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Mercer County Community College
Physical Therapist Assistant Program
Course Handbook
PTA 106
Therapeutic Measurement
Summer 2004
MaryLouise Jani, PT, MS
MS 161
Course Director
586-4800 x 3329
[email protected]
Mercer County Community College
Physical Therapist Assistant Program
Course Syllabus Form
===============================================================
Course #:
PTA 106
Course Title: Therapeutic Measurement
Credit Hours:(Lecture/Lab)
1 0/2
Contact Hours during the semester:
24
Number of weeks:
6
Clinical Contact Hours during the semester: 0
Number of clinical weeks: 0
Pre-/co-requisite courses:
Grading:
PTA 101 Intro to PTA
50
% exams(#) 5
PTA 105 Kinesiology
NA
% quizzes (#)
NA
% paper(s)
NA
% presentation(s)
10
% class/lab participation
30
% practical exam
10
% competency tests
===============================================================
Text(s):
Required:
Clarkson, Gilewich. Musculoskeletal Assessment: Joint ROM &
Muscle Strength, Williams & Wilkins, Baltimore, 1989.
Optional
Kendall, McCreary, Provance, Muscles Testing & Function 4th
Ed., Williams & Wilkins, Baltimore, 1993.
frequent use of ADAM Software in MS Computer Lab
===============================================================
Course Description:
This course is restricted to Physical Therapist Assistant students ONLY. It is a
required course for PTA majors. It is a laboratory course designed to develop
measurement skills for joint Range of Motion (ROM), and muscle strength for all the
peripheral joints. Course material will also develop student skills for volumetric,
circumferential and posture assessments and documentation skills. Students will be
performing manual muscle tests (MMTs), and ROM measurements utilizing a
goniometer. Students will be tested for competence to perform the assessments on their
classmates.
===============================================================
2
Course Objectives:
Following the completion of this course with a grade of “C” or higher, the student
will possess skills in the following domains:
Cognitive/Knowledge
The student will be able to successfully:
1. identify synergistic muscle groups that initiate and continue motion for the
peripheral joints
2. differentiate between gravity assisted, resisted and eliminated testing positions for
MMTs
3. identify muscles that will try to substitute for weak muscles to maintain or
perform a specified motion
4. differentiate between the advantages & disadvantages of various measurement
techniques for strength, ROM and extremity size or volume
5. identify the components of measurements that need to be documented in a patient
chart
6. recognize normal and abnormal joint movement
7. describe the difference between active and passive ROM
Psychomotor
The student will be able to successfully:
1. perform manual muscle tests for all grades for the prime movers
2. perform goniometric measurement of joint range of motion for all peripheral
joints
3. perform a volumetric measurement for the hand and foot/ankle
4. perform circumferential measurements for an upper extremity
5. perform a postural assessment for a seated and standing patient
6. document objective measurements in the patient chart
7. recognize normal and abnormal muscle length
8. perform goniometric measurement of muscle length for specific muscles
9. perform passive ROM for all peripheral joints
Affective
The student will be able to successfully:
1. defend the importance of licensed clinicians performing and documenting ROM,
MMTs and volumetric measurements
2. recognize the importance of explaining measurements in a manner that the patient
can understand
3. defend the inclusion of objective measurements in a patient chart
===============================================================
Course Outline:
I
Measurement of Range of Motion
A.
Tools
1.
Visual observations
2.
Patient Positioning
3.
Palpation
3
4.
Goniometer
a.
components
5.
Position
6
“Eyeball” concepts
B.
Types of Motion
1.
passive
2.
active
3.
active assisted
4.
resisted
II
Manual Muscle Testing
A.
Positions
1.
Gravity
a.
assisted
b.
eliminated
B.
Muscle grading
C.
Muscle strengthening concepts
III
Volumetric assessment
A.
Tools
1.
Volumeter
2.
Tape measure
IV
Documentation
A.
Goniometry
B.
Manual Muscle Tests
C.
Volume & Girth measurements
===============================================================
Course Schedule:
Summer 2004
T & R:
9-11, 1-3
===============================================================
PTAP Policy: Course Grading
One of the goals of the MCCC PTAP is to prepare students to practice as
PTAs. In New Jersey, as in many other states, PTAs are required to be licensed.
Licensure is granted following the successful completion of a standardized
licensing exam, with a score of 75 or higher. In recognition of this standard, set
by a board that is external to MCCC, the PTAP will adopt 75 as the minimal
passing grade. Other grade ranges are as follows:
A=
B=
93-100
84-92
C=
D=
75-83
70-74
F=
below 70
Grades below 75 are not considered passing grades for PTAP courses, and are
therefore considered unacceptable. All PTAP courses must be completed with a
grade of “C” or higher. All course grade determinations are made by the course director for
that course.
4
PTAP Attendance and Deportment Policy Statements
Physical Therapy is a respected profession. Members of the profession
abide by the Code of Ethics for Professional Conduct and the Guide for
Professional Conduct. The MCCC PTAP faculty believe that professional conduct
and deportment are essential components for success as a Physical Therapist
Assistant.
Enrollment in a PTAP course will be viewed as a commitment that is made
between the student and the instructor. Enrollment in PTAP courses is viewed as
a similar agreement to the one that exists between an employer and an
employee. Both parties agree and understand that:

Attendance is expected for every scheduled lecture, laboratory and clinical
education course.

Excused absences of didactic courses may be permitted at the discretion of
the Course Director, if the absence is discussed in advance of the
occurrence.

It is the responsibility of the student to leave a message with the PTA
Program Coordinator, Barbara Behrens if the student is going to be absent
from a scheduled lecture, laboratory or clinical education course (609-5864800x 33853). This message is to be left prior to the absence of the student.

Lateness to a scheduled lecture, laboratory or clinical education course in
unacceptable. The student and the Course Director will negotiate based upon
the frequency and circumstances, to determine what action will be taken.

Repeated lateness may adversely effect student performance and
progression within the PTAP.

Students and faculty are expected to behave at all times, in a manner that is
consistent with the behaviors of their chosen profession and those of a
civilized society.(Nothing in this statement should be construed to prohibit an individual
from having an individual lifestyle outside of the clinic environment that may differ from the
expected behaviors in the clinic or classroom.)

Failure to exhibit behaviors consistent with this policy may result in the need
for Program counseling to determine the appropriateness of the choice of
major.
Continued matriculation following acceptance in the PTAP indicates that
the student has agreed to accept and uphold their commitment to these policies.
5
Students with documented disabilities may request modifications,
accommodations, or auxiliary aids which will enable them to participate in and
benefit from all program educational activities. If you feel that this applies to you,
make an appointment to meet with the PTA program coordinator to discuss your
needs, prior to the first quiz, exam or other assignment for the course.
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Mercer County Community College
Physical Therapist Assistant Program
Confidentiality Expectations
Patients:
During the academic preparation to become a physical therapist assistant, there
will be instances when you will be expected to collect data regarding a patient that you
have seen or are seeing. This data is intended to be used for educational purposes only.
Under NO circumstances, should this data be identified with a particular patient or
individual by the use of proper names.
Sample acceptable data for collection:
diagnosis
prescribed medications
age, gender
overall medical condition of the patient
previous medical history
physical therapy plan of care
record of PT visits
physical therapy documentation
Classmates:
Periodically during the course of the semester, individuals among your classmates
may be asked to share physical anomalies or previous injuries and treatments with the
PTAP class. If an individual chooses to share this information with the class, it is NOT to
leave the classroom. If an individual does not wish to share a personal diagnosis or
anomaly with the class, it is within their rights not to do so.
Volunteers will be solicited for laboratory demonstrations. Information obtained
during these lab exercises is intended for demonstration purposes only. It is the right of
every individual NOT to volunteer for a demonstration. However, all students are
expected to volunteer to be a patient for their classmates. This may involve the removal
of minor articles of clothing. In the event that clothing is removed, draping techniques
will be employed to preserve patient dignity.
Faculty:
Any and all individuals who elect to allow themselves to be the patient during
class and lab activities can expect that all information gained during the activity will
remain confidential. This extends to all MCCC faculty and MCCC staff who elect to be
“patients”.
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Mercer County Community College
Physical Therapist Assistant Program
PTA 106 Therapeutic Measurement
Summer 2004
Tuesday & Thursday 9:00 – 11:00 AM
&
Tuesday & Thursday 1:00 – 3:00 PM in MS 352
Date
Topic(s)
Reading
5/25
Tools of Measurement
Clarkson, Chapter 1
Kendall, Chapter 1
5/27
Tools of Measurement
Clarkson, Chapter 1
Kendall, Chapter 2
6/1
Cervical & Trunk ROM
WE#1
Clarkson, Chapter 2
Kendall, Chapters 4 & 5
6/3
Shoulder ROM
6/8
Shoulder ROM
WE#2
Clarkson, Chapter 3
Kendall, Chapters 8 & 10
Clarkson, Chapter 3
Kendall, Chapters 8 & 10
6/10
Elbow, Wrist & Hand ROM
Clarkson, Chapters 4 & 5
Kendall, Chapter 8 & 10
6/15
Hip, Knee & Ankle ROM
WE#3
Clarkson, Chapters 6, 7 & 8
Kendall, Chapter 7
6/17
Upper Extremity MMT
Clarkson, Chapters 3,4 & 5
Kendall, Chapters 8 & 10
6/22
Upper Extremity MMT
WE#4
Clarkson, Chapters 3, 4 & 5
Kendall, Chapters 8 & 10
6/24
Lower Extremity MMT
Clarkson, Chapters 6, 7 & 8
Kendall, Chapters 7 & 11
6/29
Lower Extremity MMT
WE#5
Clarkson, Chapters 6, 7 & 8
Kendall, Chapters 7 & 11
7/1
PRACTICAL EXAM
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Mercer County Community College
Physical Therapist Assistant Program
Competence = adequacy, fitness
Competent = capable, fit, qualified
Competency Testing
The focus of all health related professions is the patient. As health care providers and educators,
we are striving to assure that the safety of our patient is not compromised in any way by the actions of our
students. All PTA program laboratory courses involve direct interaction between the students and the PTA
faculty. All PTA students experience both administering care and receiving care, classmates are both
“patients” and “clinicians”.
PTA laboratory courses also involve individualized competency testing for specified skills that
have been identified as entry level skills students should possess. Competency testing presents a method of
assuring the clinical community that the PTA student is competent and safe to perform procedures and
techniques with patients.
What is a competency test?



a 15 or 30 minute “appointment” made by the student with a clinician tester
an opportunity for the student to demonstrate their skill level by performing the identified
procedures on a fellow classmate in the presence of a tester
a method for the clinician tester to assure competence, safety, and skill level for a specific
procedure or technique.
Competency Tests are Composed of:
1.
2.
3.
4.
course #
course title
title of the test
objectives for the test which include
 preparation of the patient and the treatment area
 observation of the indications, contraindications & precautions
 implementation of the procedure or technique
 termination or completion of the technique or procedure
 documentation of what was observed, performed, and or measured and pre/post
assessments
 questions
clinical or medical complications and the impact that they might have on the
procedure or technique to be performed. (“what if” questions)
How do students “sign up” for Competency Tests?

A notebook labeled “PTAP Competency Testing” is located on the bookshelf inside MS352. The
notebook has a calendar of available testing times for students to select from.
How do students prove that they have been tested and are “competent” to
perform a particular task?



Students have a “Sign Off Sheet” that they are responsible for having their clinician tester sign once
the objectives for the test have been satisfied.
Once the “Sign Off Sheet” is complete for a given course, the students return the form to the PTA
program coordinator.
All tests for a given course must be completed and the “Sign Off Sheet” must be turned in to the PTA
program coordinator to establish eligibility to take the practical exam for a course.
9
Where would a student find information about competency tests for a
particular course?


Course handbooks have a copy of the requirements for the course.
A listing of the competency tests and their content can be found in every course that has a laboratory
component to it.
What remedy is there for a student who does not successfully complete a
competency test on the first try?





Students are encouraged to sign up for a test only when they feel that they are competent.
Clinician testers work with students to help them refine their skills if the “basics are there, but a little
rough around the edges”.
The responsibility for successful completion of the tests increases as the student progresses through the
PTA curriculum.
In PTA 106- Therapeutic Measurement, students may retake a competency test as often as they need
until both the tester and the student feel that the student is competent to perform the procedure.
In subsequent PTA laboratory courses, the student is capable of retaking the competency test as many
times as they need, however, points will be deducted for each unsuccessful attempt.
What is the difference between a practical exam and a competency test?






During a competency test:
the tester interacts freely with the student being tested.
the student may ask for clarification from the tester.
the student may submit their documentation the day after the test has been completed.
Students sign up for competency tests when they feel that they are ready to take them.
Students know exactly what test they will be demonstrating competence with.
During a practical exam:
the tester does not interact with the student, they take notes.
the tester provides no additional information to the student being tested.
the documentation for the test is due at the completion of the test.
Students are assigned a specific testing time.
Students select a patient problem at the time of the test. They do not know the content of the problem
in advance.
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Mercer County Community College
Physical Therapist Assistant Program
Competency Testing
Competency is a form of testing within the MCCC PTA curriculum laboratory courses. This is a
practical technique for testing to ensure that students have mastered an entry level skill, and that they are
safe to perform that skill. It is also an opportunity for the tester and student to work together one-on-one to
further develop the art of physical therapy.
Students will be learning and practicing a variety of skills in the laboratory courses. They will be
expected to be able to perform these skills in a context based situation for a tester. The experience is not a
rote exercise for duplication of the technique. Students will have a description of what is expected for each
of the competency tests, and they will be expected to perform the technique in a given set of circumstances
and provide a rationale for why they would perform the technique with a patient. The tester observes the
student interacting with their “patient”, noting whether or not the technique is performed safely and
whether or not the student demonstrates caring for the patient and an understanding of the technique.
Responsibilities of the PTA student:

signing up in advance to take a competency test, once they feel that they have mastered the
skill.

providing a suitable patient to perform the skill with. This is most often a fellow PTAP
student, who is dressed in a manner that allows the technique to be performed unrestricted
by jewelry or extraneous clothing.

preparing and cleaning up the appropriate treatment environment.

having the competency tester sign off that they performed the test in a safe and competent
manner.
Other Information:
 An individual tester will be assigned for each student competency test.
 Both the student to be tested and the tester have a copy of what is expected during the competency
test.
 Students who do not perform the skills at a satisfactory level must re-take the test until
competence is accomplished to the satisfaction of the tester and the student.
11
Mercer County Community College
Physical Therapist Assistant Program
Competency Tests:
PTA 106 Therapeutic Measurement
Testing Tools
ObjectivesThe student will successfully be able to demonstrate competence in the following skills:
 descriptions for each of the listed measurement or testing tools
 goniometer
 tape measure
 volumeter
 differentiate between the uses for different sizes of goniometers
 describe the purpose of a volumetric assessment for edema
 contrast and compare a tape measure with a volumeter for edema assessment
 demonstrate documentation of measurements taken with a goniometer, a tape measure and a
volumeter
Cervical & Lumbar ROM
ObjectivesThe student will successfully be able to demonstrate competence in the following skills:
 assessment of postural alignment & symmetry
 measurement and documentation of cervical ROM flexion/extension, L & R rotation
 utilizing either a tape measure or a goniometer
 differentiate between the advantages and disadvantages of the goniometer versus the tape measure
 measurement and documentation of lumbar ROM flexion/extension, L & R side bending
Upper Extremity ROM
ObjectivesThe student will successfully be able to demonstrate competence in the following skills:
 measurement and documentation of:
 shoulder ROM (within 50 of the tester)
1. flexion/extension
2. internal/external rotation
3. ADD/ABD
 Horizontal ABD & ADD
4. elbow ROM (within 50 of the tester)
5. flexion/extension

forearm ROM (within 50 of the tester)
6. pronation/supination

wrist ROM (within 50 of the tester)
7. flexion/extension
8. radial/ulnar deviation
12
Lower Extremity ROM
ObjectivesThe student will successfully be able to demonstrate competence in the following skills:
 measurement and documentation of:

Hip ROM (within 50 of the tester)
1. flexion/extension
2. ABDuction/ ADDuction
3. Internal/external rotation

Knee ROM (within 50 of the tester)
4. flexion/extension

Ankle ROM (within 50 of the tester)
5. dorsi/plantar flexion
6. inversion/eversion
Manual Muscle Testing
ObjectivesThe student will successfully be able to demonstrate competence in the following skills:
 assessment and documentation of Manual Muscle Tests (MMT) for:
1. shoulder ABD for a grade of
good
2. elbow flexion for a grade of
fair
3. wrist extension for grade of
fair
4. hip ADD for a grade of
normal
5. knee flexion for a grade of
good
6. knee extension break test
normal
7. ankle dorsiflexion for a grade of
trace
8. abdominal muscles trunk flexion
good
9. back extensors
normal
13
Mercer County Community College
Physical Therapist Assistant Program
Patient:
Practical Examination Score Sheet
Student: ___________________
Date: ___________________
106
Problem:
210
211 & 212
Instructions:
You will select one of the possible test scenarios that you will need to perform with an
assigned patient. You will make your selection approximately ___ minutes before your actual
testing time. During that time, you may review your notes, texts, reference materials, etc., and
make notes on a separate piece of paper that you may bring into the test with you.
Each test will take a total of ____ minutes to complete.
The tester will be looking for the following:
(from the individual being tested)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
preparation of the treatment/assessment area for your patient (before and after the
session)
preparation of yourself, handwashing before touching a patient
to see how you introduce yourself to a patient
to see that you respect the dignity of your patient
to see that you position your patient appropriately for what you are doing with them
to see that you explain what you are going to do with the patient to the patient
to see that your session and measurements are accurate and in agreement with the
testers visual assessment of the measurements and the session
to see that you record your session and measurements in a meaningful and accurate
manner
Patient Safety: to see that you have prioritized what you are going to do with the patient
and that you have a physiologically sound and rational plan for the session
Patient Safety: to see that you perform the selected tasks with evidence of skill and
safety in the techniques performed
The tester will be looking for the following from the “patient” during the test:
 that you do ONLY what you are told to do
 the you do NOT try to help the clinician
 that you do NOT ask questions of the tester
 that you do NOT prepare or clean up the area
 that you respect the stress of the clinician and do not try to make it more difficult for them to
successfully complete the practical
Please note:
Patient safety is a critical component for the successful completion of this and all PTA program courses
within the PTA curriculum. Items 9 & 10 on the list are considered to be skills that must have a score of
“8” or higher for the student to pass this practical examination.
14
Scoring
10 = entry level performance for a PTA
9 = competent for a PTA student at this level
8 = frazzled but safe
7 = unsafe or inappropriate
6 = unsafe
1.
5 = fraudulent
4 = disrespectful to the patient
3 = forgotten or incomplete task performance
2=
1=
preparation of the treatment/assessment area for your patient (before and after the
session)
Score:
Comments
2.
preparation of yourself, handwashing before touching a patient, lab coat and name tag
Score:
Comments
3.
to see how you introduce yourself to a patient (name & title), (clarity and speed)
Score:
Comments
4.
to see that you respect the dignity of your patient (making eye contact at eye level, pt.
draping)
Score:
Comments
5.
to see that you position you patient appropriately for what you are doing with them and
that you do not have them change positions un-necessarily
Score:
Comments
6.
to see that you explain what you are going to do with the patient to the patient in terms
that they will understand
Score:
Comments
7.
to see that your session and measurements are accurate and in agreement with the
testers visual assessment of the measurements and the session, recording only what is
done and planned
Score:
Comments
8.
to see that you record you session and measurements in a meaningful and accurate
manner, using correct abbreviations, spelling and documentation format in black ink
Score:
Comments
15
9.
Patient Safety: to see that you have prioritized what you are going to do with the patient
and that you have a physiologically sound and rational plan for the session
Score:
Comments
10.
Patient Safety: to see that you perform the selected tasks with evidence of skill and
safety in the techniques performed
Score:
Comments
The following items will be specifically watched by the tester during the test.
 does the student/patient do ONLY what you are told to do
 does the student/patient try to help the clinician
 does the student/patient ask questions of the tester
 does the patient/student prepare or clean up the area
 does the student/patient respect the stress of the clinician and does not try to make it more
difficult for them to successfully complete the practical
If any of these behaviors is observed, points will be deducted from the total score for the patient once they
are the clinician. (5 points per observed infraction)
Points to be deducted from the patient’s score once they are the clinician:
Comments/Infractions:
______________
Total Score for the Clinician:
_____________________
Review Date:_________________
Point Deductions (as a patient):
_____________________
Student Initials:_______________
Final Score:
_____________________
Pass / Fail
Tester: ________________________________
Bjb 7/02
16
Mercer County Community College
Physical Therapist Assistant Program
PTA 106
Therapeutic Measurement
Laboratory Exercises
Measurement Tools
Goniometers
(gon- ee- om- eters)
Components
1. Examine three goniometers of different sizes. What are the markings on the
goniometers?
2. How would you be able to determine the joint “range of motion” with the device?
3. Why do the number of degrees exceed the potential motion possible of a joint?
4. How would you know if you were reading 1800 or 00?
5. Why are the goniometers different lengths?
6. Compare and contrast the materials that the goniometers are made of and their
flexibility. Why are some flexible and others not as flexible?
7. What motions for what joints would probably be easier to measure with a flexible
goniometer?
8. Examine goniometers made of other materials. How do these goniometers differ
from the ones that you purchased?
9. Where might they be most useful? (what joints and what motions)
10. Identify potential uses for each of the goniometers

joint most useful for measuring

motions for that joint that a particular goniometer would work well for
17
Positioning
Clinician
11. Where would you need to be relative to the goniometer to be able to provide the most
accurate reading of the measurement tool?
Patient
12. How would the patient need to be positioned so that you would be able to allow full
ROM of the joint, and accessibility to measure that ROM?
Documentation
You will be recording joint ROM for various joints and motions. Determine your best
position, the patient’s best position and what additional tools you will need.
13. How would you indicate that the patient was not able to start a motion in a neutral
position or end ROM for that joint?
Tape measures
Components
14. Examine the tape measure. What are the available units of measure?
15. Is it firm or does it stretch?
16. Can the surface be cleaned with alcohol?
17. Why would you possibly do this?
18. Is the end of the tape protected? Why would this possibility be a consideration?
Select a classmate to have girth measurements for their lower extremity from the
popliteal space distally.
19. How frequently (every 1/2”, 1”, 1 1/2”, etc.) do you think that you would need to
measure the girth if you were trying to determine if there was edema?
20. What else would you need to do to determine whether or not there was edema?
21. How much tension should there be in the tape?
18
Perform one of the girth measurements and compare your result with the results of one of
your classmates.
Compare your readings, repeat your readings. Did they change?
22. What would a possible explanation be if there were differences?
23. How would you suggest that differences could be minimized?
Positioning
Clinician
24. Where should you be in relation to the patient when you are measuring girth?
Patient
25. How should the extremity being measured be positioned for measurement?
Documentation
26. What information does a tape measure provide you with?
27. How would you record your measurements with a tape measure?
28. What units of measure would you record? How?
Volumeters (Vol- ooom-eaters)
Components
Examine the components of either an upper or lower extremity volumeter.
29. What are they?
30. What do you think they would be used for?
31. How much water would you need?
32. Why?
19
Positioning
33. How would you position your patient if you were measuring the edematous volume
of their hand?
34. Their foot?
35. How should you be positioned to record the volumetric measurement?
36. What additional items or tools should you have available to you while performing this
type of measurement?
Documentation
37. How would you document your findings for volumetric assessment of a hand or foot?
38. How would you know if the extremity was in fact edematous or not?
Lab Summary

How were the measurement tools similar?

What is the difference between the information that you can obtain with a tape
measure versus a volumeter?

Could a tape measure be utilized to provide any other information than girth or
length?

If so what?
20
Mercer County Community College
Physical Therapist Assistant Program
PTA 106 Therapeutic Measurement
Laboratory Activities
Cervical and Lumbar ROM
Tools:
Goniometer
Which of the cervical ROM measurements do you believe that a goniometer would be
most useful for?
What is/are the axis/axes of motion for cervical rotation?
Is/are it/they palpable?
What is the axis of motion for cervical flexion?
Is it palpable?
What is the axis of motion for lumbar flexion/extension?
Is is palpable?
Anatomically, what would you align your stationary and moveable arms with?
21
Tape measure
Which of the cervical ROM measurements do you believe that the tape measure
What would you use as your bony landmarks to measure trunk flexion if you were
utilizing a tape measure?
Are those bony landmarks palpable?
Would trunk side-bending be measurable with a tape measure? If yes, how?
What would you need to do to determine if someone’s side bending ROM was limited?
Would this be applicable most of the time? Why or why not?
22
Positioning
What patient position would seem to make the most sense for measuring cervical ROM?
Why?
Where do you need to position yourself when measuring cervical ROM?
Why?
Where would you need to position yourself when measuring trunk or lumbar ROM?
Why?
Of what significance is the starting position of the patient when performing cervical or
trunk or lumbar ROM?
Documentation
How would you document cervical ROM, trunk ROM, and lumbar ROM?
Why?
23
Mercer County Community College
Physical Therapist Assistant Program
PTA 106 Therapeutic Measurement
Laboratory Activities
Shoulder Range of Motion
Select one of your classmates to be your partner. You will be measuring joint ROM for all motions of the
shoulder. You must be able to palpate the bony prominences of the gleno-humoral and scapulo-thoracic
joints. Your patient will need to make these areas easily accessible to you. You will also need to be able to
visually observe each of the axes of shoulder joint motion.
Through use of your text and the classroom demonstrations, record the following information for each of
the joints and motions indicated
Shoulder
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Flexion
Shoulder
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
ABDuction
Extension:
ADDuction:
24
Shoulder
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Internal rot.
Shoulder
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Horizontal ABD
External rotation:
Horizontal ADD:
Comments:
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Mercer County Community College
Physical Therapist Assistant Program
PTA 106 Therapeutic Measurement
Laboratory Activities
Elbow, Forearm, Wrist and Hand Range of Motion
Select one of your classmates to be your partner. You will be measuring joint ROM for all motions of the
elbow, forearm, wrist and hand. You must be able to palpate the bony prominences of these joints. Your
patient will need to make these areas easily accessible to you. You will also need to be able to visually
observe each of the axes of joint motion.
Through use of your text and the classroom demonstrations, record the following information for each of
the joints and motions indicated
Elbow:
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Flexion
Forearm
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Supination
Extension:
Pronation:
Comments:
26
Wrist
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Flexion
Extension:
Wrist
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Radial Deviaiton Ulnar Deviation:
Hand
MCP Flexion
1 2 3 4 5
MCP Extension
1 2 3 4 5
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Comments:
27
Hand
MP Flexion
1 2 3 4 5
MP Extension:
1 2 3 4
5
IP Flexion
1 2 3 4 5
IP Extension:
1 2 3 4
5
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Hand
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Thumb
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
ABD
ADD
Comments:
28
Thumb
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Flexion
Extension:
Comments:
29
Mercer County Community College
Physical Therapist Assistant Program
PTA 106 Therapeutic Measurement
Laboratory Activities
Hip, Knee and Ankle Range of Motion
Select one of your classmates to be your partner. You will be measuring joint ROM for all motions of the
hip, knee and ankle. You must be able to palpate the bony prominences of these joints. Your patient will
need to make these areas easily accessible to you. You will also need to be able to visually observe each of
the axes of joint motion.
Through use of your text and the classroom demonstrations, record the following information for each of
the joints and motions indicated
Hip:
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Flexion:
Extension:
Hip:
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
ABD
ADD
Comments:
30
Hip:
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Internal rot.
External rot.:
Knee
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Extension
Flexion
Ankle
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Dorsi Flexion
Plantar Flexion
Comments:
31
Ankle
patient position
use of pillows for support
draping
goniometer
axis of rotation
stationary arm
moveable arm
normal ROM
measured ROM
clinician position
prime mover
Inversion
Eversion
Comments:
32
Mercer County Community College
Physical Therapist Assistant Program
PTA 106 Therapeutic Measurement
Laboratory Activities
Manual Muscle Testing Upper Extremity
Select one of your classmates to be your partner. You will be testing muscle strength for all motions for the
of the upper extremity, for grades of Normal, Good, Fair and Trace. You must be able to palpate the bony
prominences of these joints. Your patient will need to make these areas easily accessible to you. You will
also need to be able to visually observe the muscle belly for each motion.
Through use of your text and the classroom demonstrations, record the following information for each of
the joints and motions indicated
Shoulder:
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Flexion:
Extension:
Shoulder:
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
ABD
ADD
Shoulder:
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Internal rot.
External rot.:
33
Elbow
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Extension
Forearm
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Supination
Wrist
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Flexion
Flexion
Pronation
Extension
Comments:
34
Mercer County Community College
Physical Therapist Assistant Program
PTA 106 Therapeutic Measurement
Laboratory Activities
Manual Muscle Tesing Hip, Knee and Ankle
Select one of your classmates to be your partner. You will be testing muscle strength for all motions of the
hip, knee and ankle. You must be able to palpate the bony prominences of these joints. Your patient will
need to make these areas easily accessible to you. You will also need to be able to visually observe each of
the axes of joint motion.
Through use of your text and the classroom demonstrations, record the following information for each of
the joints and motions indicated
Hip:
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Flexion:
Extension:
Hip:
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
ABD
ADD
Comments:
35
Hip:
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Internal rot.
Knee
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Extension
Ankle
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Dorsi Flexion
External rot.:
Flexion
Plantar Flexion
Comments:
36
Ankle
patient position
Normal
Good
Fair
Trace
draping
clinician position
prime mover
Inversion
Eversion
Comments:
37
Mercer County Community College
Physical Therapist Assistant Program
I, the undersigned, have received a copy of the course handbook for
_______
__. My signature acknowledges that this information
has been explained to me and that I have been given the opportunity to ask
questions about the content of the handbook. I understand that I will be held
accountable for the expectations of students within this course handbook and the
PTA program handbook as stated or implied within them. My signature is
provided voluntarily.
There were a total of _____ pages. This signature page is page number
_______. I have retained my copy of the other pages. I will keep this handbook
as my guide throughout this semester.
student name
signature
date

Mercer County Community College
Physical Therapist Assistant Program
I, the undersigned, have received a copy of the course handbook for
_______
__. My signature acknowledges that this information
has been explained to me and that I have been given the opportunity to ask
questions about the content of the handbook. I understand that I will be held
accountable for the expectations of students within this course handbook and the
PTA program handbook as stated or implied within them. My signature is
provided voluntarily.
There were a total of _____ pages. This signature page is page number
______. I have retained my copy of the other pages. I will keep this handbook as
my guide throughout this semester.
student name
signature
date
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39
Mercer County Community College
Physical Therapist Assistant Program
Competency Testing Sign Off Sheet
Student Name:
Date Submitted:
Semester: Fall Spring Summer
Year: 04 05 06 07 08
Comments
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
Course/Competency Test:
tester/date:
Attempt #: 1 2
3
40
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