Download Major postural muscle length and strength test instructions

Major postural muscle length and strength test instructions
Assess the length of the major postural muscles as described below. Grade the strength of the muscles
using the traditional five-grade classification. Record the results on the Major postural muscle length and
strength test results form.
Sternocleidomastoid
1. Place the patient in the supine position.
2. Fix in place the muscle insertion at the sternum on the side to be tested.
3. While stabilizing the head in a slightly tucked-in position, passively extend, contralaterally laterally
flex, and ipsilaterally rotate the head:
•
The muscle is short if the end feel is hard instead of soft.
4. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Upper trapezius
1. Place the patient in the supine position.
2. Passively flex and ipsilaterally rotate the head.
3. While stabilizing the head, depress the shoulder:
•
The muscle is short if the end feel is hard instead of soft.
4. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Levator scapulae
1. Place the patient in the supine position.
2. Passively flex and contralaterally rotate the head.
3. While stabilizing the head, depress the shoulder:
•
The muscle is short if the end feel is hard instead of soft.
4. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Major postural muscle length and strength test instructions (Dr. V. Weatherall)
1
Pectoralis major
1. Place the patient in the supine position.
2. Stabilize the trunk to prevent rotation.
3. Passively abduct the arms to 90°:
•
The sternal portion of the muscles is short if the arms do not reach the table level.
•
The end feel should be soft on gentle overpressure.
4. Passively abduct the arms to 30°:
•
The clavicular portion of the muscles is short if the arms do not reach at least 20° below the table
level.
•
The end feel should be soft on gentle overpressure.
5. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Erector spinae
1. Sit the patient at the end of the table.
2. While stabilizing at the waist, have the patient bend forward:
•
The erector spinae are short if the lumbar curve does not reverse.
Quadratus lumborum
1. Place the patient in the side lying position.
2. Have the patient prop up on their elbow:
•
The ipsilateral muscle is short if the inferior angle of the scapula is not at least 2 in. from the
table.
3. Repeat the above sequence on the opposite side and generally compare the muscle extensibility.
Or
1. Have the patient stand.
2. Have the patient perform a side bend:
•
The contralateral muscle is short if the lumbar curve is not smooth and convex upwardly.
3. Repeat the above sequence on the opposite side and generally compare the muscle extensibility.
Major postural muscle length and strength test instructions (Dr. V. Weatherall)
2
Hip abductors
1. Place the patient in the Modified Thomas position.
2. Passively adduct the test hip maximally:
•
The TFL and ITB are short if adduction is less than 15-20°.
•
The groove in the ITB will deepen if it is short.
•
The end feel should be soft on gentle overpressure.
3. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Hip adductors
The following tests evaluate and the two-joint long hip adductors the (gracilis, semimembranosus,
semitendinosus) and the one-joint short hip adductors (pectineus; adductor magnus, brevis, and longus).
1. Place the patient in the supine position (with the knees straight).
2. Passively abduct the test hip maximally:
•
The long (two-joint) hip adductors are short if abduction is less than 40°.
•
The end feel should be soft on gentle overpressure.
•
Tight hamstrings may cause a false positive.
3. Bend the knee on the test hip side and then passively abduct the hip again:
•
The short (one-joint) hip adductors are short if abduction does not increase from the first test.
•
The end feel should be soft on gentle overpressure.
4. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Hip flexors
1. Place the patient in the Modified Thomas position with the test thigh off the side of the table:
•
The iliopsoas is short if hip extension is less than 10-15°.
•
The rectus femoris is short if the knee compensatorily extends with less than 100-105° of flexion.
•
The end feel should be soft on gentle overpressure.
2. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Major postural muscle length and strength test instructions (Dr. V. Weatherall)
3
Hamstrings
1. Place the patient in the supine position with the non-test hip and knee flexed.
2. Passively raise the test leg:
•
The hamstring is short if the angle of rise is less than 80°.
3. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Hip external rotators
1. Place the patient in the supine position.
2. Passively flex the hip to less than 60° while fully adducting it.
3. Stabilize the pelvis (by pushing the knee upwards toward the hip along the long axis of the femur)
and internally rotate the hip:
•
The muscle is short if the end feel is hard.
•
There may also be pain the the buttock.
4. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel
Foot dorsiflexors
1. Place the patient in the supine position with the knee flexed.
2. Passively dorsiflex the foot:
•
The soleus (a one-joint muscle) is short if the foot does not dorsiflex to 90°.
•
The end feel should be soft on gentle overpressure.
3. Straighten the knee and then passively dorsiflex the foot again:
•
The gastrocnemius (a two-joint muscle) is short if the foot does not dorsiflex to 90°.
•
The end feel should be soft on gentle overpressure.
4. Repeat the above sequence on the opposite side and generally compare the muscle extensibility and
end feel.
Major postural muscle length and strength test instructions (Dr. V. Weatherall)
4