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PT LCCW (MM rehab)

strength, stretch, strenghening, etc...

QuestionAnswer
What mm. Does the forward bending test involve? gastroc, soleus, hamstrings (seminembranosus, semitendinosus, biceps femoris), low back, upper back.
Patient position for forward bending test? Pt seated on table w/ legs extended & knees locked, feet should be at right angles w/ no internal or external rotation.
What is the motion of the forward bending test? Pt reaches to toes
What is a possible observation of the arms or legs during a forward bending test? can Pt reach toes> disproportionate arm;leg length ratio, which may or may not let pt easily rech toes
What is a possible observation of the calves during a forward bending test? ask pt if calves are “burning”
What is a possible observation of sacrum angle during a forward bending test? angle b/w table and sacrum should be 70-90⁰, if <70 then tight hamstrings, if >90 weak or elongated hamstrings
What is a possible observation of low back curvature during a forward bending test? low back curvature should not be flat or straight, should have a natural curve.
What is a possible observation ofupper back curvature found during a forward bending test? upper back curvature should be a smooth gradual curve, not straight nor should the scapulae be reaching far forward. Often pt get a lot of their reach from the upper back as the mm are elongated and weak.
What are the MMs involved with the hamstring length test? semimembranosus, semitendinosus, biceps femoris
What is the Patient position during a hamstring length test? pt on back on table w/ legs extended & knees locked, low back must be flat on table so the pelvis is level (w/ back flat pelvis is tilted 10 degrees posteriorly)
What leg is stabilized and why; during a hamstring length test? opposite leg stabilized to avoid posterior pelvic tilt.
What is the motion of a hamstring length test? Dr. brings pt leg w/ knee locked up like SLR, angle should be 70-90 degrees- should correspond w/ angle from forward bending test (if not retest as an examiner error has taken place)
What is the observation made during a hamstring length test? PREFORM BILATERALLY (if <70 then tight hamstrings, if >90 weak or elongated hamstrings)
If back will not flatten for a hamstring length test what should be done? If can not flatten back then use pillows to assure that the back is flat
What is the position (patient) for a hamstrings stretch? pt on back on table w/ legs extended & knees locked, low back must be flat on table so pelvis is level. (stabilize opposite leg to avoid posterior pelvic tilt.
What is the motion for hamstrings stretch? Dr brings pt leg w/ knee locked up like a SLR
What is the patient position for a hip extensor strength test (hamstrings)? pt on stomach on table w/ opposite leg extended and knee locked, leg to be tested is flexed at 90 degree.
Where is the stabilization for a hip extensor strength test (hamstrings)? stabilize on sacrum
What is the action for a hamstrings hip extensor strength test? What is the motion? action-extends hip jt, flexes & internally rotates knee>>>motion-provides force as dr pushes flexed leg toward table, (PREFORM BILATERALLY).
Using rubber tubing, how can the hamstrings be strengthen? 1-seated facing door,tubbing attached to ankle,(bending knee)>>2-pt laying head away frm door, tubing to ankle, pt pull extended leg into a 90⁰ pos >>3-pt stand fac door, tubing attached to ankle knee lock,knee locked away frm door.
What is the action of the Gluteus maximus? extends and externally rotates hip joint. (HIP EXTENSOR)
What is the patient position for the hip extensor strength test (Glut-Max)? pt on stomach on table with opposite leg extended & knee locked, leg to be tested is flexed @ 90 degrees
What is the motion of a hip extensor strength test (Glut-Max)? what is the stabilization? dr stabilizes on sacrum and has pt lift thigh up off table while pt provides force as Dr. pushes raised thigh toward table (perform bilaterally).
How is the Gluteus Maximus strengthening done? pt standing facing door w/ rubber tubing on ankle, knee locked in extension (or bend at 90 degrees is OK), w/ patient holding on to rail or wall or chiar pt extends hip away from door
What is the test for hip flexor length test? What are the MMs tested? Thomas test length test >>>iliopsoas & rectus femoris
What is the patient position for a hip flexor (Thomas test length test)? pt seated on edge of table with thigh 1/2 – 2/3 of the way off
What is the motion of a hip flexor (Thomas test) length test? pt hold knee (either underneath if knee problem or on top) and lies down on table bringing knee to chest, low back should be flat on the table
What is the observation being made during a hip flexor (Thomas test) length test? thigh NOT being held observed, off the table then either rectus femoris or liopsoas is tight, if leg lies flat on the table length is fine. ALSO LOOK to see if KNEE is extended (NOT 90⁰) which is indicates of a tight rectus femoris (PREFORM BILATERALLY)
What is indicative of a tight rectus femoris during a hip flexor (Thomas test) length test? if KNEE is extended (NOT 90⁰)
How do you differentiate length b/w the rectus femoris & iliopsoas (hip flexor length test)? while pt is still in Thomas test position carefully extend the knee of the leg being tested (which provides slack for the rec-fem) if the thigh stays up the iliopsoas is tight, if thigh drops to table then rec-fem is tight.
What is a error that must be watched for while patient is laying on back during the hip flexor (Thomas test) length test? avoid too much posterior pelvic tilt when pulling knee to chest (Rolling up on back)
What are the MMs that are stretched in the hip flexor (Thomas test) position? iliopsoas & Rectus Femoris
What is the patient position for stretching the hip flexors? pt seated w/ thigh 1/2 – 2/3 off table, then low back flat on table>>pt holding knee (Thomas test)
What is the motion for stretching the hip flexors? dr places hand on knee being held by patient and other hand on thigh to be stretched (contra-thigh) Dr gently (w/o harming pt) pushes contra-thigh to table…. Need only go to level with table
What is the patient position for hip flexor strength test? pt seated on edge of table w/ 1/3 off the thigh off table
What is the action of the hip flexors strength test? pt flexes hip jt w/ origin fixed, trunk flexion w/ insertion fixed.
What is the motion of a hip flexor strength test? pt holds thigh up off the table about 1-2 inches, dr pushes down as pt resists. (dr grades MM strength/ performs bilaterally)
How do you differentiate b/w the iliopsoas & Rectus Femoris during a hip flexor strength test? while in same position of a hip flexor strength test> have pt hold knee up as high as they can, dr pushes down as pt resists, this high position isolates iliopsoas.
What is the action done during a hip flexor (PSOAS MAJOR ) strength test? pt flexes hip jt w/ origin fixed, trunk flexion w/ insertion fixed
What is the patient position for a hip flexor (PSOAS MAJOR) strength test? pt on back w/ leg abducted 45⁰ laterally from midline (knee locked) foot rotated externally 45⁰)
What is the motion of a hip flexor (PSOAS MAJOR) strength test? Dr pushes down towards floor as pt resists (grade MM. Strength / bilaterally)
What MMs are strengthen during hip flexor strengthening? iliopsoas & rectus femoris
What is the patient position during hip flexor strengthening while on back? / What is the motion of hip flexor strengthening? pt on back, rubber tube attached to ankle, leg straight w/ knee locked in extension/ pt brings knee toward chest allowing knee to bend
What is the patient position during hip flexor strengthening while standing? / What is the motion of hip flexor strengthening? pt facing away from door, tubing attached to ankle & under door / pt lifts leg away from door keeping knee locked
What is the patient position during hip flexor strengthening while on all fours? / What is the motion of hip flexor strengthening? pt on hands and knees, tubing attached to ankle & under door / pt brings knee toward chest allowing knee to bend
What muscles are used in knee extension? quadriceps & rectus femoris
What is the patient position for knee extensor strengthening? / What is the motion? pt seated w/ back to door tubing @ ankle & under bottom of door / begin w/ knee bent then extend leg, can support w/ hands on chair etc…
What is the action of the quadrates lumborum? assists in extension (knee), & laterally flexes lumbar spine.
What is the pt position for Quadratus Lumborum stretch? What is the motion? pt seated / pt leans opposite tight muscle (lateral bend at hip) keep ischial tuberosity on table.
What is the pt position and motion for strength test of quadrates Lumborum? pt on side, pillow b/w legs, head-trunk-pelvis-lwr extremities in line w/ top arm straight dwn ontop of leg, bottm arm across chest holding upper shoulder Dr stabilizes heavily on pelvis & leg / pt attempts to laterally flex bring body up off table.
Created by: JRW