Biomechanics - Test Positioning

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In range of motion and manual muscle testing, positioning of the patient is key to achieving accuracy and consistency. Furthermore, palpating bony landmarks is also critical. Proper body position and palpation is necessary to correctly align the goniometer for ROM testing (1). By palpating bony landmarks, various therapists can place the goniometer in the same position, improving interrater reliability of the ROM measurement (2). Locating bony segments also allows for appropriate stabilization of the body during MMT (3). Palpation is an important tool for recognizing irregularities in bony segments, or identifying tissue swelling that may contraindicate measuring (4).

In addition to proper positioning of the patient, putting the limb being measured in the "test position" is also essential for successful MMT. The test position puts the muscle in a position for the greatest contraction, or greatest mechanical advantage (5). This allows for fair and accurate measurement of muscle strength.

If the patient is unable to perform an osteokinematic motion against the resistance of gravity, the therapist can position him or her in the gravity-eliminated position, or in the position to perform the motion parallel to the ground. This position allows the therapist to measure the strength of patients with a MMT grade between 0 and 2, giving insight into client ROM without resistance (6).

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