The Importance of "Test Positioning"

    When conducting any form of test or measurement, it is important to establish standards and protocols. These guidelines help increase the validity and reliability of the tests. Validity determines the accuracy of your data, while reliability determines the consistency. In order to ensure accurate and consistent measurements, it is important to use the same test positioning every time tests are performed. 

    Test positioning applies to the position of the client and the therapist during range of motion and manual muscle testing. For example, it matters whether the client is sitting or lying down, whether their elbows are bent or flexed, whether their palms are facing up or down, etc. These considerations along with many others all influence the data collected. During testing, therapists also use bony landmarks to ensure proper positioning. Bony landmarks are used because they are normally found in the same spot from person to person. For example, everyone's acromion process should be at the highest point of their shoulder. It is easily identified, and it ensures each therapist is using the same starting point while conducting measurements. 

    In addition to client positioning, it is important for the therapist to position themselves the same way each time they perform range of motion and manual muscle testing. While performing range of motion testing, it is important for the therapist to align their vision directly with the goniometer. Not doing so can greatly affect how the data is read. Therapist positioning during manual muscle testing is also crucial. For example, where the therapist applies the resistance force can affect how the client performs. For example, when testing muscle strength for elbow flexion, the therapist should apply resistance in the middle of the forearm, slightly closer to the wrist. If resistance is applied at the wrist, the client will have to provide greater force. On the other hand, if the therapist applies resistance too close to the elbow, the client will barely need to apply force. Additionally, it is important for the therapist to stabilize the client in the same way each time. Proper stabilization also provides accurate and consistent results. 

    In some cases, clients are too weak to perform manual muscle testing (MMT) against gravity. Since we should always prioritize the safety and wellbeing of our clients, we can eliminate gravity during MMT. Gravity eliminated testing involves its own set of protocols and procedures. As previously mentioned, it is important to always follow the protocols for test positioning, so we can obtain valid and reliable measurements.