Monday, October 22, 2018

Upper and Lower Extremity Screening Cheat Sheet - Part 1

Explanation of Procedure and Rationale:  The therapist should explain to the patient they are conducting an assessment of the patients neck and arms (Upper Extremity, UE) or back and legs (Lower Extremity, LE).  The patient will be asked to perform UE or LE movements to the best of their ability.  The patient is instructed to tell the therapist if/when they feel pain, numbness, tingling, or weakness.  The rationale behind this is that these tests provide a rapid assessment of mobility and neurological function of the neck, UE's, lumbar spine or LE's.

Step One: Check active range of motion for the desired screening quarter (UE or LE), check for range of motion and assess for pain during AROM.  If symptoms do not increase apply slight over pressure to gauge passive range of motion and reassess symptoms.

AROM Norms for Cervical Spine:

  • Flexion - 80 - 90 degrees
  • Extension - 70 degrees
  • Side Bending - 20 - 45 degrees
  • Rotation 70 - 90 degrees
AROM Norms for Upper Extremities Tested:
  • Flexion/Abduction: 180 degrees
  • Extension: 45 - 60 degrees
  • Internal Rotation 70 degrees
  • External Rotation: 90 degrees
AROM Norms for Lumbar Spine:
  • Forward Flexion: 40 - 60 degrees
  • Extension: 20 - 35 degrees
  • Side Bending: 15 - 20 degrees
  • Rotation: 3 - 18 degrees
AROM Norms for Lower Extremities Tested:
  • Hip Flexion: 120 degrees
  • Extension: 30 degrees
  • Abduction 45 degrees
  • Adduction 30 degrees

Step 2:  Test the Myotomes (or resisted movements) to assess strength. Test to be done bilaterally
Myotome Tests UE:
  • C1, C2 nerve roots: Test resisted cervical flexion
  • C3: Test resisted cervical side flexion
  • C4: Test resisted shoulder elevation
  • C5: Test resisted shoulder abduction
  • C6: Test resisted Elbow Flexion
  • C7: Test resisted elbow extension
  • C8: Test resisted Thumb extension
  • T1: Test resisted finger abd/adduction
Myotome Tests for LE:
  • L1, L2 nerve roots: Test resisted hip flexion
  • L3: Test resisted knee extension
  • L4: Test resisted ankle dorsiflexion
  • L5: Test resisted Great toe extension
  • S1: Test resisted ankle plantar flexion

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