Manual Muscle Testing: Scapular Retraction/ Adduction: Difference between revisions

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'''Original Editor '''- Claire Knott
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  &nbsp; 
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== Muscles Involved: ==
== Muscles Involved: ==
* [[Gastrocnemius]]
* [[Trapezius]] (middle)
* [[Soleus]]
* [[Rhomboids|Rhomboid]] major
OR
* Soleus only
 
== Patient Positioning ==
== Patient Positioning ==
For testing gastrocnemius and soleus together:
* Patient is prone, head turned to non-test-side
* Grades 3-5 - Test in standing on test leg, knee extended, patient can hold stable object such as a table or bench for balance
* test-side arm shoulder at 90° abduction and elbow in 90° flexion
* Grades 0-2 - Test in side-lying position, knee extended and ankle off plinth.
* For grades 0-2 the patient is seated with arm externally rotated (palm up) and arm supported on a flat surface such as a plinth ('gravity minimal' position)
For testing soleus only:
* Grades 3-5 - Test in standing on test leg, knee slightly FLEXED, patient can hold stable object such as a table or bench for balance
* Grades 0-2 - Test in side-lying with testing side knee bent to 90 degrees.
 
== Joint start Position ==
In standing test start position, start with ankle in plantar grade.
 
In side-lying test start position, start at mid point between available dorsiflexion and plantar flexion range.


== Therapist Position ==
== Therapist Position ==
Both gastrocnemius and soleus together and soleus only:
* Stand at test side
* Grades 3-5 - Therapist to position comfortably with a lateral view of the movement being performed
* Palpate shoulder adductor muscles
* Grades 0-2 - Therapist to position at the feet


== To Test ==
== To Test ==
* Patient to perform plantar flexion in the form of single-limb heel raise<ref>Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.</ref>
* Patient to perform scapula adduction "lift tip of elbow towards the ceiling"
* For grades 4 to 5, provide resistance over distal humerus in the direction opposite to scapular adduction <ref>Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.</ref>
* '''Note:'''as with all resisted testing of vertebro-scapular muscles, the preferred resistance point is that which constitutes <u>the longest lever</u> as this more closely reflects the functional demands of the limb. 
* To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) '''OR''' maintain an end point range (break testing) against maximum resistance. 
 
{{#ev:youtube|v=csEUxYhWGAo}}


== References ==
== References ==

Latest revision as of 11:33, 19 December 2019

Original Editor - Claire Knott

Top Contributors - Claire Knott and Wanda van Niekerk  

Muscles Involved:[edit | edit source]

Patient Positioning[edit | edit source]

  • Patient is prone, head turned to non-test-side
  • test-side arm shoulder at 90° abduction and elbow in 90° flexion
  • For grades 0-2 the patient is seated with arm externally rotated (palm up) and arm supported on a flat surface such as a plinth ('gravity minimal' position)

Therapist Position[edit | edit source]

  • Stand at test side
  • Palpate shoulder adductor muscles

To Test[edit | edit source]

  • Patient to perform scapula adduction "lift tip of elbow towards the ceiling"
  • For grades 4 to 5, provide resistance over distal humerus in the direction opposite to scapular adduction [1]
  • Note:as with all resisted testing of vertebro-scapular muscles, the preferred resistance point is that which constitutes the longest lever as this more closely reflects the functional demands of the limb.
  • To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.

References[edit | edit source]

  1. ↑ Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.
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