Clinical Skills Gonio/MMT Midterm

Gonio shoulder flexion degrees

160-180 degrees

Gonio shoulder extension degrees

65-80 degrees

gonio shoulder abduction degrees

170-180 degrees (GH=120, ST=60)

dont worry about shoulder adduction measurements

gonio internal rotation degrees

ABD - 30-50 degrees (what we do), (ADD - 75-86 degrees)

gonio shoulder external rotation degrees

90-100 degrees @ABD (60-70 ADD)

Serratus Anterior MMT test options

-scapular protraction (lay down on back and punch out)

-scapular aBduction and upward rotation (sitting up and punch forward)

(stabilize rib, move shoulder blade)

Upper Trapezius Test

-scapular elevation (shoulder shrug)
(stabilize shoulder/neck while resisting movement)

Levator Scapulae Tests

-scapular elevation

-scapular adduction and downward rotation (w on stomach)

Middle Trapezius Test

-shoulder adduction and retraction (thumb up on stomach, straight T and push down against resistance while stabilizing the opposite shoulder

Rhomboid Major/Rhomboids tests

-scapular adduction/retraction (thumb down straight T)

-scapular adduction/downward rotation (hand behind back, stabilize opposite shoulder and push arm down)

Pectoralis Minor Test

-scapular anterior tilt

Latissimus Dorsi Tests

-scapular depression (shrug down for 3, stand on hands on table for 5)

-Shoulder Extension (on stomach and straight arm back, elbow straight and apply resistance to the forearm, if weak triceps push at humerus higher than traps)

-Shoulder Internal Rotation (on stomach, arm at 90 degrees, apply resistance at wrist while stabilizing elbow, push back)

Teres Major Tests

-scapular depression (shrug down, hands on table for 5)

-shoulder extension (on tummy, arm straight back, I push down)

-shoulder internal rotation (prone, 90/90 push back, can be done seated in clinics)

SAME TESTS AS LATS

Posterior Deltoid Tests

-scapular depression

-shoulder extension

-shoulder horizontal abduction (on stomach, downward elbow bent, push on SAME shoulder rather than opposite) (almost like scapular adduction/retraction test)

Anterior Deltoid and Coracobrachialis Test

-shoulder flexion (arm forward hold for 3, hand on shoulder and slightly above elbow, I push them down)

Middle Deltoid and Supraspinatus Tests

-Shoulder Scaption (sitting, hold arm like Y, I push arm down, hand on shoulder and slightly above elbow)

-Shoulder Abduction (same as scaption, except hand is up straight to the side)

Pectoralis Major Combo

-shoulder horizontal aDduction (on back, internally rotate bent arm for a 3, hold bicep and opposite shoulder and push out) → (sternal and clavicular tests??)

-Shoulder Internal Rotation (on tummy, 90/90, push them back)

Infraspinatus and Teres Minor Test

Shoulder External Rotation (on stomach, 90 degree elbow I push them up, for a 3 get them in that position)

Subscapularis Test

-Shoulder Internal Rotation (on stomach, arm at 90 degrees, apply resistance at wrist while stabilizing elbow, push back)

Gonio Elbow Flexion degrees

-130-145 degrees (on back, lateral epicondyle to head of femur, distal arm on styloid)

-SOFT END FEEL

Gonio Elbow Extension degrees

-0 to 5 degrees hyperextension (done after flexion, establish extension end feel)

Gonio forearm pronation degrees

-75 degrees (lateral side gonio)

Gonio Forearm Supination degrees

85 degrees (medial side)

Bicep Brachii MMT

-elbow flexion (thumbs up)

-forearm supination (hold for stabilization at elbow, thenar emminence palm area)

Brachialis MMT

-elbow flexion (pronated)

Brachioradialis MMT

-elbow flexion (neutral grip, DO MOTION FOR A 3)

Triceps and Anconeus MMT

Elbow Extension (on tummy, straight arm out for a 3, stabilize humerus and push out like a T)

Pronator Teres and Pronator Quadratus Test

Forearm Pronation (elbow bent, thenar eminence to hold)

Shoulder Abduction and Upward Rotation

Serratus Anterior

Scapular Protraction

Serratus Anterior

Scapular ELevation

Upper Trap and Levator Scapulae

Scapular Adduction/Retraction

Middle Traps (thumbs up) and Rhomboid Major (thumbs down)

Scapular Adduction/Depression

Lower Traps

Scapular Adduction/ Downward Rotation

Rhomboids (hand behind back), Levator Scapulae (W, push bicep down), together is w push up at elbow, hold opposite shoulder)

Scapular Anterior Tilt

Pectoralis Minor

Scapular Depression

Latissimus Dorsi, Teres Major, Posterior Deltoid

Shoulder Flexion

Anterior Deltoid and Coracobrachialis

Shoulder Extension

Latissimus Dorsi, Teres Major and Posterior Deltoid

Shoulder Scaption

Middle Deltoid and Supraspinatus (POINT THUMB DOWN DURING TEST)

Shoulder Abduction

Middle Deltoid and Supraspinatus

Shoulder Horizontal Abduction

Posterior Deltoid

Shoulder Horizontal Adduction

Pectoralis Major combo

Shoulder External Rotation

Infraspinatus and Teres Minor

Shoulder Internal Rotation

Subscapularis, Pectoralis Major, Latissimus Dorsi, Teres Major

Elbow Flexion

Bicep Brachii, Brachialis, Brachioradialis

Elbow Extension

Triceps and Anconeous

Forearm Supination

Bicep Brachii and Supinator

Forearm Pronation

Pronator Teres and Pronator Quadratus

How do you minimize gravity for shoulder flexion MMT

-Lay them on their side and support their arm through motion (rate them a 2)

How do you minimize gravity in shoulder abduction MMT?

Lay pt supine and support their arm through motion (rate them 2)

How to minimize gravity for shoulder internal rotation MMT

have pt sit and have elbow flexed and supported by table, and hold their hand slightly above table into internal rotation

How to minimize gravity for shoulder external rotation MMT

have elbow at 90 degrees support on table, and hold their hand slightly above table into ER

How to minimize gravity in shoulder horizontal abduction MMT

have pt sit beside table and have whole arm on table @90 degrees ABD, and then have them bring arm forward

how to minimize gravity in shoulder horizontal adduction MMT

have pt sit beside table and have whole arm on table @90 degrees ABD, and then have them bring arm back (from forward position)

how to minimize gravity for shoulder abduction and upward rotation

lay pt on their side and support arm on table

alternative test for scapular adduction and downward rotation

instead of pushing up at elbow, stabilize head of humerus and push up

how to minimize gravity in scapular protraction

support arm on plinth table to minimize gravity (i.e. punch straight arm table)

how to minimize gravity for scapular elevation

lay them in supine and have them shrug

how to minimize gravity in scapular depression

lay them in supine and have them depress their shoulders

what to do if pt has a weak posterior deltoid when trying the scapular adduction and retraction MMT

apply pressure to distal scapular instead of arm

what to do if patient has weak GH joint during scapular adduction and depression MMT

apply pressure on distal scapula

elbow flexion feel

soft

elbow extension feel

hard

how to minimize gravity for elbow flexion and extension MMT

pt lay arm on table, bend at elbow and go forward to flex (drag it), and bring it back to extend

how to minimize gravity in wrist flexion/extension

perform motion with wrist in neutral grip