Test Positioning

Test Positioning

    Range of motion (ROM) is measured using a goniometer, which ranges in size to be able to adequately measure the different joints of the body. Being able to accurately find and identify bony landmarks is crucial to taking proper and reliable ROM measurements. Bony landmarks serve as a "map" to the body and by being knowledgeable of their location, the therapist can know exactly where to place the axis of the goniometer and in what direction to point the arms. An example of this would be when measuring the knee joint, always have the stationary arm positioned towards the greater trochanter and the moving arm positioned in line with the midline of the fibula pointing towards the lateral malleolus. Proper positioning is also essential in accurately measuring ROM; this is because when the client is in the correct position, the therapist can watch for compensatory movements that, if undetected, would skew the results of the measurements.
    

    Manual muscle testing (MMT) is performed to gather data on a client and to assess weak muscles that alter the way they perform their daily occupations. The purpose of test positioning in MMT is to ensure the client is in the most optimal position to be able to effectively exert the muscle group being tested. For proper positioning, the client will be placed in "mid ROM"; this position is used to help muscles facilitate the formation of crossbridges and to establish a stretched muscle which develops a length tension relationship that creates potential energy. Because this position increases cross bridge formation, a stronger muscle contraction is produced.

    Most MMT is performed against gravity to document baseline data on a client and see if their muscles are functioning properly. If a client cannot complete against-gravity testing due to pain or muscle damage, the client will then be moved into a position where the affected muscles can be tested without the effects of gravity. In order to achieve this state, the client must be positioned to where the affected extremity can perform the movement parallel to the ground. An example of a gravity eliminated testing position could be testing knee flexion/extension. For this test, the therapist would instruct the client to lay on their unaffected side with the injured knee moved into a position that is parallel to the ground. Once in place, the therapist can then perform muscle testing in a safe way for the client through passively moving them through their ROM while keeping the leg stabilized.