1. Assignment # 4 (5 points)

2.  Range of Motion (Chapter 5 Table 5.1, 5.2A, 5.2B, 5.3  Changes with age, greatest in infancy, declines with age  Varies widely  Specific joints are affected by intrauterine position UE table 5.1 page 188, LE table 5.2A & 5.2 B pps 189-190

3.  Strength (isolated vs synergy)  Movement against gravity  MMT-more subjective  SCALE specific testing to determine isolated muscle control  4 years reliability with hand held dynamometer  Spasticity / Tone  Ashworth Scale  Tardieu Scale  Hypotonia Assessment Tool (HAT)

4. Scales to document assessment of SPASTICITY:  Modified Ashworth Scale - MAS (refer to page 236, box 8.2 of PR text for a more detailed description)  0 No increase in tone (normal)  1 Slight increase in tone, end of the range (may catch and release)  1+ Slight increase in tone through less than ½ the range  2 Marked increase through most of the range (still moves easily)  3 Passive movement difficult  4 Rigid (no movement) in flexion or extension  Modified from Bohannon and Smith3  NM1 notes p.194

5. Tardieu Scale This test is performed with patient in the supine position, with head in midline. Measurements take place at 3 velocities (V1, V2, and V3). Responses are recorded at each velocity as X/Y, with X indicating the 0 to 5 rating, and Y indicating the degree of angle at which the muscle reaction occurs. By moving the limb at different velocities, the response to stretch can be more easily gauged since the stretch reflex responds differently to velocity. Velocities: V1: As slow as possible, slower than the natural drop of the limb segment under gravity V2: Speed of limb segment falling under gravity V3: As fast as possible, faster than the rate of the natural drop of the limb segment under gravity Scoring 0 No resistance throughout the course of the passive movement 1 Slight resistance throughout the course of passive movement, no clear catch at a precise angle 2 Clear catch at a precise angle, interrupting the passive movement, followed by release 3 Fatigable clonus with less than 10 seconds when maintaining the pressure and appearing at the precise angle 4 Unfatigable clonus with more than 10 seconds when maintaining the pressure and appearing at a precise angle 5 Joint is immovable NMI notes p.187 Video http://www.youtube.com/watch?v=JOL6FjY0-zkhttp://www.youtube.com/watch?v=JOL6FjY0-zk http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=1038

6. 1. Leg length 2. Adams 3. Thomas test 4. Staheli test 5. Ober Test 6. Ryder or Craig Test 7. Popliteal angle test 8. Hamstring Length test 9. Straight leg test 10. Valgus and Varus 11. Tibial Torsion 12. Weight bearing 13. Dorsi Flexion 14. Plantar Flexion 15. Foot Supination and Pronation 16. Metatarsus adductus

7.  Leg length  Limp, obliquity, asymmetrical gait, back pain ASIS Medial Malleolus Galeazzi sign

8.  Range of Motion  Spine  Scoliosis  Adams test  Kyphosis

9.  Hip  Thomas test  Staheli test

10.  Hip  Ober test  Ryder or Craig test

11.  Knee  Popliteal angle test  Hamstring length test  Straight leg test

12. Knee  Valgus and varus  Tibial torsion

13.  Posture what is normal posture as a child develops in  Sitting  Kneeling  Crawling  Standing  Walking  Posture in sitting, kneeling, crawling, standing and walking (Describe how you will check posture for all positions listed).

14.  Length for Age and Weight for Age (Use chart provided) What % of the standard is the child you are working with? What does this tell you?  Gross Motor– score the child using the HELP provided in your packet. Explain why you chose the developmental age you gave to the child.

15.  Timed Up & Go (Tug)  Timed Floor to Stand  Thirty Second Walk Test  Pediatric Reach Test PRT or Pediatric Functional Reach Test  Pediatric Balance Scale (PBS) or Pediatric Berg Balance Scale

16.  Once you have complete your exam and reviewed and practicing all tests: List 6 lessons learned about exam and evaluation of pediatric clients that will help you in POINT Lab. 