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MMT
Manual Muscle Testing
| Question | Answer |
|---|---|
| Strong and Painless | a. No lesion to ms/tendon b. No Neurological lesion to ms/tendon |
| Strong and Painful | a. Minor lesion of tested ms/tendon b. Usually the tendon |
| Weak and Painless | a. May be some interruption or nerve supply to muscles being tested. Findings must be correlated with those other ms/neuro test b. May be complete rupture of tendon/ms |
| Weak and Painless | a. there may be partial rupture of ms/tendon in which there are still some intact fibers taht are being stressed b. May be a result of painful inhibition in association with some serious pathological condition such as fracture, neoplasm, or acute inflamm |
| Shoulder Flexion | Anterior deltoid, Coracobrachialis |
| Shoulder Extension | Larissimus Dorsi, Teres Major, Posterior Deltiod |
| Shouder Abduction | Middle Deltoid, Supraspinatus |
| Horizontal Abduction | Posterior Deltiod |
| Horizontal Adduction | Pectoralis Major |
| External Rotation | Infraspinatus, Teres minor |
| Internal Rotation | Subscapularis |
| Scauplar Elevation | Upper Trapezius |
| Scapular Adduction | Middle Trapezius |
| Scapular Depression and adduction | Lower Trapezius |
| Scapular Adduction and Downward Rotation | Rhomboids |
| Elbow Flexion | Biceps Brachii, Brachialis, Brachioradialis |
| Extension | Triceps Brachii |
| Forearm Supination | Supinator, Biceps Brachii |
| Pronation | Pronator teres, pronator quadratus |
| Wrist Flexion | Flexor Carpi Ulnaris, Flexor Carpi Radialis |
| Wrist Extension | Extensor Carpi Radialis Long, Brevis and Ulnaris |
| Hip Flexion | Psoas major, iliacus |
| Hip Flexion, Abduction, Ext. Rotation and Knee flexion | Sartorius |
| Hip Extesion | Gluteus Maximus, Hamstrings |
| Hip Abduction | Glutues medius and minimus |
| Hip Adduction | Adductor Magnus, Brevis, Longus, Pectineus, and Gracilis |
| Hip External Rotation | Obturator Internus and Externus, Gemmelae Superior and Inferior, Piriformis, Quadratus Femoris, Gluteus Maximus |
| Internal Rotation | Gluteus Minimus and Mediua, TFL |
| Knee Flexion | hamstring groups |
| Knee Extension | Quadricep group |
| Ankle Plantar Flexion | Gastrocnemius, Soleus |
| Ankle Doriflexion and inversion | tibialis anterior |
| Ankle Inversion | tibialis posterior |
| Ankle Eversion and Plantar flexion | peroneus longus and brevis |
| Ankle Eversion and Dorsiflexion | Peroneus Tertius |
| Trunk Extension | Iliocostalis thoarcis and Lumborum, Longissimus Thoracis, Spinalis thoracis, Semispinalis thoracis, Multifidi, Rotators |
| Trunk Elevation | Quadratus Lumborum, Latissimus Dorsi, External and Internal Abdominal Oblique, Iliocostalis Lumborum |
| Trunk Flexion | Rectus Abdominis, External and Internal Abdominal Oblique, Psoas Major and Minor |
| Trunk Rotation | External and Internla Abdominal Oblique, Latissimus Dorsi, Rectus Abdominis, Deep back muscles |
| Neck Capital Flexion | Rectus Capitus Posterior Major and Minor, Obliqus Capitis Superior and Inferior, Longissimus Capitus, Splenius Capitus, Semispinalis Capitus |
| Neck Cervical Extension | Longissimus, Semispinalis, Iliocostalis and Splenius Cervicis |
| Neck Capital Flexion | Rectus Capitus Anterior, Rectus Capitus lateralis, LOngus Capitis |
| Neck Cervical Flexion | Scalenes, SCM, Longus Colli |
| Neck Cervical Rotation | Rectu Capitus Posterior Major, Obliqus Capitus Inferior, Longus capitis, Semispinalis Capitus and Cervicis, Splenius Capitus and Cervicis, Iliocostalis Cervicis, Anterior and Posterior Scalene, SCM, LOngus Colli |
| Definition | A technique performed for evaluating the relative strength and/or weakness of a prime mover by assessing its ability to effect voluntary movement in a selected position, and develop resistance to a force specifically opposing that movement |
| Purpose | To assess the strengths of prime movers in relation to the principal joints in each segment of the body |
| Applications and Limitations | used to evaluate the degree of muscular weakness resulting from disease, injury, or disuse, primarily involving contractile elements, the myo-neural junction, and the lower motor neuron. |
| Validity | Whether a test actually measures what it is intended to measure 1. positioning of client 2. Stabilization by you 3. Palpation by you 4. Observation by you |
| Reliability | whether the results are predictably reproducible a. by another examiner b. at another time within a short period of time |
| MMT has been shown to have high reliability, given that the following factors are taken into account: | 1. 0 substitution of muscles other than the prime movers 2. Variations in relative strength due to age, sex, length and bulk of body parts 3. variation in force that a muscle can exert at various points though the ROM 4. always performed in the same |
| Fixation | structure held in stationary position, contracting isometrically, part of stabilization, support, and counter-pressure |
| Substitution | using muscles otehr than the prime movers |
| Stabilization | holding limb proximal to joint in order to ensure a valid test, motion is isolated |
| Counter-pressure | equal opposite pressure, influenced by firmness of table, body weight, muscular fixation, and examiners stablization |
| Subjective | 1. examiners impression of the amount of resistance to give before test 2. actual amount of tolerated during test |
| Objective | 1. client can perform full ROM 2. client can hold position once placed there 3. client can move part against gravity or is unable to move it at all |
| The Grading System | 1. Observed and/or palpated presence of contraction of the prime movers 2. Degree of ability of the prime mover to move a body segment through a complete ROM against gravity, 3. Amount of resistance developed by the PM by an opposite force |
| Normal | 5 - holds against resistance and can hold break test |
| Good | 4 - holds against resistance but can't hold break test |
| Fair | 3 - full ROM with gravity only |
| Poor | 2 - full ROM with gravity reduced/elminated |
| Trace | 1 - noticeable contraction by no movement |
| Zero | 0 - no contractile activity |
| The client may influence the results of MMT by: | varying the true effort expended the client's willingness to endure discomfort or pain may vary the client's ability to understand test requirements motor skills for test may be beyond some clients cultural, social, and gender issues (palpating, explo |
| Preparing for MMT | client should be free of any discomfort a quiet non-distracting environment firm table know the sequence of tests beforehand to minimize client's position changes have available all the materials - texts, documents, sheets, references |
| Scapular Elevation | PT: short sitting, hands on lap TH: standing behind patient with hand on top of both shoulders VC: shrug your shoulders or raise your shoulders towards your ears, Hold it, dont let me push you down *test both sides at once, check asymmetry is scapulae |
| Scapular Depression and Adduction | PT: prone with arms overhead 145o abduction, thumb is pointing towards the ceiling TH: stand at test side, resist proximal to elbow, palpate along side of thoracic spine with other hand VC: Raise your arm off the table as high as possible. Hold it . . . |
| Scapular Adduction | PT: prone with shoulder at edge of table. Shoulder is at 90o of abduction and slight elbow flexion and externally rotated TH: stand on test die close to patients arm, stabilize contralat scap; with other hand placed prox. to wrist, resistance is to floor |
| Scapular Adduction Continued | VC: lift your arm/thumb towards the ceiling. Hold it, dont let me push it down |
| Scauplar Adduction and Downward Rotation | PT: same as scapular adduction test, but thumbs are down TH: same as above VC: Lift your arm towards the ceiling, Dont let me push you down VC: Lift your arm up towards the ceiling, Dont let me push it down |
| Shoulder Flexion | PT: short sitting with arms at sides, with forearm pronated and elbow slightly flexed TH: Stand on test side, slightly behind patient, Hand resists prox to elbow while other stabilizes shoulder VC: Raise your arm to shoulder height. Hold it.... |
| Horizontal Adduction Pectoralis Major Whole muscle | PT: Supine shoulder abducted to 90o, elbow flexed to 90o TH: stand at test side, resistance applied proximal to wrist. Other hand palpates pectoralis major muscle VC: Move your arm across your chest. Hold it, dont let me pull it back |
| Horizontal Adduction Pectoralis Major Clavicular Head | PT: shoulder in 60o abduction, elbow flexed to 90o TH: stand at test side, resistance applied proximal to wrist. other hand palpates muscle VC: Move your arm up and in. Hold it, dont let me pull it back |
| Horizontal Adduction Pectoralis Major Sternal Head | PT: shoulder in about 120o abduction with elbow flexed to 90o TH: Stand on test side, resistance applied proximal to wrist. Other hand paplates muscle VC: Move your arm down and in. Hold it, dont let me pull it back |
| Shoulder Abduction |
Created by:
lazerbeam
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