L9: Static Analysis/Motion Testing

Question 1

Which is more concerning: painless or painful weakness?

Answer 1

• Painless weakness concerning for neurological problem. Painful weakness may indicate muscle tear.

Question 2

What does static analysis of a pt reveal to the physician?

Answer 2

• Muscle imbalances
• Strain patterns
• SDs
• Neurologic disease (wasiting, weakness)
• Orthopedic disease or deformity
• Emotional state

Question 3

When assessing ROM, always assess passive ROM before active ROM. True / False.

Answer 3

• False. Assess, active ROM (from pt) before passive ROM (from physician)

Question 4

With passive ROM, what are normal end-feels? Abnormal?

Answer 4

• Normal: elastic, hard (painless), tissue approximation – these depend on location
• Abnormal: guarding (aka empty) voluntary or involuntary, muscle spasm

Question 5

Is OMM contraindicated with guarding and muscle spasm end feels during passive ROM testing?

Answer 5

• Yes, contraindicated until underlying condition is diagnosed

Question 6

What is the gravitational line?

Answer 6

• Imaginary line in coronal plane which in theoretical ideal posture passes through: external auditory meatus, lateral aspect of head of humerus at tip of shoulder, greater trochanter, lateral condyle of knee, slightly anterior to lateral malleolus

Question 7

What is a hip drop test? What is a negative test? What is a positive test?

Answer 7

• A ROM test for lumbar sidebending by evaluating asymmetries of iliac crests
• Pt stands on one leg and observe position of iliac crests.
• Negative: iliac crest on unsupported side drops 20-25 degrees with a smooth lumbar curvature toward weight-bearing side of body, so lumbar spine should side-bend to the side that drops the least
• Positive: iliac crest does not drop 20-25 degrees on unsupported side and there is an angled uneven or poor l-spine curve toward weight-bearing side of body. Indicates that lumbar and / or TL spine has difficulty side-bending toward weight-bearing side

Question 8

Describe positive standing flexion test

Answer 8

• PSIS that moves further cephalad, not the one that moves first