hey everyone today we're going to go over module five and specifically we're going to dive into the crucial aspects of range of motion and manual muscle testing for the shoulder and the elbow manual muscle testing and range of motion are assessments that are really vital for evaluating functional movements that could significantly be impacted and make it so that it's difficult to complete daily occupations now shoulder and elbow joints are super important to numerous daily activities all the way from reaching overhead to lifting objects and Performing precise tasks like writing or using tools accurate assessment of these joints helps us tailor interventions that enhance functional Independence in the patients that we get to work with so let's talk about range of motion and specific to the shoulder movements that we're going to be measuring this week first is shoulder flexion and extension now shoulder flexion involves moving the arm forward and upward and it's critical for actions like reaching overhead or lifting items from off of a high shelf extension is the exact opposite which involves moving the arm backwards and that can be really important for things like opening doors abduction is the movement of the arm away from the body crucial for activities like reaching out to the side to grab an object um even just coming up and waving there's so many different things getting a shirt on getting a jacket on abduction is really valuable and important in everyday movement one of the uh ways that I actually remember abduction is that it's like I'm being my arm is being abducted away from my trunk and it needs to be in that frontal plane if it's in A sagittal plane you're talking about flexion if it's in a frontal plane you're talking about abduction abduction is just the opposite direction which brings the arm back towards the body this is going to be so important for tasks that involve bringing objects close to through your trunk I kind of feel like internal and external rotation of the shoulder is the one that's overlooked the most yet it's the one that gives us so much variety and ability to do so many different tasks internal rotation involves rotating the arm towards the body that's necessary for tasks like fastening a seat Bel doing buttons tucking in your shirt so many different things zippers all of those those end up being from internal rotation external rotation involves rotating the arm in the opposite direction away from the body and that's can be used things like brushing hair throwing a ball um reaching out even just reaching out to the side thing about internal and external rotation is that that's going to be in a horizontal or a transverse plane two other types of movements that we're going to be measuring is protraction and retraction protraction involves moving the shoulder blade forward while retraction involves pulling them backwards both movements being important for activities that are requiring shoulder blade mobility and stability so just as an example if you keep your elbow straight and you bring your arm back your shoulder will go back and that's retraction and going away from your body is protraction the elbow movements I feel like everybody has at least a basic understanding of these elbow flexion and elbow extension flexion is the bending of the elbow that's going to be essential for bringing food to the mouth performing personal grooming honestly anything that has to do with anything close to your body and your face requires elbow flexion elbow extension is the straightening of the elbow and it's necessary for pushing objects away or performing tasks that require straight arm now that we've talked about the range of motion let's talk about manual muscle testing for just a minute manual muscle testing is crucial for determining muscle strength and identifying areas of weakness that might impact functional performance here's a streamlined approach that we went over to really get manual muscle testing explain the procedure ensure the client understands the process and feels comfortable with what you're asking them to do number two position the client and place them in a position position where the movement will be against gravity this will help you recognize whether or not you need to go gravity minimized or if you can start putting resistance make sure that you stabilize The Joint that's being moved as a way to prevent compensatory movements number four ask the client to perform the movement actively if the individual Can Do It Against Gravity then you gradually apply resistance and assess the client's ability to hold the position if you don't see anything you then will put them in a gravity minimized situation and if you still don't see any movement then you want to palpate the muscle that is supposed to be doing the activity that will help you figure out if the person is scoring a zero or a one don't forget to make sure that you record accurately make sure that you note the strength that you got and put it down also when you do this make sure that you identify how you have the individual laying sitting and and what position they were in because that will help you to keep interrater reliability As you move forward into the next week and as you measure it again for example when testing shoulder flexion remember shoulder flexion instruct the client to lift their arm against gravity apply resistance at the distal humoris and palpate the anterior deltoid to ensure it's Contracting this method helps identify any weakness or compensatory pattern learns understanding range of motion and manual muscle testing is essential for Designing effective interventions that enhance our clients functional abilities when it comes to Orthopedic injuries now I want to take a second and identify this measuring range of motion and manual muscle testing is a great way to get some form of information that you can then test week after week however don't get so stuck on it being strength as the issue because when you start getting into the neurobasal it is not NE it's not necessarily a strength issue as much as it's a connection issue however if you can improve shoulder flexion and strength a client can regain their ability to reach for items on high shelves while enhancing elbow flexion can Aid on personal grooming tasks in actual practice accurate measurement and assessment is going to allow us to develop targeted exercise programs and therapeutic activities for example a client struggling with shoulder abduction remember abduction due to weakness now pay attention it's identifying its due to weakness might benefit from exercises that specifically Target the deltoid muscles additionally understanding the compensatory movements at the shoulder can help us provide better guidance and prevent further injury and that's it for today's and that's it for module 5 video lecture thanks for going through this process this is a lot of information however in order to increase your capabilities and to increase what you're going to be able to do with your clients classes like this are extremely important so in order to increase your ability to have effective intervention ions and improve the quality of life for our clients make sure that you practice and you take these to heart because doing that is going to make a big difference for you in the future I'll see you guys on Wednesday