P - MSK I - Hip Isometric Muscle Test & Muscle Length Test

Hip Isometric Muscle Test & Muscle Length Test

• pain elicited?

• ​weak / strong contraction?

• screen ​integrity of contractile unit: muscle / tendon lesion

​Therapist needs to note

• assess muscle strength

• ​mostly at a length in which it produces maximum force - mid-range

​We have learnt this...

Resisted Isometric Test

2 types of test procedures for isometric testing (IF for testing muscle strength)

1. A “make” test involves the patient exerting a maximum voluntary effort against fixed resistance provided by the examiner.

2. A “break” test requires the patient to exert maximum voluntary effort against an increasing counterforce by the examiner to exceed or “break” the isometric force being generated by the patient 

​Resisted Isometric Test is usually referred to make test

for the test to differentiate muscle problem or joint problem

Points to be noted

1. resting position (mostly mid range): keeping the inert tissues off of stretch and no movement at the joint

2. avoid trick movements: testing muscles are the only muscles to be included

Not really understand, FYI

​Presentation	​Interpretation
​Strong and painless	​No lesion in contractile unit
​Strong and painful	​Minor lesion
​Weak and painless	​Complete rupture / impaired nerves resulting in muscle weakness
​Weak and painful	​Serious impairment (e.g. fracture) but if no pain on repetition --> only severe weakness
​Painful on repetition	​Can check whether the first time strong and painless is true
​All resisted movement painful	​A gross lesion in proximal part (mostly capsular lesion)

• All in supine (vs against gravity position)

• ​Abd & Add 2 versions: knee bent/straight

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​Resisted isometric movement test at hip

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​Ext

​Flex

​Add

​Add

​Abd

​Abd

​IR

​ER

Muscle Length Test

Old: Thomas test, Ober's test, hip adductors muscle length test

New​: Kendall test, Ely's test, 90-90 SLR

• assess hip flexion contracture (most common)

• tight hip flexors --> ​excessive lumbar lordosis

• +ve: thigh left plinth​

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​Thomas test

Multiple Select

In the presence of which muscle tightness could lead to positive sign in Thomas test?

• iliopsoas

• tensor fascia latae

• sartorius

• rectus femoris

Multiple Choice

If a restriction of hip extension is present during the Thomas test, in combination of the tested thigh is observed to abduct so that the extension of hip increases, what would be the muscle contributing to the flexion deformity?

• iliopsoas

• tensor fascia latae

• sartorius

• rectus femoris

• assess rectus femoris contracture

• ​+ve: knee passive extension

• feel muscle stretch (may be capsular stretch)​

​Kendall test

• assess rectus femoris contracture

• ​+ve: hip passive flexion

​Ely's test

• assess hamstrings contracture

• ​+ve: >20deg knee Ext lack

​90-90 straight leg raising test

• assess TFL / ITB contracture

• ​+ve: thigh not touching plinth

• extend hip --> ITB pass over greater trochanter

• greater stretch with extended knee (original: flexed)

Ober's test

• assess hip adductors contracture

• ​PHT1021: PROM of abduction

• On new note: diamond shape to check unilateral tightness​

​Hip adductors muscle length test