Substitution is when a muscle or muscle group attempts to compensate for a weak or paralyzed muscle. These substitutions appear similar to normal movements. The examiner must learn to identify these substitutions by placing the part in the test position and by using proper patient positioning as much as possible. The former action allows even inexperienced examiners to detect the sudden shift of the body part, which accompanies the substitution for muscle weakness. Placing the patient in the proper position tends to block known substitution patterns by resisting body shifting and turning the body part to use gravity.
Gravity is a form of resistance affecting the testing of trunk, neck and extremity muscles.
Movements in the horizontal plane are gravity-lessened. Testing Children . In higher grades, success depends on the child's cooperation and understanding Young children seldom cooperate in strong test movements. We must perform our evaluations with consideration of the orthotic management we intend to provide. Evaluating these characteristics individually might cause us to miss an abduction contracture of one of the hip joints.