraspinatus Trapezius (Upper) Levator Scapulae Trapezius (Middle) Trapezius (Lower)

Appendix C: Sample Evaluation Forms ■ 291 Assessment Report for Isolated Manual Muscle Testing of the Upper Extremity (continued ) LEFT RIGHT MUSCLE MUSCLE GRADE GRADE Elbow: Biceps brachii Brachialis Brachioradialis Triceps Aconeus Forearm: Pronator Teres Pronator Quadratus Supinator Wrist: Flexor carpi radialis Flexor carpi ulnaris Palmaris longus Extensor carpi radialis longus Extensor carpi radialis brevis Extensor carpi ulnaris

292 ■ Appendix C: Sample Evaluation Forms Assessment Report for Isolated Manual Muscle Testing of the Hand GRADE HAND: LEFT RIGHT DIGIT # 2345 234 5 Flexor digitorum superficialis Flexor digitorum profundus GRADE Flexor digiti minimi Extensor digitorum LEFT RIGHT Extensor indicis Extensor digiti minimi Lumbricals Palmar interosseous Dorsal interosseous Abductor digiti minimi HAND/THUMB: Opponens digiti minimi Opponens pollicis THUMB: Flexor pollicis brevis Flexor pollicis longus Abductor pollicis brevis Abductor pollicis longus Adductor pollicis Extensor pollicis longus Extensor pollicis brevis

Appendix C: Sample Evaluation Forms ■ 293 Assessment Report for Isolated Manual Muscle Testing of the Lower Extremity LEFT RIGHT MUSCLE MUSCLE GRADE GRADE Hip: Iliacus Psoas major Gluteus maximus Sartorius Gluteus medius Gluteus minimus Tensor fascia latae Pectineus Adductor magnus Gracilis Adductor longus Adductor brevis Piriformis Quadratus femoris Obturator internis Obturator externus Gemellus superior Gemellus inferior Knee: Semitendinosus Semimembranosus Biceps femoris Rectus femoris Vastus intermedius Vastus lateralis Vastus medialis Ankle: Tibialis anterior Gastrocnemius Soleus Tibialis posterior Peroneus longus Peroneus brevis

294 ■ Appendix C: Sample Evaluation Forms Assessment Report for Isolated Manual Muscle Testing of the Foot GRADE FOOT: LEFT RIGHT DIGIT # 2345 23 45 Lumbricales Flexor digitorum longus GRADE Flexor digitorum brevis Abductor digiti minimi LEFT RIGHT Dorsal interossei Extensor digitorum longus Extensor digitorum brevis GREAT TOE: Flexor hallucis brevis Flexor hallucis longus Abductor hallucis Extensor hallucis longus Extensor digitorum brevis

Index A Cervical rotation, goniometric measure- humeral internal rotation, 20 ments of, 14 knee extension, 50 Abductor digiti minimi, 98, 118, 197, 258 knee flexion, 49 Abductor hallucis, 118, 256 Client position radial/ulnar deviation, 29 Abductor pollicis brevis, 206–207 for goniometric measurements spinal extension, 8 Abductor pollicis longus, 101, 208–209 ankle dorsiflexion, 51 spinal flexion, 7 Active range of motion (AROM), defined, 2 ankle eversion (forefoot), 53 spinal lateral flexion, 9 Activities of daily living (ADL), 1, 65 ankle eversion (hindfoot), 55 spinal rotation, 10 Adductor brevis, 107, 228 ankle inversion (forefoot), 54 thumb CMC abduction, 40 Adductor longus, 107, 227 ankle inversion (hindfoot), 56 thumb CMC adduction, 41 Adductor magnus, 107, 226 ankle plantar flexion, 52 thumb CMC extension, 39 Adductor pollicis, 102, 210–211 cervical extension, 12 thumb CMC flexion, 38 ADL (activities of daily living), 1, 65 cervical flexion, 11 wrist flexion/extension, 27–28 Against gravity, 66 cervical lateral flexion, 13 for gross manual muscle testing Anconeus, 88 cervical rotation, 14 ankle dorsiflexion, 112 Ankle elbow extension, 23 ankle plantar flexion, 113 elbow flexion, 23 elbow extension, 88 goniometric measurements of foot DIP extension, 64 elbow flexion, 87 dorsiflexion, 51 foot DIP flexion, 63 foot eversion, 115 eversion (forefoot), 53 foot MTP abduction, 59 foot inversion, 114 eversion (hindfoot/subtalar), 55 foot MTP adduction, 60 forearm pronation, 90 inversion (forefoot), 54 foot MTP extension, 58 forearm supination, 89 inversion (hindfoot/subtalar), 56 foot MTP flexion, 57 hand MCP abduction, 98 plantar flexion, 52 foot PIP extension, 62 hand MCP flexion, 95 foot PIP flexion, 61 hand PIP/DIP flexion, 96 gross manual muscle testing forearm pronation, 26 hand/thumb opposition, 99 dorsiflexion, 112 forearm supination, 25 hip abduction, 106 plantar flexion, 113 hand MCP abduction, 37 hip adduction, 107 hand MCP adduction, 36 hip extension, 105 isolated manual muscle testing hand opposition, 42 hip external rotation, 108 gastrocnemius, 243–244 hand PIP extension, 33 hip flexion, 104 soleus, 245–246 hand PIP flexion, 32 hip internal rotation, 109 tibialis anterior, 241–242 hand/thumb DIP extension, 35 humeral abduction, 81 hand/thumb DIP flexion, 34 humeral adduction, 82 Anterior deltoid, 79, 84, 86, 128–129 hand/thumb MCP flexion/extension, humeral extension/hyperextension, 80 Anterior posterior axis, 4 30 humeral external rotation, 83 Anterior tilt, 7 hand/thumb MCP hyperextension, humeral flexion, 79 Arc of motion, 1 31 humeral horizontal abduction, 85 AROM (active range of motion), defined, 2 hip abduction, 45 humeral horizontal adduction, 86 Auditory meatus, 11 hip adduction, 46 humeral internal rotation, 84 Axis of the body, 2, 4–5 hip extension, 44 knee extension, 111 hip external rotation, 47 knee flexion, 110 B hip flexion, 43 MCP/PIP/DIP extension, 97 hip internal rotation, 48 neck extension, 74 Biceps brachii, 87, 89, 158–159 humeral abduction, 17 neck flexion, 73 Biceps femoris, 236–237 humeral adduction, 18 scapular abduction, 78 Brachialis, 87, 160–161 humeral extension/hyperextension, 16 scapular adduction, 77 Brachioradialis, 87, 162 humeral external rotation, 19 scapular depression, 76 humeral flexion, 15 scapular elevation, 75 C humeral horizontal abduction, 21 thumb CMC abduction, 102 humeral horizontal adduction, 22 Cervical extension, goniometric measure- 295 ments of, 12 Cervical flexion, goniometric measurements of, 11 Cervical lateral flexion, goniometric meas- urements of, 13

296 ■ Index gracilis, 229 Contraindications iliacus and psoas major, 217 goniometric measurements, 6 Client position, for gross manual muscle infraspinatus, 141 muscle testing, 68 testing (continued) latissimus dorsi, 137 thumb CMC flexion, 101 levator scapulae, 147 Coracobrachialis, 79, 130–131 thumb IP flexion, 103 lumbricals, 192, 252 Coronal plane, 3 thumb MCP flexion, 100 middle deltoid, 127 toe IP flexion, 117 obturator externus, 233 D toe MTP abduction, 118 obturator internis, 233 toe MTP flexion, 116 opponens digiti minimi, 199 Digits toe MTP/PIP extension, 119 opponens pollicis, 201 goniometric measurements of trunk extension, 70 palmar interosseous, 194 DIP flexion/Thumb: IP flexion, 34 trunk flexion, 68 pectineus, 229 MCP abduction, 37 trunk lateral flexion, 72 pectoralis major (clavicular head), MCP adduction, 36 trunk oblique flexion, 71 MCP flexion/extension, 30 wrist extension, 92 133 MCP hyperextension, 31 wrist flexion, 91 pectoralis major (sternal head), 135 opposition of first and fifth, 42 wrist radial deviation, 93 pectoralis minor, 157 PIP extension, 33 wrist ulnar deviation, 94 pelvic elevation, trunk lateral flex- PIP flexion, 32 gross manual muscle testing for isolated manual muscle testing ion, 122–123 hand MCP abduction/adduction, 98 abductor digiti minimi, 259 peroneus brevis, 250 hand MCP flexion, 95 abductor hallucis, 257 peroneus longus, 250 hand PIP/DIP flexion, 96 abductor pollicis brevis, 207 piriformis, 233 hand/thumb opposition, 99 abductor pollicis longus, 209 posterior deltoid, 125 MCP/PIP/DIP extension (hyper- adductor brevis, 229 pronator quadratus, 171 extension), 97 adductor longus, 229 pronator teres, 169 isolated manual muscle testing adductor magnus, 229 quadratus femoris, 233 abductor digiti minimi, 197 adductor pollicis, 211 rectus femoris, 240 dorsal interossei, 195–196 anconeus, 165 rhomboids, 153 extensor digiti minimi, 190 anterior deltoid, 129 sartorius, 221 extensor digitorum, 187–188 biceps brachii, 159 semitendinosis, 235 extensor indicis, 189 biceps femoris, 237 serratus anterior, 155 flexor digiti minimi, 185–186 brachialis, 161 soleus, 246 flexor digitorum profundus, brachioradialis, 163 subscapularis, 139 183–184 coracobrachialis, 131 supinator, 167 flexor digitorum superficialis, dorsal interossei, 259 supraspinatus, 145 181–182 dorsal interosseous, 196 tensor fascia latae, 225 lumbricals, 191–192 extensor carpi radialis brevis, 178 teres major, 137 palmar interossei, 193–194 extensor carpi radialis longus, 178 teres minor, 143 extensor carpi ulnaris, 180 tibialis anterior, 242 DIP extension extensor digitorum, 188 tibialis posterior, 248 goniometric measurements of, 35, 64 extensor digitorum brevis, 262 trapezius (lower), 151 gross manual muscle testing, 97 extensor digitorum longus, 262 trapezius (middle), 149 extensor hallucis longus, 262 trapezius (upper), 147 DIP flexion extensor pollicis brevis, 215 triceps, 165 goniometric measurements of, 34, 63 extensor pollicis longus, 213 vastus intermedius, 240 gross manual muscle testing, 96 flexor carpi fadialis, 173 vastus lateralis, 240 isolated manual muscle testing, flexor carpi ulnaris, 175 vastus medialis, 240 253–254, 261 flexor digiti minimi, 186 CMC abduction/adduction flexor digitorum brevis, 255 goniometric measurements of, 40–41 Distal forearm, 25 flexor digitorum longus, 255 gross manual muscle testing, 102 Dorsal interossei, 98, 118, 195–196, 258 flexor digitorum profundus, 184 isolated manual muscle testing, flexor digitorum superficialis, 182 E flexor hallucis brevis, 252 206–211 flexor hallucis longus, 255 CMC extension Elbow flexor pollicis brevis, 203 goniometric measurements of flexor pollicis longus, 205 goniometric measurements of, 39 extension, 24 gastrocnemius, 244 gross manual muscle testing, 101 flexion, 23 gemellus inferior, 233 isolated manual muscle testing, gross manual muscle testing gemellus superior, 233 extension, 88 gluteus maximus, 219 214–215 flexion, 87 gluteus medius, 223 CMC flexion isolated manual muscle testing gluteus minimus, 223 anconeus, 164–165 goniometric measurements of, 38 biceps brachii, 158–159 gross manual muscle testing, 101 brachialis, 160–161 Compensation, 5 brachioradialis, 162–163

triceps, 164–165 gross manual muscle testing Index ■ 297 End feel pronation, 90 supination, 89 hip adduction, 46 defined, 2 hip extension, 44 firm end feel, 5 isolated manual muscle testing hip external rotation, 47 hard end feel, 5 pronation, 168–171 hip flexion, 43 soft end feel, 5 pronator quadratus, 170–171 hip internal rotation, 48 Erector spinae, 70, 74 pronator teres, 168–169 humeral abduction, 17 Extensor carpi radialis brevis, 92–93 supination, 166–167 humeral adduction, 18 Extensor carpi radialis longus, 92–93 humeral extension/hyperextension, 16 Extensor carpi ulnaris, 92, 94, 179–180 Frontal aces, 4 humeral external rotation, 19 Extensor digiti minimi, 97, 190 Frontal plane, 2–3 humeral flexion, 15 Extensor digitorum, 97, 187–188 Fulcrum, goniometer, 1–2 humeral horizontal abduction, 21 Extensor digitorum brevis, 119, 261 humeral horizontal adduction, 22 Extensor digitorum longus, 115, 119, 260 G humeral internal rotation, 20 Extensor hallucis longus, 114, 119, 260 knee extension, 50 Extensor indicis, 97, 189 Gastrocnemius, 113, 243–244 knee flexion, 49 Extensor pollicis brevis, 100–101, 214–215 Gemellus inferior, 108, 232 spinal lateral flexion, 9 Extensor pollicis longus, 103, 212–213 Gemellus superior, 108, 232 spinal rotation, 10 External oblique, 68, 71–72 Gluteus maximus, 105, 218–219 thumb CMC abduction, 40 External rotation, hip Gluteus medius, 106, 109, 222–223 thumb CMC adduction, 41 goniometric measurements of, 47 Gluteus minimus, 106, 109, 222–223 thumb CMC extension, 39 gross manual muscle testing, 108 Goniometer thumb CMC flexion, 38 wrist extension/flexion, 27–28 F defined, 1 wrist radial deviation, 29 fulcrum, 1–2 Goniometry, purpose of, 1 Firm end feel, 5 illustration of, 2 Gracilis, 107, 227 Flexor carpi radialis, 91, 93, 172–173 movable arm, 1–2 Grades, muscle, 67 Flexor carpi ulnaris, 91, 94, 174–175 numbers, 6 Gravity-eliminated, 66 Flexor digiti minimi, 185–186 placement of, 2 Gross manual muscle testing. See Muscles Flexor digitorum brevis, 117, 254 stationary arm, 1–2 Flexor digitorum longus, 113, 253 zero points, 5 H Flexor digitorum profundus, 95–96, Goniometer position ankle dorsiflexion, 51 Hamstrings, 110 183–184 ankle eversion (forefoot), 53 Hand, goniometric measurements of Flexor digitorum superficialis, 95–96, ankle eversion (hindfoot), 55 ankle inversion (forefoot), 54 DIP extension/Thumb: IP extension, 35 181–182 ankle inversion (hindfoot), 56 opposition of first and fifth digits, 42 Flexor hallucis brevis, 116, 251–252 ankle plantar flexion, 52 Hand/thumb, gross manual muscle Flexor hallucis longus, 113, 117, 253 cervical extension, 12 Flexor longus, 117 cervical flexion, 11 testing, 99 Flexor pollicis brevis, 100–101, 202–203 cervical lateral flexion, 13 Hard end feel, 5 Flexor pollicis longus, 103, 204–205 cervical rotation, 14 Hip Foot elbow extension, 24 elbow flexion, 23 goniometric measurements of goniometric measurements of foot DIP extension, 64 abduction, 45 DIP extension, 64 foot DIP flexion, 63 adduction, 46 DIP flexion, 63 foot MTP abduction, 59 extension, 44 MTP abduction, 59 foot MTP adduction, 60 external rotation, 47 MTP adduction, 60 foot MTP extension, 58 flexion, 43 MTP extension, 58 foot MTP flexion, 57 internal rotation, 48 MTP flexion, 57 foot PIP extension, 62 PIP extension, 62 foot PIP flexion, 61 gross manual muscle testing PIP flexion, 61 forearm pronation, 26 abduction, 106 forearm supination, 25 adduction, 107 gross manual muscle testing hand MCP abduction, 37 extension, 105 eversion, 115 hand MCP adduction, 36 external rotation, 108 inversion, 114 hand opposition, 42 flexion, 104 MTP flexion, 116 hand PIP extension, 33 internal rotation, 109 hand PIP flexion, 32 isolated manual muscle testing hand/thumb DIP extension, 35 isolated manual muscle testing peroneus brevis, 249–250 hand/thumb DIP flexion, 34 adductor brevis, 228 peroneus longus, 249–250 hand/thumb MCP extension, 30 adductor longus, 227 tibialis posterior, 247–248 hand/thumb MCP hyperextension, 31 adductor magnus, 226 hip abduction, 45 gemellus inferior, 232 Forearm gemellus superior, 232 goniometric measurements of gluteus maximus, 218–219 pronation, 26 gluteus medius, 222–223 supination, 25 gluteus minimus, 222–223

298 ■ Index goniometric measurements of, 48 Metacarpal, 27–30 gross manual muscle testing, 109 Middle deltoid, 81, 126–127 Hip, isolated manual muscle testing Interspinales, 70 Middle trapezius, 77 (continued) Intertransversarii, 70 Movable arm, goniometer, 1–2 gracilis, 227 IP extension, isolated manual muscle MTP abduction, goniometric measure- iliacus, 216–217 obturator externus, 231 testing, 212–213 ments, 59 obturator internis, 231 IP flexion, gross manual muscle testing, 103 MTP adduction, goniometric measure- pectineus, 226 Isolated manual muscle testing. See piriformis, 230 ments, 60 psoas major, 216–217 Muscles MTP extension quadratus femoris, 230 sartorius, 220–221 K goniometric measurements, 58 tensor fascia latae, 224–225 isolated manual muscle testing, Knee Horizontal plane, 3 goniometric measurements of 261–262 Humeral abduction extension, 50 MTP flexion flexion, 49 goniometric measurements of, 17 gross manual muscle testing goniometric measurements, 57 gross manual muscle testing, 81 extension, 111 isolated manual muscle testing, isolated manual muscle testing, flexion, 110 isolated manual muscle testing 251–252 126–127, 144–145 biceps femoris, 236–237 Multifidi, 70 Humeral adduction rectus femoris, 238 Muscles semimembranosus, 234–235 goniometric measurements of, 18 semitendinosus, 234–235 abductor digiti minimi, 98, 118, 197, gross manual muscle testing, 82 vastus intermedius, 238 258 isolated manual muscle testing, vastus lateralis, 239 vastus medialis, 239 abductor hallucis, 118, 256 132–133, 136–137 abductor pollicis longus, 101, 208–209 Humeral extension/hyperextension L adductor brevis, 107, 228 adductor longus, 107, 227 goniometric measurements of, 16 Lateral hamstrings, 110 adductor magnus, 107, 226 gross manual muscle testing, 80 Lateral ulna, 19–20 adductor pollicis, 102, 210–211 isolated manual muscle testing, 124, Latissimus dorsi, 80, 82, 84, 136–137 anconeus, 88 Levator scapulae, 75, 146–147 anterior deltoid, 79, 84, 86, 128–129 134–137 Longus capitus, 73 biceps brachii, 89, 158–159 Humeral external rotation Longus colli, 73 biceps femoris, 236–237 Lower trapezius, 76 bicpes brachii, 87 goniometric measurements of, 19 Lumbricals, 116, 191–192, 251–252 brachialis, 87, 160–161 gross manual muscle testing, 83 brachioradialis, 87, 162 isolated manual muscle testing, 124, M coracobrachialis, 79, 130–131 dorsal interossei, 98, 118, 195–196, 258 140–143 MCP abduction erector spinae, 70, 74 Humeral flexion goniometric measurements of, 37 extensor carpi radialis brevis, 92–93 gross manual muscle testing, 98 extensor carpi radialis longus, 92–93 goniometric measurements of, 15 isolated manual muscle testing, extensor carpi ulnaris, 92, 94, 179–180 gross manual muscle testing, 79 195–197 extensor digitii minimi, 97 isolated manual muscle testing, extensor digitorium brevis, 119 MCP adduction extensor digitorum, 97, 187–188 128–133 goniometric measurements of, 36 extensor digitorum brevis, 261 Humeral horizontal abduction isolated manual muscle testing, extensor digitorum longus, 115, 119, 193–194 goniometric measurements of, 21 260 gross manual muscle testing, 85 MCP extension extensor hallucis longus, 114, 119, 260 isolated manual muscle testing, 124, gross manual muscle testing, 97 extensor indicis, 97, 189 isolated manual muscle testing, extensor pollicis brevis, 100–101, 140–143 214–215 Humeral horizontal adduction 214–215 MCP flexion extensor pollicis longus, 103, 212–213 goniometric measurements of, 22 digit and thumb, goniometric measure- external oblique, 68, 71–72 gross manual muscle testing, 86 ments of, 30 flexor carpi radialis, 91, 93–94, isolated manual muscle testing, gross manual muscle testing, 95, 100 isolated manual muscle testing, 172–173 128–129, 132–135 191–192 flexor carpi ulnaris, 91, 174–175 Humeral internal rotation flexor digiti minimi, 185–186 MCP hyperextension, goniometric meas- flexor digitorum brevis, 117, 254 goniometric measurements of, 20 urements of, 31 flexor digitorum longus, 113, 253 gross manual muscle testing, 84 flexor digitorum profundus, 95–96, isolated manual muscle testing, Measurements. See Goniometer position Medial hamstrings, 110 183–184 128–129, 136–139 flexor digitorum superficialis, 95–96, I 181–182 Iliac crests, 10 Iliacus, 216 Iliopsoas, 104 Infraspinatus, 83, 85, 140–141 Internal oblique, 68, 71–72 Internal rotation, hip

flexor hallucis brevis, 116 trunk lateral flexion, 72 Index ■ 299 flexor hallucis longus, 113, 117, 253 trunk oblique rotation, 71 flexor longus, 117 wrist extension, 92 scapular depression, 150–151 flexor pollicis, 103 wrist flexion, 91 scapular downward rotation, flexor pollicis brevis, 100–101, 202–205 wrist radial deviation, 93 gastrocnemius, 113, 243–244 wrist ulnar deviation, 94 152–153, 156–157 gemellus inferior, 108, 232 iliacus, 216 scapular elevation, 146–147 gemellus superior, 108, 232 iliopsoas, 104 scapular upward rotation, 146–147, gluteus maximus, 105, 218–219 infraspinatus, 83, 85, 140–141 gluteus medius, 106, 109, 222–223 internal oblique, 68, 71–72 150–151 gluteus minimus, 106, 109, 222–223 interspinales, 70 thumb CMC abduction, 206–209 gracilis, 107, 227 intertransversarii, 70 thumb CMC adduction, 210–211 gross manual muscle testing isolated manual muscle testing thumb IP extension, 212–213 ankle dorsiflexion, 241–242 thumb IP flexion, 204–205 ankle dorsiflexion, 112 ankle plantar flexion, 243–246 thumb MCP flexion, 202–203 ankle plantar flexion, 113 DIP extension, 189–192 wrist extension, 177–179 elbow extension, 88 DIP flexion, 183–184 wrist flexion, 176 elbow flexion, 87 elbow extension, 164–165 wrist flexion, wrist radial deviation, foot eversion, 115 elbow flexion, forearm supination, foot inversion, 114 172–173 forearm pronation, 90 158–162 wrist flexion, wrist ulnar deviation, forearm supination, 89 foot eversion, 249–250 grades, list of, 67 foot inversion, 241–242, 247–248 174–175 hand MCP abduction, 98 forearm pronation, 168–171 lateral hamstrings, 110 hand MCP flexion, 95 forearm supination, 166–167 latissimus dorsi, 80, 82, 84, 136–137 hand MCP/PIP/DIP extension hip abduction, 220–225 levator scapula, 75, 146–147 hip adduction, 226–228 longus capitus, 73 (hyperextension), 97 hip extension, 218–219 longus colli, 73 hand PIP/DIP flexion, 96 hip external rotation, 220–221, lower trapezius, 76 hand/thumb opposition, 99 lumbricals, 191–192, 251–252 hip abduction, 106 230–232 medial hamstrings, 110 hip adduction, 107 hip flexion, 216–217, 220–221, middle deltoid, 81, 126–127 hip extension, 105 middle trapezius, 77 hip external rotation, 108 224–225, 238 multifidi, 70 hip flexion, 104 hip internal rotation, 222–225 obturator externus, 108, 231 hip internal rotation, 109 humeral abduction, 126–127, obturator femoris, 108 humeral abduction, 81 obturator internis, 108, 231 humeral adduction, 82 144–145 opponens digiti minimi, 99, 198–199 humeral extension/hyperextension, humeral adduction, 132–133, opponens pollicis, 99, 200–201 palmar interossei, 193–194 80 136–137 palmaris longus, 91, 176–178 humeral external rotation, 83 humeral extension, 124–125, pectineus, 107, 226 humeral flexion, 79 pectoralis major, 79–80, 82, 84, 86, humeral horizontal abduction, 85 134–137 humeral horizontal adduction, 86 humeral external rotation, 132–135 humeral internal rotation, 84 pectoralis minor, 78, 156–157 knee extension, 111 124–125, 140–143 peroneus brevis, 115, 249–250 knee flexion, 110 humeral flexion, 128–133 peroneus longus, 115, 249–250 neck extension, 74 humeral horizontal abduction, piriformis, 108, 230 neck flexion, 73 posterior deltoid, 80, 83, 85, 124–125 scapluar elevation, 75 124–125, 140–143 pronator quadratus, 90, 170–171 scapular abduction, 78 humeral horizontal adduction, pronator teres, 90, 168–169 scapular adduction, 77 psoas major, 216 scapular depression, 76 128–129, 132–135 quadratus femoris, 108, 230 thumb CMC abduction, 102 humeral internal rotation, quadratus lumborom, 72, 122–123 thumb CMC flexion, 101 rectus abdominis, 68, 71–72 thumb IP flexion, 103 128–129, 136–139 rectus capitis anterior, 73 thumb MCP flexion, 100 knee extension, 238–240 rectus capitis posterior, 74 toe IP flexion, 117 knee flexion, 234–237 rectus femoris, 104, 111, 238 toe MTP abduction, 118 knee internal rotation, 234–237 rhomboids, 152–153 toe MTP flexion, 116 MCP abduction, 195–198 sartorius, 104, 106, 220–221 toe MTP/IP extension, 119 MCP adduction, 193–194 scalenus anterior, 73 trunk extension, 70 MCP extension, 187–190 semimembranosus, 105 trunk flexion, 68–69 MCP flexion, 185–186, 191–192 semispinales thoracis, 70 pelvic elevation, trunk lateral semispinalis capitis, 74 semispinalis cervicis, 74 flexion, 122–123 semitendinosus, 105, 234 PIP extension, 189–192 serratus anterior, 78, 154–155 PIP flexion, 181–182 scapular abduction, 154–157 scapular adduction, 148–149, 152–153

300 ■ Index Muscles (continued) PIP flexion Semispinales thoracis, 70 soleus, 113, 245–246 goniometric measurements, 32, 61 Semispinalis cervicis, 74 spinator, 89, 166–167 gross manual muscle testing, 96 Semisplinalis capitits, 74 splenius capitus, 74 Semitendinosus, 105, 234 splenius cervicis, 74 Piriformis, 108, 230 Serratus anterior, 78, 154–155 sternocleidomastoid, 73 Planes Shoulder subscapularis, 84, 138–139 supraspinatus, 81, 144–145 and axes of body, 4 goniometric measurements of tensor fascia latae, 104, 106, 109, joint motion, 2 humeral abduction, 17 224–225 Positions. See Client position; Goniometer humeral adduction, 18 teres major, 80, 82, 84 humeral external rotation, 19 teres minor, 83, 85, 142–143 position; Therapist position humeral flexion, 15–16 thomboids, 77 Posterior deltoid, 80, 83, 85, 124–125 humeral horizontal abduction, 21 tibialis anterior, 112, 114, 241–242 Precautions humeral horizontal adduction, 22 tibialis posterior, 113–114, 247–248 humeral internal rotation, 20 trapezius (lower), 150–151 goniometric measurements, 6 hyperextension, 16 trapezius (middle), 148–149 muscle testing, 68 trapezius (upper), 146 PROM (passive range of motion), defined, gross manual muscle testing triceps, 88, 164–165 humeral abduction, 81 upper trapezis, 75 2 humeral adduction, 82 vastus intermedius, 111, 238 Pronator quadratus, 90, 170–171 humeral extension/hyperextension, vastus lateralis, 111, 239 Pronator teres, 90, 168–169 80 vastus medialis, 111, 239 Psoas major, 216 humeral external rotation, 83 humeral flexion, 79 N Q humeral horizontal abduction, 85 humeral horizontal adduction, 86 Nares, 11 Quadratus femoris, 108, 230 humeral internal rotation, 84 Neck, goniometric measurements of Quadratus lumborum, 72, 122 isolated manual muscle testing cervical extension, 12 R anterior deltoid, 128–129 cervical flexion, 11 coracobrachialis, 130–131 cervical lateral flexion, 13 Rectus abdominis, 68, 71–72 infraspinatus (tested with teres cervical rotation, 14 Rectus capitis anterior, 73 minor), 140–141 Neck extension, gross manual muscle Rectus capitis posterior, 74 latissimus dorsi, 136–137 Rectus femoris, 104, 111, 238 levator scapulae, 146–147 testing, 74 Resistance, 66 middle deltoid, 126–127 Neck flexion, gross manual muscle testing, Rhomboids, 77, 152–153 pectoralis major (clavical head), 132–133 73 S pectoralis major (sternal head), 134–135 O Saggital plane, 3 posterior deltoid, 124–125 Sartorius, 104, 106, 220–221 subscapularis, 138–139 Obliquus capitus, 74 Scalenus anterior, 73 supraspinatus, 144–145 Observation skills Scapula, isolated manual muscle testing teres minor (tested with infraspina- tus), 142–143 clinical judgment, 5 pectoralis minor, 156–157 trapezius (lower), 150–151 developing, 1 rhomboids, 152–153 trapezius (middle), 148–149 Obturator externus, 108 serratus anterior, 154–155 trapezius (upper), 146–147 Obturator femoris, 108 Scapular abduction Obturator internis, 108, 231 gross manual muscle testing, 78 Soft end feel, 5 Opponens digiti minimi, 99, 198–199 isolated manual muscle testing, 154–157 Soleus, 113, 245–246 Opponens pollicis, 99, 200–201 Scapular adduction Spinal extension, goniometric gross manual muscle testing, 77 P isolated manual muscle testing, 15o, measurements, 8 Spinal flexion, goniometric measurements, Palmar interossei, 193–194 148, 152–153 Palmaris longus, 91, 176–178 Scapular depression 7 Passive range of motion (PROM), defined, Spinal lateral flexion, goniometric gross manual muscle testing, 76 2 isolated manual muscle testing, measurements, 9 Pectineus, 107, 226 Spinal rotation, goniometric measurements, Pectoralis major, 79–80, 82, 84, 86, 150–151 Scapular downward rotation, isolated man- 10 132–135 Splenius capitus, 74 Pectoralis minor, 78, 156–157 ual muscle testing, 152–153, Splenius cervicis, 74 Peroneus brevis, 115, 249–250 156–157 Stabilization, 66 Peroneus longus, 115, 249–250 Scapular elevation Stationary arm, goniometer, 1–2 PIP extension gross manual muscle testing, 75 Sternocleidomastoid, 73 isolated manual muscle testing, Styloid, 27 goniometric measurements, 33, 62 gross manual muscle testing, 97 146–147 Scapular upward rotation, isolated manual muscle testing, 146–147, 150–151 Screening, defined, 1 Semimembranosus, 105, 234

Subcapularis, 84, 138–139 knee extension, 50 Index ■ 301 Supination knee flexion, 49 spinal extension, 8 wrist radial deviation, 93 goniometric measurements of, 25 spinal flexion, 7 wrist ulnar deviation, 94 gross manual muscle testing, 89 spinal lateral flexion, 9 for isolated manual muscle testing Supinator, 89, 166–167 spinal rotation, 10 abductor digiti minimi, 259 Supraspinatus, 81, 144–145 thumb CMC abduction, 40 abductor hallucis, 257 thumb CMC adduction, 41 abductor pollicis brevis, 207 T thumb CMC extension, 39 abductor pollicis longus, 209 thumb CMC flexion, 38 adductor brevis, 229 Tensor fascia latae, 104, 106, 109, wrist extension/flexion, 27–28 adductor longus, 229 224–225 wrist radial deviation, 29 adductor magnus, 229 for gross manual muscle testing adductor pollicis, 211 Teres major, 80, 82, 84 ankle dorsiflexion, 112 anconeus, 165 Teres minor, 83, 85, 142–143 ankle plantar flexion, 113 anterior deltoid, 129 Therapist position elbow extension, 88 biceps brachii, 159 elbow flexion, 87 biceps femoris, 237 for goniometric measurements foot eversion, 115 brachialis, 161 ankle dorsiflexion, 51 foot inversion, 114 brachioradialis, 163 ankle eversion (forefoot), 53 forearm pronation, 90 coracobrachialis, 131 ankle eversion (hindfoot), 55 forearm supination, 89 dorsal interossei, 259 ankle inversion (forefoot), 54 hand MCP abduction, 98 dorsal interosseous, 196 ankle inversion (hindfoot), 56 hand MCP flexion, 95 extensor carpi radialis brevis, 178 ankle plantar flexion, 52 hand MCP/PIP/DIP extension, 97 extensor carpi radialis longus, 178 cervical extension, 12 hand PIP/DIP flexion, 96 extensor carpi ulnaris, 180 cervical flexion, 11 hand/thumb opposition, 99 extensor digitorum, 188 cervical lateral flexion, 13 hip abduction, 106 extensor digitorum brevis, 262 cervical rotation, 14 hip adduction, 107 extensor digitorum longus, 262 elbow extension, 24 hip extension, 105 extensor hallucis longus, 262 elbow flexion, 23 hip external rotation, 108 extensor pollicis brevis, 215 foot DIP extension, 64 hip flexion, 104 extensor pollicis longus, 213 foot DIP flexion, 63 hip internal rotation, 109 flexor carpi profundus, 184 foot MTP abduction, 59 humeral abduction, 81 flexor carpi radialis, 173 foot MTP adduction, 60 humeral adduction, 82 flexor carpi ulnaris, 175 foot MTP extension, 58 humeral extension/hypextension, 80 flexor digiti minimi, 186 foot MTP flexion, 57 humeral external rotation, 83 flexor digitorum brevis, 255 foot PIP extension, 62 humeral horizontal abduction, 85 flexor digitorum longus, 255 foot PIP flexion, 61 humeral horizontal adduction, 86 flexor digitorum superficialis, 182 forearm pronation, 26 humeral internal rotation, 84 flexor hallucis brevis, 252 forearm supination, 25 knee extension, 111 flexor hallucis longus, 255 hand MCP abduction, 37 knee flexion, 110 flexor pollicis brevis, 203 hand MCP adduction, 36 neck extension, 74 flexor pollicis longus, 205 hand opposition, 42 neck flexion, 73 gastrocnemius, 244 hand PIP extension, 33 scapular abduction, 78 gemellus inferior, 233 hand PIP flexion, 32 scapular adduction, 77 gemellus superior, 233 hand/thumb DIP extension, 35 scapular depression, 76 gluteus medius, 223 hand/thumb DIP flexion, 34 scapular elevation, 75 gluteus minimus, 223 hand/thumb MCP extension, 30 thumb CMC abduction, 102 glutues maximus, 219 hand/thumb MCP hyperextension, thumb CMC flexion/extension, 101 gravilis, 229 31 thumb IP flexion, 103 iliopsias, 217 hip abduction, 45 thumb MCP flexion, 100 infraspinatus, 141 hip adduction, 46 toe IP flexion, 117 latissimus dorsi, 137 hip extension, 44 toe MTP abduction, 118 levator scapulae, 147 hip external rotation, 47 toe MTP flexion, 116 lumbricals, 192, 252 hip flexion, 43 toe MTP/IP extension, 119 middle deltoid, 127 hip internal rotation, 48 trunk extension, 70 obturator externus, 233 humeral abduction, 17 trunk flexion, 68–69 obturator internis, 233 humeral adduction, 18 trunk lateral flexion, 72 opponens digiti minimi, 199 humeral extension/hyperextension, trunk oblique flexion, 71 opponens pollicis, 201 16 wrist extension, 92 palmar interosseous, 194 humeral external rotation, 19 wrist flexion, 91 pectineus, 229 humeral flexion, 15 pectoralis major (clavicular head), humeral horizontal abduction, 21 humeral horizontal adduction, 22 133 humeral internal rotation, 20

302 ■ Index MCP hyperextension, 31 spinal lateral flexion, 9 gross manual muscle testing spinal rotation, 10 Therapist position, for isolated manual Trunk extension, gross manual muscle muscle testing (continued) CMC abduction, 102 pectoralis major (sternal head), 135 CMC flexion/extension, 101 testing, 70 pectoralis minor, 157 IP flexion/extension, 103 Trunk flexion, gross manual muscle pelvic elevation, trunk lateral MCP flexion/extension, 100 flexion, 123 isolated manual muscle testing testing, 68–69 peroneus brevis, 250 abductor pollicis brevis, 206–207 Trunk lateral flexion, gross manual muscle peroneus longus, 250 abductor pollicis longus, 208–209 piriformis, 233 adductor pollicis, 210–211 testing, 72 posterior deltoid, 125 extensor pollicis brevis, 214–215 Trunk lateral flexion, isolated manual mus- pronator quadratus, 171 extensor pollicis longus, 212–213 pronator teres, 169 flexor pollicis brevis, 202–203 cle testing, 122–123 psoas major, 217 flexor pollicis longus, 204–205 Trunk oblique flexion, gross manual mus- quadratus femoris, 233 opponens pollicis, 200–201 rectus femoris, 240 Tibialis anterior, 112, 114, 241–242 cle testing, 71 rhomboids, 153 Tibialis posterior, 113–114, 247–248 sartorius, 221 Toes U semitendinosis, 235 gross manual muscle testing serratus anterior, 155 IP flexion, 117 Ulna, 27 soleus, 246 MTP abduction, 118 Upper trapezius, 75 subscapularis, 139 MTP/IP extension, 119 supinator, 167 isolated manual muscle testing V supraspinatus, 145 abductor digiti minimi, 258–259 tensor fascia latae, 225 abductor hallucis, 254 Vastus intermedius, 111, 238 teres major, 137 dorsal interossei, 258–259 Vastus lateralis, 111, 239 teres minor, 143 extensor digitorum brevis, 261 Vastus medialis, 111, 239 tibialis anterior, 242 extensor digitorum longus, 260 Vertical axis, 4 tibialis posterior, 248 extensor hallucis, 260 trapezius (lower), 151 flexor digitorum brevis, 254 W trapezius (middle), 149 flexor digitorum longus, 253 trapezius (upper), 147 flexor hallucis brevis, 251–252 Wrist triceps, 165 flexor hallucis longus, 253 goniometric measurements of vastus intermedius, 240 lumbricales, 251–252 flexion/extension, 27–28 vastus medialis, 240 Transverse plane, 3 radial/ulnar deviation, 29 Trapezius (lower), 150–151 gross manual muscle testing Thoracic vertebrae, 13 Trapezius (middle), 148–149 extension, 92 Thumb Trapezius (upper), 146 flexion, 91 Triceps, 88, 164–165 radial deviation, 93 goniometric measurements of Trunk, goniometric measurements of ulnar deviation, 94 CMC abduction, 40 spinal extension, 8 isolated manual muscle testing CMC adduction, 41 spinal flexion, 7 extensor carpi radialis brevis, CMC extension, 39 177–178 CMC flexion, 38 extensor carpi radialus longus, MCP flexion/extension, 30 177–178 extensor carpi ulnaris, 179–180 flexor carpi radialis, 172–173 flexor carpi ulnaris, 174–175 palmaris longus, 176