Test Positioning- Biomechanics Blog #2

When performing Manual Muscle Testing or Range of motion testing, it is important to follow certain procedures. In ROM testing bony landmarks is necessary because it gives the therapist a point of reference for positioning the goniometer. A goniometer has a stationary arm, a moving arm, and an axis. By placing the axis or stationary of the goniometer at a particular bony landmark, you can measure precise angles. Having landmarks allows testing range of motion to be universal and precise. Proper positioning is also important because you could be putting the client at a disadvantage, by placing them in an incorrect position. The client may not be able to move as freely or their movements may be less controlled if they were not specifically positioned. If landmarks and proper positioning were not established, there would be ambiguity in measuring change over time. Following the protocol for range of motion allows precise and accurate results. This is important for billing and charting improvement. It also allows for interrater reliability among therapists if a client sees a different therapist in the course of therapy.
Manual muscle testing measures muscle strength and function. Test position is crucial for MMT because certain muscle groups should be activated when performing a particular test. It is also important to be sure that the client is in mid-range of motion for a particular muscle group because the muscles should be at the greatest mechanical advantage. The therapist should also be mindful of their own positioning in testing. The therapist should be in a position to apply a great amount of force in the correct direction.
Gravity eliminated positioning is used for weaker muscle groups or when the grade is below 2+. Gravity eliminated positioning allows a muscle to move parallel to the floor. This eleminated the perpendicular force of gravity. It is important to use accuracy in MMT to best decide a grade. If a client is graded inaccurately, it could be dangerous for them to remain moving against gravity instead of gravity eliminated.