Manual muscle testing
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What is MMT?
assessment of muscular strength and function as fundamental components of mvmt and performance
What is MMT organization based on?
jt motions rather than ind muscles
sometimes we try to isolate ind muscles
What is manual resistance that has been applied to a limb or other body part after it has completed it ROM or been placed at the end of range?
Manual resistance should always be applied in which direction?
line of pull of the muscles
With what type of muscles do we apply resistance at the end of the range as opposed to midrange?
one joint muscles
With what type of muscles do we apply resistance at the midrange pointas opposed to end range?
two jt muscles
Where should the examiner apply the resistance at?
distal end of segment
What are some things the examiner needs to know to be sure of accuracy?
- location/anatomic features of muscles
- line of pull
- function of particular muscles
- postitioning and stabilizing
- identify patterns of substitutions
- detect contractile activity
- aware of deviations from normal values/laxity/deformity
- dont grasp muscle belly
- identify muscles with same innervations
- knowledge of relationship of diagnosis
- ability to modify
- effects of fatigue
- effects of sensory loss
What are some patient influences of MMT?
- true effort of pt
- willigness to endure discomfort or pain
- ability to understand
- motor skills
- cultral, social, gender issues (palpation)
A grade 5 muscle is considered what?
What are the criteria for a grade 5 muscle?
ability to complete full ROM against gravity and against maximal resistance
What are the 3 pieces of information you use to determine muscle grading?
- how much ROM?
- against gravity or not?
- how much resistance?
A grade 4 muscle is considered what?
What is the criteria for a grade 4 muscle?
full ROM against gravity and can tolerate strong resistance without breaking, but when pushed to maximal resistance the muscle breaks
What is a grade 3 muscle considered?
What are the criteria for a grade 3 muscle?
can complete full ROM against gravity, but can not tolerate any manual resistance
What is a grade 2 muscle considered?
What are the criteria for a grade 2 muscle?
can complete a full ROM in a gravity minimized position (horizontal ROM)
What is a grade 1 muscle considered?
What are the criteria for a grade 1 muscle?
contractile activity can be detected visually or by palpation...no movement, resistance or gravity
What is a grade 0 muscle considered?
What is the criteria for a frade 0 muscle?
absolutely nothing, muscle is completely quiet
What is the criteria for a grade 3+ (fair +) muscle?
can complete full ROM against gravity, and the pt can hold the position against mild resistance but it will break with strong
What is the criteria for a grade 2- (poor -) muscle?
can complete partial ROM in the horizontal plane...no resistance or gravity
What is the criteria for a 2+ (poor +) muscle?
can complete full ROM in a gravity minimized position against resistance
What is the criteria for a 3- (fair -) muscle?
does not complete full ROM against gravity, but does complete more than half
What is 4- (good -) muscle criteria?
full ROM against gravity with minimal/slight-moderate resistance
What is 4+ (good +) muscle criteria?
full ROM against gravity with moderate-maximal/strong resistance
What are some things you can do during a pt screening test?
- watch pt walk into room - gait abnormalities
- watch pt sit and rise from chair, fill out forms, remove clothing etc
- have pt walk on toes and then heels
- have pt grip examiners hand
- perform bilateral muscle group checks
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