Biomechanics: Test Positioning

When testing range of motion (ROM), it is very important that a therapist palpate for bony landmarks. Palpating for bony landmarks allows the therapist to find the locations to place the goniometer; without finding these landmarks, the test results would most likely be inaccurate and unreliable. Another important reason to palpate for bony land marks is to increase inter-rater reliability in testing ROM. Finally, when palpating for bony landmarks, a therapist may find abnormalities in soft tissue or bones that could identify an issue affecting one’s ROM. It is also imperative to properly position a client when assessing ROM. The client should be in a position that allows full ROM and gives reliable results. Test positioning also plays a key role in manual muscle testing (MMT). Following protocol, one should screen all clients against gravity initially, however, the client may benefit from a gravity-eliminated plane. Correctly positioning a patient allows the therapist to grade the test accurately and allows the client to remain comfortable and safe. It is imperative for a therapist to place a patient’s joint in a midrange position for accurate results. Finally, gravity-eliminated (GE) positioning is relevant in MMT because it allows testing on a client who may not be able to tolerate the force of gravity. By placing a client in a GE position, the therapist can evaluate even small muscle contractions.