Edmund M. Kosmahl, PT, EdD

Department of Physical Therapy - University of Scranton

PT350 - Intro to Therapeutic Exercise - Dr. Kosmahl

PERFORMANCE EXAM ITEMS EVALUATION SHEET

MANUAL STRETCHING AND RESISTANCE UPPER EXTREMITY

GONIOMETRY, MMT

NAME: ___________________________________________ DATE: _______

Examiner: ______________________________________________

Random pick of one item from each category. Each item worth 5 points. Exam worth 15 points total.

Goniometry or MMT: Item:

Score and Comments:

Manual Stretch: Item:

Score and Comments:

Manual Resistance: Item:

Score and Comments:

CRITERIA - MANUAL STRETCHING AND RESISTANCE UPPER EXTREMITY GONIOMETRY, MMT

GONIOMETRY:

Position in zero position and stabilize proximal joint component. (1 point)

Move part through full range of motion and determine end feel. (1 point)

Identify and palpate bony landmarks. (1 point)

Align goniometer. (1 point)

Read goniometer and record measurement. (1 point)

MANUAL MUSCLE TESTING:

Position subject to provide best stabilization. (1 point)

Stabilize proximal body part. (1 point)

Use test position or test movement. (1 point)

Apply pressure opposite the direction body part moves when the test muscle contracts or allow body part to move through horizontal test movement if too weak. (1 point)

Evaluate and record grade. (1 point)

MANUAL STRETCHING:

choose an appropriate stretching exercise (1 point)

appropriate patient positioning and stabilization (1 point)

appropriate hand placement to make stretch effective (1 point)

appropriate duration and force of stretch (1 point)

other (1 point)

MANUAL RESISTANCE:

choose an appropriate manual resistance exercise (1 point)

appropriate patient positioning and stabilization (1 point)

appropriate hand placement to make exercise effective (1 point)

appropriate amount of resistance (1 point)

other (1 point)

PERFORMANCE EXAM ITEMS

MANUAL STRETCHING AND RESISTANCE

UPPER EXTREMITY GONIOMETRY, MMT

Goniometry:

shoulder flexion and extension
shoulder abduction
shoulder medial (internal) and lateral (external) rotation
elbow flexion and extension
forearm supination and pronation
wrist flexion and extension
wrist radial and ulnar deviation
metacarpophalangeal joint flexion and extension
metacarpophalangeal joint abduction and adduction
interphalangeal joint flexion and extension
thumb carpometacarpal joint flexion and extension
thumb carpometacarpal joint abduction and adduction
thumb carpometacarpal joint opposition

Manual Muscle Test: (be prepared to use hand-held dynamometer if instructor asks)

serratus anterior

trapezius (3 parts)

rhomboids

shoulder lateral and medial rotators

latissimus dorsi

pectoralis major (upper and lower)

pectoralis minor

teres major

deltoid (3 parts)

supraspinatus

triceps brachii and anconeus

biceps brachii

brachialis

brachioradialis

supinator

pronator teres

pronator quadratus

extensor carpi ulnaris

extensor carpi radialis longus and brevis

flexor carpi ulnaris

flexor carpi radialis

flexor digitorum profundus

flexor digitorum superficialis

extensor digitorum, indicis, and digiti minimi

palmaris longus

lumbricales and interossei

adductor pollicis

abductor pollicis brevis

abductor pollicis longus

opponens pollicis

flexor pollicis brevis

flexor pollicis longus

extensor pollicis brevis

extensor pollicis longus

abductor digiti minimi

opponens digiti minimi

flexor digiti minimi

grip and pinch strength dynomometers

Manual Stretch

stretching for cerebro-vascular accident patient with hemiplegia and spastic elbow flexors

stretching program for adhesive capsulitis of the shoulder, PROM: flex 120, abd 100, ER 50, IR 70, use contract-relax

stretching for patient who cannot close his fingers due to tight intrinsic hand muscles (lumbricales and interossei)

stretching for tight pectoralis major and minor preventing normal range of scapular retraction

Manual Resistance

patient has weakness (3/5) of elbow extensors after brachial plexus injury, use manual resistance

patient has weakness (4/5) of all left upper extremity musculature after immobilization for fracture of humerus (now healed), use PNF diagonals

manual resistance exercise for weak wrist extensors after lateral epicondylitis

manual resistance exercise for shoulder extensors in preparation for crutchwalking