MANUAL MUSCLE TESTING (MMT) – Flashcards
Unlock all answers in this set
Unlock answersquestion
MANUAL MUSCLE TESTING (MMT)
answer
"assessment of power with which musculotendinous units act across a bone-joint lever-arm system to actively generate motion, or passively resist movement against gravity and resistance (Dutton, 2004)"
question
Break test
answer
Manual resistance applied at an end of range (isometric contraction) (MMT)
question
Make test
answer
Resistance applied through a range of motion (isotonic contraction) (NOT MMT)
question
MMT GENERAL PRINCIPLES
answer
Muscle Physiology, Biomechanical Principles
question
MMT Muscle Physiology
answer
Muscle Length (active & passive insufficiency)
question
MMT Biomechanical Principles
answer
Gravity and patient position Mechanical lever arm
question
MMT ACTIVE INSUFFICIENCY
answer
-Inability to generate sufficient force when muscle is in a fully shortened position --Hip extension with knee fully flexed --Finger flexors with wrist in full flexion --triceps brachii during shoulder extension and elbow extension -Active = lack of ability to generate muscle force
question
MMT PASSIVE INSUFFICIENCY
answer
-Inability of muscle to stretch enough to permit full range at both joints at the same time --biceps femoris during knee extension and hip flexion --quadriceps femoris during knee flexion and hip extension -Passive = lack of muscle length
question
MMT STRENGTH TESTING Fully lengthened
answer
Position of passive insufficiency
question
MMT STRENGTH TESTING Mid-range
answer
Muscle in strongest position
question
MMT STRENGTH TESTING Fully shortened
answer
Muscle in weakest position
question
MMT One joint
answer
Application of resistance at end of range position
question
MMT Two joint
answer
Application of resistance at midrange position
question
MMT PATIENT POSITION
answer
Position patient such that segment being tested is in an antigravity* test position
question
MMT APPLICATION OF RESISTANCE
answer
-Near distal end of the segment, open palm (not wrapped hand) --Exceptions- Hip abductors: Application at ankle --> longer lever arm --Scapular muscles: Application at arm --> better representative of functional demands -Gradual build to maximum resistance over 5 seconds -Opposite direction to the muscular force: In the line of pull of the muscle -Uniform with flat/open palm
question
WHAT TO KNOW for MMT test
answer
Patient position: Tester position: Stabilization: Hand placement: Force direction:
question
PERFORMING MMT
answer
-Explanation of procedure to patient -Position patient: Based on muscle length, gravity, and stabilization of the body -Provide stabilization proximal to area being tested -Have patient perform AROM of segment against gravity -If pt. is ABLE to hold for 5 seconds: continue MMT in anti-gravity position -If pt. is UNABLE to hold for 5 seconds: change to a horizontal plane position
question
ANTIGRAVITY POSITION
answer
-Provide clear directions to patient -Gradually apply pressure ramping up to maximum, Ensure uniform pressure with open palm hand -Monitor patient for substitutions: Patient's use of synergist muscles to compensate for weak muscle, Manage substitutions with clear directions, tactile cues
question
GRADING FOR MMT
answer
0, 1, 2-, 2, 3, 4, 5 May differ between testers, requires interpretation of clinical relevance
question
GRADING FOR MMT: 5
answer
Normal, Overcome considerable resistance with full range of movement
question
GRADING FOR MMT: 4
answer
Good, Overcome moderate resistance with full range of movement
question
GRADING FOR MMT: 3
answer
Fair, Complete range of movement against gravity with no resistance
question
GRADING FOR MMT: 2
answer
Poor, Complete range of movement when in horizontal plane
question
GRADING FOR MMT: 2-
answer
Poor-, Partial range of movement in horizontal plane
question
GRADING FOR MMT: 1
answer
Trace, Evidence of slight contractility, no movement
question
GRADING FOR MMT: 0
answer
No activity, No evidence of contractility
question
WHAT HAPPENS WHEN GRAVITY IS A PROBLEM?
answer
HORIZONTAL PLANE POSITION (Gravity eliminated): Testing the muscle perpendicular to the line of gravity
question
MMT Fingers and Toes
answer
Testing against gravity not essential Degree of force is less Often graded as Intact, Impaired, or Absent
question
MMT DOCUMENTATION
answer
Side Muscle segment Patient position (if deviates from standard test position) Grade Quality (pain-free, painful, symptom reproduction)
question
MMT DOCUMENTATION examples
answer
-Right Deltoid 4/5 pain-free -Left Medial Hamstring 2/5, painful, tested in sidelying -Left ECRB 4/5, painful at lateral epicondyle, reproduces tingling in left hand
question
MMT CONTRAINDICATIONS
answer
Dislocation-unhealed fracture Myositis ossificans Acute cervical injury or fusion (for neck)
question
KNOWLEDGE REQUIREMENTS for test
answer
Standard test position (Alternate test position if needed) PT position Stabilization mechanism Direction of resistance Grade (reference Grading table)
