Test Positioning: Why is it Relevant?

    It is very important to use bony landmarks and proper positioning for measuring range of motion. The bony landmarks act as a guide to ensure that the goniometer is measuring the angle of the joint correctly. The axis or fulcrum of the goniometer is placed proximal to the joint being measured. The stationary arm is placed on the midline of the bone that is remaining stationary. The moving arm moves with the bone that is connected to the joint which allows the reader of the goniometer to get a measurement of the joints range of motion. Without using bony landmarks, the measurement will not be accurate. It is important to get the positioning correct to allow the joint to be able to perform its full range of motion. It the positioning is incorrect. The measurement of the joint will not portray its full range of motion.

    Manuel muscle testing is done to determine weak muscles and to determine a baseline to see where the client is at in regards to strength. Without the proper test position, you will not be able to see the clients full potential. The test position is placed in the optimal position for contraction. The place for optimal contraction is a position that allows the most cross bridges form. This is typically at mid-range of motion. It is essential that each therapist uses the same test position when measuring muscle strength. This allows for measurements to be documented accurately and allows for consistency within the clients measurements.  

    A gravity eliminated position allows for there to be no resistance acting against the muscle itself. It is used for clients who do not have enough strength to fight against gravity. If a client could not perform a motion and the therapist did not try to use the gravity eliminated position, it may seem as if the client's joint does not have the ability to function. With the gravity eliminated position, it allows for therapists to see the the joint is functioning properly, but the client is just not strong enough to fight the force of gravity. In a gravity eliminated position, the motion is performed parallel to the ground to ensure that there is no resistance coming from gravity. It is important for every therapist to perform the gravity eliminated position if the client can not do the motion against gravity. If some therapists did not instruct the client to try this position, therapists may have different notes regarding the clients abilities and the functioning of the clients joint. It allows validity and accuracy to occur when all therapist perform their test positions the same way.