Common Physical Testing Methods Used By Physiotherapists

Physiotherapists play an important role in improving the quality of life. They involves in promotion, prevention, diagnosis, treatment and rehabilitation. In this article I have mentioned few tests conducted by the physical therapist to diagnose the condition before going through the treatment part.

Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention and rehabilitation. This encompasses physical, psychological, emotional, and social well being. Physiotherapists uses various testing methods and equipment to carry out diagnostic procedure. Mode of treatment is depends on diagnosis.
Every test used must be standardized as far as possible, i.e. carried out in the same way and under the same circumstances on each occasion. Record charts are dated and kept for use each time the test is performed. Some of the Physical testing method in common use are as follows:

Functional tests

These are used to assess the patient's need and abilities with regard to functional activities, e.g. mobility (in bed, transfers, ambulation, etc), personal care (eating, dressing, washing, etc), household or garden jobs (cooking, washing up, sweeping, lifting, etc), work and recreation. They are carried out in the patient's normal environment or in circumstances which are as nearly like it is possible. His performance is recorded as skilled, adequate, requiring assistance (stand by minimal, maximal) or failure.

Test of joint range:

Measurement of limitation of joint range presents any difficulties in practice. A suitable position is selected for the patients so that he is stable, to make sure that any structures which would be limit the normal range of movement are relaxed, e.g. calf muscles must be relaxed by bending the knee to measure full range of ankle movement. the bone proximal to the joint in which range is to be measured is fixed and movement in the joint accomplished in a particular plane. An angle measure or goniometer is used with the pivot over the joint in question and one arm in alignment with the proximal bone, the other in line with the area which is moved.

The degree of angulation is read off on the scale and recorded as X degree movement, or, it is often less confusing to record the number of degrees the joint lacks in a particular direction, e.g. knee extension lacks 30 degree of the normal range. As the normal range of movement varies considerably in individuals, the contralateral joint should always be measured first when possible. When an angle measure is unsuitable an inextensible tape measure may be used to measure the distance between two bony points to provide a means of assessing an increase or decrease in range of movement.

Test for neuromuscular efficiency

These may be carried out electrically, manually or mechanically.

Electrical tests

These may be carried out by the specialist physiotherapist with the use of the electro-myograph or by means of the strength-duration curve. They are particularly valuable for diagnostic purposes.

Manual muscle testing

To be accurate and efficient manual muscle testing requires a standardized technique and considerable experience. The classification of muscle testing is as follows:
0- No contraction
1- Flicker of contraction
2- Weak. Small movement with gravity counterbalanced
3- Fair. Movement against gravity
4- Good. Movement against gravity and some resistance
5- Normal

Circumference measurement

This test relies on the fact that there is a relationship between the development of power and that of hypertrophy. A tape measure made from some inextensible material is used to measure the circumference of the limb at a predetermined level. Experiment on normal limbs indicates that this method is unreliable even in experienced hands; although it is still used.

Static power test

The power of static or isometric contraction may be recorded by means of spring balance capable of registering up to 50 or 1oo pound. The extensibility of the spring within this type of balance is virtually negligible and it can be arranged in such a way that contraction of muscle group can take place at any predetermined point within its range. Record can be made of the maximum pound age recorded or of the average poundage recorded as the result of three efforts made at one minute intervals. In some instances, such as that of gripping with the hand, compression of the spring or of a rubber sphere to which a suitable pressure recording device is attached may prove convenient.

Dynamic power test

This method is devised by de lorme, and Watkins as a basis for progressive resistance exercise (PRE). The maximum weight which can be lifted once only through a prescribed range is called the one repetition maximum (10 RM) and maximum weight which can be lifted ten times at natural speed without rest between lifts is the ten repetition maximum. Experience in estimating the approximate weight which can be lifted is essential to avoid fatigue which results from continued trial and error and which rapidly reduces the poundage which can be lifted.

Endurance test

Endurance may be calculated by recording the drop in the maximal power of the muscles when their effort of contraction is repeated at given intervals for a specific period of time.

Speed test

The successful performance of functional activities can be timed by the use of stop watch, eg. Time taken to dress or walk a measured distance.

Test for coordination

Coordination of movement, or the lack of it, is observed in the patient's gait, his performance of purposeful movements or during specific movements such as bringing the finger to the tip of nose or moving the heel up and down along the opposite shin bone.

Measurement of vital capacity and range of respiratory excursions

A spirometer is used to measure vital capacity. The patient is instructed to breath in as much as possible and then breath out through the mouthpiece of the spirometer which registers the volume in cubic centimeters.

Measurement of leg length

True shortening of the leg is measured from the anterior superior iliac spine or the superior margin of the greater trochanter to the lateral malleolus, and apparent shortening from the umbilicus or xiphisternum to the level of the knee joint or the tip of the medial malleolus.

Measurement of the angle of pelvic inclination

Antero posterior inclination of the pelvis may be measured by means of a pelvic inclinometer.

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