Importance of Testing Positioning

When testing range of motion (ROM) on a client, it is important to use bony landmarks and proper positioning for accurate measurement when using a goniometer. Being able to locate bony landmarks will help the therapist in determining where the goniometer should be place when performing the test and the correct muscle contractions for that specific movement. Having the client in the proper position will help determine the extent of ROM at that specific joint and will make sure no compensatory movements are being used. When performing a manual muscle test (MMT) on a client, it is important that the therapist places the muscle in a mid-range position for optimal muscle contraction. This technique is known as the testing position. The majority of our activities of daily living are performed against gravity, therefore gravity would be classified as the resistance to the movement you are performing. Gravity eliminated positions are optimal for low strength clients, while against gravity positions are optimal for medium to normal strength clients. You always want to start the assessment by positioning the client in a way where the plane of movement is parallel to the floor. If testing in the wrong positions compensatory movements may give an incorrect test score as they will have the appearance of having a greater ROM. Another thing to consider when performing manual muscle testing is to remember that safety is important when working with a client who might be fragile. If you give too much resistance and push down too hard you might cause injury to the client.