Module 3 - Hands-on Assessment

MAT is commonly used by seating clinicians as part of the seating assessment process. It is also referred to as biomechanical assessment and physical evaluation, and more recently given the name Mechanical Assessment Tool by Sheila Buck.

A MAT is a musculoskeletal examination of the client's range of motion, joint flexibility, muscle length and skeletal alignment. It usually involves postural assessment of the person in their existing seating system, supine, and sitting on a firm surface. Neurological issues such as tone and spasm pattern should be noted as they impact on posture and muscle length.

• Muscle length and joint flexibility can restrict the posture or positioning which the client can assume in seating. It also impacts on functional capacities such as arm reach to control power module, or propulsion of a manual wheelchair.
  
• Tone and spasm may become evident whilst conducting the MAT. An assessment task may be halted during an intense spasm and can resume again when it subsides. Spasm can also be triggered by internal or external stimuli such as urinary tract infection, blocked catheter, rough terrain and reclined backrest. Unsupported posture during spasm may place the client at risk of falls or development of postural deformities.

This process enables the clinician to select the appropriate seating system providing suitable shape and size fitting to the client's requirement for functional, postural and pressure management.

Clinical knowledge required to conduct the MAT

• Locate landmarks
  • Particularly, locating bony landmark of the pelvis. See video "Finding bony landmarks in the pelvis"
  • Download handy tips for finding bony landmarks.

• Understanding anatomy - how the skeleton joins together and the influence of muscle groups over these joints. Download "Clinical knowledge for conducting MAT"
• Understanding planes and range of movement to identify fixed vs flexible deformities.